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Patient Handbook Index A. Mission Statement B. Services
9. HIPAA (Health Insurance Portability and Accountability Act) policies C. Tips for dealing with insurance companies MISSION STATEMENT Our mission is to help patients to maximize their functional abilities and to run a profitable business by providing a caring and professional environment and providing speech therapy services with skill and competence. We currently offer speech/language screenings, evaluations, therapy, oral-motor therapy and feeding therapy for pediatric patients, along with articulation and tongue thrust therapy for older patients. Our goal is to tailor the patient interview information to insure the patient’s and family’s comfort and satisfaction while addressing goals that target the patient’s individual needs.
BD Therapy offers free speech, language and hearing screenings for preschool-aged children. Screenings generally take 15-20 minutes and are administered in the BD Therapy office. Screenings are performed in order to either rule out a speech, language or hearing problem or to determine the need for a complete speech and language or audiological evaluation. Parents may schedule screening appointments by calling 512-789-3398.
BD Therapy administers evaluations for the young patient. Evaluations may look at a patient’s receptive language (comprehension), expressive language (grammar and sentence structure), articulation (sound production), fluency (stuttering) or pragmatics (social use of language), and feeding and oral motor difficulties and/or tongue thrust. Evaluation sessions are scheduled in two hour blocks of time. A typical evaluation session will involve free play/observation, book reading, observation and manipulation of facial features, and/or direct administration of tasks using pictures or objects and a snack. Following the evaluation session, a thorough report is developed including recommendations.
Therapeutic services are provided for patients with a current evaluation. BD Therapy uses information from the evaluation along with input from the patient and/or parents to develop short term and long term goals. The therapy schedule is decided upon on an individual basis depending upon the needs of the patient. Sessions are scheduled to last 45-minutes and homework assignments are often given in order to assist in the patient’s progress and carryover into everyday life. A progress report is created every six months in order to keep the patient’s goals current and to give the patient, parents and doctor feedback on the patient’s progress.
Carryover and Maintenance
Carryover of learned skills is an important part of the therapeutic process. After all, the goal is for the patient to use the skills everyday, all day, in all environments. It is imperative that homework be completed on a daily basis so the patient begins to use the learned skills at home and with other peers and adults. Occasionally, we find it helpful to visit a patient’s daycare, home or school setting in order to assist with optimal carryover ideas. Out of office visits are charged at the same rate as therapy with additional charges for travel time and expenses.
We are committed to providing quality consistent services to our clients. Therapy will be most beneficial to your patient with consistent attendance. It is also important that you arrive on time so that you or your patient can benefit from a full session.
BD Therapy encourages parents to attend the therapy sessions whenever possible. Viewing the therapeutic process will assist you in carryover to other environments and in accurate completion of homework assignments. There may be times when we ask you to remain in the waiting area so we can work with the patient without extra distractions.
Parent leaving BD Therapy office
For your convenience, BD Therapy allows parents/legal guardians or caregiver to leave the premises during their patient’s appointment provided that we have a current mobile telephone number to reach you during the session. It is very important to be back on the premises 10-minutes before the patient’s appointment is scheduled to end so the therapist can discuss treatment with the parent/legal guardian or caregiver. If we notice chronic tardiness in picking up children, we will begin asking the parent/legal guardian or caregiver to stay on site during the treatment session.
Please keep in mind that siblings in the therapy room may be distracting to the patient receiving services. When siblings are present, please plan on staying in the waiting room. Feel free to enjoy the books, crayons and paper, magazines and toys that are provided in the waiting area. Please monitor all children while in the waiting room. Safety of all family members is important to us as well as providing a calm and comfortable environment for everyone.
Broken appointments cost us money and do not allow for consistent work on the patient’s goals. We have a 24 hours of prior notice to cancel an appointment. We understand that emergencies do occur that do not allow for 24 hour notice. We ask that you call the office number (512-789-3398) and leave a message detailing your reason for emergency cancellation. It is in the best interest of you or your child’s progress to reschedule any cancelled appointments. Routine broken appointments will result in loss of your regular appointment time. If you miss an appointment and give no notification or “no show,” you will be charged the appointment fee for that session. Insurance companies do not reimburse for broken appointments.
While we try to keep these to a minimal amount, there are times when the speech therapist will need to cancel your session. Families will be notified of clinician vacations, illness, or continuing education conferences as far in advance as possible. We will attempt to reschedule any cancelled appointments at times that are convenient for the patient.
Waiting Room Policies
In order for all therapists and their patients to have successful sessions, we ask that you refrain from excessive noise in the waiting area. Please take cell phone calls and noisy children to other areas of the office complex. There are nice grassy areas and picnic tables picnic tables on both sides of the building. In addition, we ask that you not bring food and drinks (water is okay) into the waiting area so that we can protect the beautiful oriental rug. Food and drinks can be enjoyed in the hallway or on the outdoor picnic tables located on either side of the building. We appreciate your assistance with both of these issues.
Please feel free to provide any suggestions or feedback that might facilitate a more efficient clinical environment.
Speech therapy services are payable through your medical insurance policy or by fee-for-service charges.
Fee-for-Service, Copayments and Deductibles
Any per session charges are expected in full and are collected on the day of the session unless other arrangements have been made. Payments are accepted in the form of cash, check or credit card (VISA, Mastercard, Discover, American Express). Credit card charges are filed weekly unless other arrangements have been made.
BD Therapy is in network with the following insurance plans:
Blue Cross Blue Shield of Texas
Texas State Medicaid
United Healthcare and its affiliates
Sendero Health Plans
If you have coverage by these insurance companies, we will be happy to file your claims to your insurance company. You are responsible for any charges not covered by your insurance company. Any insurance payments denied to Brenda Davis/BD Therapy become your responsibility to pay in full immediately (within 30 days), regardless of whether or not you choose to appeal the insurance company’s decision. Should you appeal and win, your payments will be reimbursed immediately upon receipt of the insurance payment.
It is your responsibility to thoroughly investigate the exclusions in your plan. It is very important for you to review the benefits information provided by your health plan. Call your insurance company and ask about limitations and exclusions. Ask for clarification in writing from the plan administrator, or download and print a copy from the company’s website. Always keep a record of all correspondence and telephone calls, including date, time, and the name of the person you spoke with. We are available to assist you if necessary.
BD Therapy HIPAA - Your Privacy Rights This Notice Describes How Medical Information About You May Be Used And Disclosed And How You Can Get Access To This Information. Please Review It Carefully.
BD Therapy is required by law to keep your health information safe. This information may include:
A government rule, called the Health Insurance Portability and Accountability Act, or HIPAA, requires that you get a copy of this privacy notice. We will ask you to sign a paper saying that you have been given this notice.
Read and refer to this notice at any time to see how your health information can be used and who can see it.
How Your Health Information May Be Used or Shared
We may use or share your health information without your permission for the following reasons:
Treatment. We may share information with doctors and other health care providers who care for you. For example, if your doctor orders speech therapy, we will share the results of our treatment with that doctor.
Payment. We may use and share information about the treatment you receive with your insurance company or other payer to receive payment for services. This may include sharing important medical information. We may share information to:
get the insurance company’s permission to start treatment
get permission for more treatment
get paid for the treatment you receive
Health Care Operations. We may use and share your health information to run the clinic and be sure that all patients receive good care. For example, we may use your health information to:
Your Health Information May Also Be Used or Shared Without Your Permission for:
Abuse and Neglect. We may share your health information with government agencies when there is evidence of abuse, neglect, or domestic violence.
Appointment Reminders. We will use your information to remind you of upcoming appointments. Reminders may be sent in the mail, by e-mail, or by phone call or voicemail message. If you do not wish to get reminders, please tell your speech-language pathologist.
As Required by Law. We will share your information when we are told to do so by federal, state, or local law. We will also share information if we are asked by the police or courts.
Government Functions. Your information may be shared for national security or military purposes. If you are a veteran, your information may be shared with the Office of Veteran’s Affairs.
Information About a Person Who Has Died.We may share information with the coroner, medical examiner, or a funeral director, as needed.
Marketing. We may use your information to let you know of other services that might be of interest to you.
Public Health Risks. We may report information to public health agencies as required by law. This may be done to help prevent disease, injury, or disability. It may also be done to report medical device safety issues to the Food and Drug Administration and to report diseases and infections.
Regulatory Oversight. We may use or share your information with agencies overseeing health care. This may include sharing information for audits, licensure, and inspections.
Research. We may share your health information with researchers to be included in their research project. Information will be shared only for projects that have been through a special approval process. These projects have rules to protect your privacy, too.
Threats to Health and Safety.Your health information may be shared if we believe that it will prevent a threat to your health and safety or the health and safety of others.
Worker’s Compensation. We will share your information with Worker’s Compensation if your case is being considered as a work-related injury or illness.
When Your Permission Is Needed to Use or Share Your Health Information
You must give us permission to use or share your health information for any situation that is not listed in this notice. You will be asked to sign a form, called an authorization, to allow us to use or share your information. You are allowed to take back this authorization, called revoking authorization, at any time. We will not be able to get back the information that we shared with your permission.
Your Privacy Rights
You have the right to:
Ask us not to share your information. You can ask us not to use or share your information for treatment, payment, or health care operations. You can also ask us not to share information with people involved in your care, like family members or friends. You must ask for limits in writing. We must share information when required by law. We do not have to agree to what you ask.
Ask us to contact you privately.You can ask us to contact you only in a certain way or at a certain place. For example, you may want us to call you but not to e-mail you. Or you may want us to call you at work and not at home. You must ask us in writing. We will do all we can to do what you ask.
Look at and copy your health information. You have the right to see your health information and to get a copy of that information. You have a right to see treatment, medical, and billing information. You may not be able to see or copy information put together for a court case, certain lab results, and copyrighted materials, such as test protocols.
Ask for changes to your health information. You can ask us to change information that you think is wrong. You can also ask that we add information that is missing. You must ask us in writing and give us a reason for the change. We do not have to make the change.
Get a report of how and when your information was used or shared. You can ask us to tell you when your information was shared and who we shared it with. There are some rules about this:
You need to ask us in writing.
You must tell us the dates you are asking about and if you want a paper or electronic copy.
You may get information going back 6 years, but it cannot be for earlier than
April 14, 2003. This is the date when the government privacy rules took effect.
Get a paper copy of this privacy notice.You can get a paper copy of this notice at any time. You can get a copy even if you have already signed the form saying you have seen this notice.
File complaints. You can file a complaint with us or with the government if you think that
your information was used or shared in a way that is not allowed
you were not allowed to look at or copy your information
any of your rights were denied
Who Is Covered by This Notice
The people who must follow the rules in this notice are:
all speech-language pathologists working at [insert practice name here]
anyone who is allowed to add health information to your file, including students and other staff
any volunteers who may help you while you are in this clinic
Changes to the Information in This Notice
We may change this notice at any time. Changes may apply to information we already have in your file and to any new information. Copies of the new notice will be available from our staff. The notice will have a date on the front page to tell you when it went into effect.
You may file a complaint if you think we did something wrong with your information. You can complain to your regional office of the United States Office of Civil Rights. To find out more about filing complaints, go to www.hhs.gov/ocr/privacy/hipaa/complaints/index.html. All complaints must be in writing. You will not get in trouble for filing a complaint.
If you have any questions about this notice or your privacy rights, please contact Brenda Davis at Brenda@BDTherapy.com.
TIPS FOR DEALING WITH INSURANCE COMPANIES At times, dealing with insurance companies can be a hassle. Below are some helpful tips on how to ensure your speech therapy visits are covered by your insurance company.
Contact your insurance company and ask if they cover speech therapy. Many plans specifically exclude anything that they consider to be educational and not restorative. If they do cover it, are there exclusions? Limitations on visits per year?
Keep a record of all contact with the insurance company including date, time of day, name of representative, and results.
Do you have a co-payment? If so, what is the amount per session?
Have you met your deductible for the year? If not, what is the amount you must meet before your insurance will cover the cost?
Do you need a referral, pre-authorization, or doctor’s orders from your primary care physician? If so, contact the physician’s office and have them fax the information to 512-857-1479 prior to your first visit.
It is your responsibility to keep track of the number of visits you have had for the year.
Notify BD Therapy immediately when you change insurance carrier.
Keep all EOB (Explanation of Benefits) forms from your insurance company.
For more information please visit the following websites
American Speech-Language-Hearing Association www.asha.org
Texas Speech-Language-Hearing Association www.txsha.org