Frequently asked questions and answers are provided to clarify King’s Speech and Learning Center’s pragmatic treatment philosophies, use of evidenced based practices, insurance coverage for speech-language therapy, and how our treatment differs from traditional Behavioral Therapy (ABA therapy) for autism and communication behaviors, and psychological counseling for social emotional problems and social skills groups.
Are your services covered by insurance?
Any of our services are covered by most commercial insurances. Speech and O.T. services are considered to be a medical service , and are not managed under your behavioral health services.
When calling your insurance to confirm benefits, refer to the initial service as a speech-language or Occupational Therapy evaluation. Provide a medical diagnosis if it is known to you such as autism, or hearing loss. If no medical diagnosis has been confirmed by a doctor or psychologist, just indicate that an evaluation is needed to determine the diagnostic code. You may refer to the appropriate CPT (procedure) codes below to determine if there is a restriction on therapy coverage for particular diagnoses once an evaluation is completed.
Speech Therapy Procedural Codes:
92506 speech-language evaluation, 92507 speech-language treatment, and 97535 home management training (can be used by any rehab discipline), 92526 oral feeding and/or swallowing treatment
Occupational Therapy Procedural Codes:
97003 O.T. eval, 97112 neuromuscular re-education, 97530 direct treatment activities, and 97535 home management training, 92526 oral feeding and/or swallowing treatment
Also ask if you have a deductible, a copay, and if you are limited to a certain number of visits per calendar year.
Is there a co-pay?
Your co-pay is due at the time of the session for all office visits. The amount varies according to your specific plan, and is most typically the amount indicated on your insurance card for a specialist. King’s Speech is required by contract to charge a co-pay for each visit. If your co-pay varies by the percent of the total allowed for the visit, the co-pays will be billed to you via an email invoice once the reimbursement has been received, and the copay amount is indicated on your claim.
What if I have a deductible?
King’s Speech will bill your insurance company and they will indicate the allowable amount to apply toward your deductible. You will then be billed via email invoice the allowable amount credited toward your deductible. We will let you know when your deductible has been met, and if there are any co-payments due for the rest of the year. It is crucial that you pay your deductible to King’s Speech promptly when it is billed to you. Credit cards and Health Savings Account cards are accepted in the office for your convenience. On-line payments can be made using a bank debit card through Intuit Payment Network as instructed on your emailed invoice.
What is your cancellation Policy?
We ask that you give us as much notice as possible, preferably 48 hours. If you do not call within 24 hours, or do not show for an appointment there will be a $50.00 fee . Group therapy is reserved on a monthly basis, so full payment is due for any missed sessions. Since regular attendance is crucial for all our programs, we ask that you hold off on treatment until your scheduling problems resolve rather than keeping the time open and attending inconsistently.
What is the difference between speech pathology and speech therapy?
No difference at all. The name of the profession changed from speech therapy to speech-language pathology many years ago to reflect the growth in the medical side of the profession, and to include language as well as speech. It should be noted that speech- language pathologists diagnose and treat communication, cognitive, and swallowing problems.
Is a diagnoses needed for therapy.?
No, although you would need a doctor’s prescription for a speech-langue evaluation with a reason for the evaluation.
” Speech- language evaluation by SLP to assess possible auditory attention or processing problems”
“Speech-language evaluation due to frequent middle ear infections”
What is language pragmatics?
“Language pragmatics” refers to how language is used across communication contexts. Someone with intact language skills from a grammatical perspective may not use language appropriately if they fail to look at others when they talk or use proper facial expression. The term can be used interchangeably with “social communication”. Pragmatic language disorders fall under the realm of speech-language pathology as opposed to psychology, which addresses the social-emotional effects of a pragmatic language disorder. Our groups follow a systematic plan of therapy which typically either follows an individual course of therapy, or is incorporated into individual therapy on an alternate weekly basis. It is by no means just a safe recreational outlet for a child without friends.
How are your services different from other social skills programs ?
King’s Speech and Learning Center uses a pragmatic language program developed by the owner, called “wait Your Turn” which uses sound methods of intervention for the treatment of language disorders. The structure of the program is similar to The DIR/Floortime method, which is a form of play therapy that uses interactions and relationships to benefit children with developmental delays and autism. Like the Floortime model, the goal of the “Wait Your Turn” is to increase back and forth interactions. However, the Wait Your Turn program focuses more on training strategies (to parents of young children, or to the child themselves if they are higher functioning and school aged) that optimize speech, language and communication skills verses training on all areas of child development. Another difference is that we focus on language building in natural contexts which are intrinsically motivating from an emotional and/or sensory standpoint to allow for generalization to novel contexts.
For mild cases, or high level functioning individuals, we address more sophisticate language skills such as comprehension of abstract language, topic introduction,perspective taking, message closure, and referencing all within the structure of a balanced, reciprocal exchanges in natural contexts.
Are there a minimum number of visits that I have to commit to?
No, however, we do ask you to commit to any schedule that is arranged. We recommend regular and more frequent follow-ups in the first couple of months, and then work to shift the training responsibility to the parents so that progress is not dependent on the number of minutes of speech therapy per week. Since parents are with their children for multiple hours/day, seven days/week, it makes more sense to teach parents and/or caregivers how to be trainers.
How do we know which program to sign up for first?
Our free initial telephone consult will determine what is best. Typically, services would start with a speech-language evaluation, or if a formal test battery has already been completed, a social communication evaluation with play analysis. After the evaluation, our clinician would suggest either individual treatment, peer or sibling mediated treatment, group language therapy, and/or music therapy.
We encourage waiting until language goals are mastered in the parent-child context before progressing to the child-peer context, and finally to group therapy for generalization of pragmatic language goals.
Why should I use King’s Speech and Learning Center rather than a traditional rehabilitation program for speech therapy?
Our model combines traditional healthcare within the fields of speech and occupational therapy with academic intervention, and social emotional needs of the individual to offer a more holistic approach to managing communication and learning challenges. KSLC focuses on “real life” issues that get in the way of success. We aim to fill the gap between home and school This means spending more time with parents before during, or after treatment sessions. Because we are a small group of specialists we will take the time to help you manage any part of your child’s life that needs “tweaking” (e.g. reviewing your IEP, helping you manage play dates, job interviewing for teens, etc.).
When will it be necessary to obtain additional assessments?
When dealing with a child’s development it is often hard to draw a sharp line between disciplines. Thus, it is very important to have related specialists available as an integral part of our program. The decision to refer for additional testing ( occupational therapy, physical therapy, Ear Nose and Throat assessment, psychological evaluation, or developmental evaluation) will be made either at the time of our initial telephone intake, or after your child’s speech-language evaluation. The decision would be made based on prior history of work-up, current school intervention and performance, parent reports, and evaluation results. Since speech pathologists can only make speech, language, cognitive or swallowing diagnoses, a referral to a related specialist may be necessary for a developmental, physical, psychological, behavioral, or learning related diagnosis.
We use our own consultants who are contracted with King’s Speech for occupational therapy, music, drama, sign language, tutoring , oral feeding, and alternative/assistive communication (e.g. iPad applications)
How is your language program suited for adults?
Many adults have gone through life struggling with social communication problems that have never been diagnosed or treated. As an adult, one may feel lonely, anxious around people or lack confidence in their communication skills. If an adult is open and motivate to change, then it is never too late to make improvements. Some common pragmatic problems in adults include, interrupting, loud talking, argumentative or needing to be right, self- centered topic selection, poor conversational turn taking, lack of social initiation, and flat affect.
Adults may also experience new communication problems due to a neurological condition such as brain injury, stroke, or tumor. Any adult communication disorder can be treated using our approach to focus on natural social communication verses traditional methods of training via worksheets and flash cards.
Why would my teenager need private interview training if this is covered at his school?
Most high school guidance departments offer a nice summary of what to do, and what not to do on your college interview. However, this is very different than having a licensed speech-language pathologist evaluate your child’s speech clarity, verbal and nonverbal language expression, and overall communicative effectiveness; target behaviors for change; and provide follow up training to ensure progress on their goals.
How do I know if I need to supplement my child’s IEP at school with private therapy?
If you answer “no” to any of the following questions, then your child probably needs more help:
- Is your child receiving at least an hour/week in speech therapy?
- Is your child receiving pragmatic language therapy by a licensed speech pathologist?
- Are you satisfied with your child’s progress with their speech-language and/or O.T. goals over the last 6 months?
- Have you been trained on how to work with your child?
- Is your child improving in his peer interactions and ability to form close bonds?
- Do you know what the school therapists are working on, their methods of treatment, and where they see your child for therapy?
How do I know if I need to hire an educational consultant?
We will help you with that process as well, but in general, you can ask the question:
Am I satisfied with the amount, and quality of special services that my child is receiving at school?
If the answer to the above question is no, you would benefit by a consultant. We have an expert on board who is available to help you on an hourly basis.
Would you ever speak to a parent group?
Sure, KSLC offers a variety of parent and professional training workshops. Please call us for more information, or to arrange a custom presentation to your parent group.
Can I pay privately for a home evaluation and then transition over to covered services at your office?
Absolutely, providing that you are within reasonable driving distance in CT. If needed, the report can be submitted to your insurance company later with your therapy claims. For out-of-state clients we offer Skype visits.
Do you offer payment plans?
We do not have any formal payment plans in place, though we would be happy to speak with you to make special arrangements if services would present a hardship for you.