We are currently in network with Blue Cross Blue Shield of Illinois (BCBS). If you are not in-network with BCBS, you may be able to apply private payments to your out-of-network deductible. Both private and insurance payments can be paid using your Health Savings Account or Flexible Spending Account.
If you chose to use your BCBS insurance to help pay for visits, we suggest you take the following steps:
- Call your insurance provider to confirm that Metro East Therapy is in-network with your specific BCBS plan. You may call our office and request our NPI number to assist insurance with making a determination.
- If Metro East Therapy is an in-network provider, ask the insurance representative if you have speech and/or occupational therapy benefits.
- If you do have speech and/or occupational therapy benefits, ask the representative if any exclusions apply. Sometimes children are only eligible for services if they have a diagnosis of Autism or if there was an accident/injury.
- Ask the insurance representative if you need a pre-authorization for services.
- Ask the insurance representative how many speech and/or occupational therapy visits you have per calendar year. This is important to communicate to our office.
- Ask the insurance representative if you have a deductible, out-of-pocket, or co-payment for office visits.
Insurance may ask you for a specific diagnosis code to confirm coverage. You are encouraged to call our office so that we can give you a list of possible diagnosis codes, but know that we are providing you this information prior to seeing your child. It is possible this information may change after an evaluation is completed.
Metro East Therapy will submit claims on your behalf to BCBS. If we have issues with a claim, we will attempt to call insurance to resolve the issue. If we find that we are having difficulty resolving the issue, we will ask you to call insurance to help resolve the issue.
If you are confused or uncertain after speaking with insurance, please call our office. We are more than happy to help you understand your benefits and patient responsibilities!
