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Insurance & Billing For New Clients

For general information related to coverage guidelines that commonly apply, please select your insurance below:

Blue Cross Blue Shield
  • BDI Playhouse is in-network with BCBS PPO plans. 
  • BDI is not in-network with BCBS HMO plans.
  • Most plans have generous Pediatric Therapy benefits.
  • Some plans limit coverage so please check with your carrier for any limitations on your policy.
Aetna
  • Most Aetna plans only cover speech therapy when it directly relates to a birth defect, brain injury, stroke, or head trauma.  Review Aetna’s policy regarding Speech-Therapy coverage for more information.
  • Aetna does not cover the cost of Aquatic therapy.  BDI offers a Private Pay rate if services are not covered. 
  • Aetna allows one appointment maximum per day.  
  • While your plan may have an annual visit allowance, that is not considered a guarantee of coverage. Coverage of services is always dependent on medical necessity, not the policy’s annual visit limit.

 

 

Private Pay Discount Details

In the event that insurance funding is not available, or services are limited or not covered by the policy, our private pay discount rate offers parents another option. Details on the discount for our affordable private pay rate options can be found here.

Early Intervention Funding

Early Intervention (EI) is a state-funded program offering services to children birth to age three with a qualifying level of delay or qualifying diagnosis. 

  • EI serves as a secondary insurance: Providers bill your insurance first and then Early Intervention for portions not covered by your plan.
  • A monthly family fee typically applies
  • Services are often required (by the program) to be provided in the family’s home and children with this funding source are rarely approved for services in-clinic at BDI. 

Many families receive services BOTH through the Early Intervention AND separately through their insurance so that they may receive services in clinic, allowing the best of both worlds in their child’s intervention. 

Waiting periods in Early Intervention are common. We recommend scheduling a free screening or consultation at BDI Playhouse prior to starting the Early Intervention evaluation process, as we can typically schedule within one week.  We can also offer services temporarily while you wait for Early Intervention to complete the initial evaluations, schedule a meeting to generate the service document called an IFSP, and assign treating therapists. 

More detailed information regarding this program can be found here.

Please review the Early Intervention website, but do not hesitate to ask us to walk you through how the Early Intervention Program works and how accessing this resource might benefit your family. 

Cigna
  • BDI Playhouse is in-network with Cigna PPO plans for  Physical Therapy and Occupational Therapy 
  • We are not in-network for Speech Therapy. 
  • Speech therapy can be billed to Cigna and will process to your Out of Network benefits
  • Specific billing codes can be provided to help you confirm coverage.

 

Other Insurance Plans

BDI Playhouse is In-Network with:

 

  • Blue Cross/Blue Shield
  • Aetna
  • Cigna
  • Multiplan Networkparticipant: offers a 10% discount for Out of Network claims

 

Claims billed to any other insurance plan would process to your Out of Network benefits coverage.

HMO Plans
  • We are contracted BCBS Ingalls HMO. 
  • For other HMOs ask your child’s pediatrician to provide assistance in requesting a “single case agreement or waiver” to allow for coverage outside the network, at your in-network level of benefits. Click here for instructions to begin that process.  
  • If coverage cannot be secured, please consider our private pay discount rates. 
Medicaid and State Plans
  • BDI is not contracted with Government supported plans such as Medicaid or any State-funded plans (Illinois Medicaid, BCBS Community, Illinicare, Meridian, Health Alliance, Aetna Better Health, County Care, etc).
  •  We offer a significantly discounted private pay rate. Please see the attached link for more information.

 

DSCC
  • DSCC: is the Division of Specialized Care for Children
  • Financially assists IL families and Children with special healthcare needs
  • Acts as a secondary insurance and often covers what primary insurance doesn’t
  • Eligibility is determined by family income and  the diagnosis or needs of the child