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Tag: insurance verification

Insurance & Billing For Current Clients

Insurance and Billing Information

Providing the best services for your child requires a HIGHLY TRAINED TEAM of therapists AND office professionals.

Our knowledgeable office team provides information and guidance to streamline and support processes that save your precious family-time. Securing coverage or providing a plan that allows your child to receive uninterrupted QUALITY services is our goal.

If you have questions, we have answers. Call us any time or schedule a call with our office at a time that is convenient for you HERE.

100+ years of combined office and billing experience

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Insurance & Billing For New Clients

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. If coverage cannot be secured, please consider our private pay discount rates. 
  • 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. Private pay rates can viewed by clicking the button below. 
    • 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.
    • If coverage cannot be secured, please consider our private pay discount rates. To view rates, please click the button below. 

    Private Pay Rates

  • United Healthcare

    • BDI Playhouse is not in-network with United Health Care Plans. 
      • Therapy can be billed to UHC and will process to your Out of Network benefits
      • Specific billing codes can be provided to help you confirm coverage.
      • We offer significantly discounted private pay rates. To view rates, please click the button below. 

    Private Pay Rates

  • 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 by clicking the button below.

    Private Pay Rates

  • 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

    Starting January 1, 2023, BDI Playhouse will not be in-network with Cigna PPO plans. 

    • 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.
    • We offer significantly discounted private pay rates. To view rates, please click the button below. 

    Private Pay Rates

  • Other Insurance Plans

    • Multiplan Network participant: 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.
    • If coverage cannot be secured, please consider our private pay discount rates. To view rates, please click the button below. 

    Private Pay Rates

  • HMO Plans

    • We are contracted with 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. To view rates, please click the button below. 

    Private Pay 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 significantly discounted private pay rates. To view rates, please click the button below. 

    Private Pay Rates

  • 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
    • Go here for more information.
    • If coverage cannot be secured, please consider our private pay discount rates. To view rates, please click the button below. 

    Private Pay Rates

  • Grants

    Apply for grant funding at: https://www.healthwellfoundation.org/

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