Paying more out-of-pocket for speech therapy?

Frequent concerns that I hear from clients are, “My insurance coverage for speech isn’t much” or “There aren’t any in-network providers near me.” As a private practitioner of a small practice, I have come to accept that dealing with insurance companies is both a necessity and a curse to my business. It makes speech therapy more affordable to the innumerous families seeking services, and I love that! On the other hand, it is a major, royal, Grade A, Wagyu beef and Alaskan King crab pain in the booty to have to chase after the money!

Post-pandemic (or should I say ‘peri-pandemic’), I discharged a client. All was fine and dandy, and best of all…paid! Then, six months later, I receive a notice from the insurance company that essentially said, “Oh, just kidding, we shouldn’t have paid for those services and are going take it all back.” Which they did. Thousands of dollars. The nightmare of sending appeals, resubmitting documents, following up for updates then took over for months on end.

As a service provider, it takes at least 1-1.5 hours to actually get through to a live person at the insurance company on the phone. Then, once I get through to a person, I get a “Please submit ‘more’ documentation” or “Please resubmit documentation ‘again’” or “We received your documentation. Please wait 30-business days for the claim to be (re)processed” or I get an unceremonious [click] when they try to transfer me to the “right” department, and I have to start the whole 1-1.5 hour waiting game all over again. It’s b-e-y-o-n-d infuriating. Who has 3-5 hours to just sit on the phone on any given day??

How many health care providers have discontinued their contracts with insurance companies for exactly this reason? Spending more time trying to chase the money than actually making the money has become a sad reality for both patients and providers. So, if you wonder why you can’t find an in-network provider in your area or why you’re having to pay more out-of-pocket for services, it’s because healthcare reimbursements are such a challenge for providers.. small businesses… working mothers… Affordable healthcare in the U.S. that allow families access to the services they need? Well THAT’s a different post altogether.