Billing and Insurance

We’re happy to provide you with our best advice for getting your insurance information organized.

In-Network Plans

Please contact your insurance carrier to verify your benefit information. Please note that the information provided during the verification process is not a guarantee of coverage or payment. Often times there are limitations and exclusions to plan benefits. Coverage and payment are not determined until the claim is received and processed by your insurance carrier. Copays, deductibles, and non-covered services are due at the time of service.

No Surprises Act - Good Faith Estimate

Effective January 1, 2022, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and medical visit charges.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nos urprises or submit an email to billing@marshallpediatrictherapy.com

For out-of-network plans

On an out-of-network basis, we will file to most other insurance plans. For those out-of-network, we can help families with exploring single case agreements for in-network status with their plan. We currently do accept Tricare and Aetna as out-of-network coverage.

For Mental Health Therapy Services

Aetna Better Health

AMCO

HMCO

Passport

Wellcare

Kentucky Medicaid

Blue Cross Blue Shield

Humana

Cigna

United Healthcare

Caresource Marketplace

For Occupational Therapy, Physical Therapy, and Speech Therapy Services

Aetna Better Health

AMCO

HMCO

UMCO

Passport

Wellcare

Kentucky Medicaid

Blue Cross Blue Shield

Humana

Cigna

United Healthcare

Caresource Marketplace

For our Building Blocks Program (ABA)

Humana MCO

Aetna Better Health

Blue Cross Blue Shield

Wellcare

Kentucky Medicaid

Anthem MCO

Cigna

Advanced Care Credit Options

Advance Care provides a quick and easy alternative to paying for therapy services that might not be covered by your insurance. Interest-free periods of 6-14 months are available along with flexible terms, and low-interest rates. Advance Care offers helpful customer service by calling 1-800-432-9470, or visiting their website to learn more.

Alternative Funding Resources

Therapy is a true investment in the future of each of our family's lives. At Marshall Pediatric Therapy, we sincerely acknowledge that not everyone has access to insurance coverage, and those that do, might additionally accumulate hefty out-of-pocket expenses. At Marshall, we will continue to advocate on the behalf of our families to have the most financial options and insurance presently available. Fortunately, there are a number of organizations that support funding efforts for children with disabilities which could help greatly offset the cost of therapeutic services or equipment. Funding grants and criteria might vary per organization.