Billing + Insurance
Did you know Seattle Therapy Network is actually two businesses in one clinic? Giant Steps Children's Therapy provides Occupational Therapy services and Sound Pediatric Therapy provides Speech Language Pathology and Oral Motor/Feeding Therapy services. Since our clinic is comprised of two different businesses, the insurance providers we accept may vary.
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Once your are scheduled for services, our team will share a health benefits summary which includes an estimate of your insurance coverage. This is not a guarantee of payment and we highly encourage clients to call their insurance providers directly regarding therapy coverage.
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Private pay options may be available for clients who have insurance plans that we are unable to bill. Please note that we cannot offer private pay to clients with Medicaid plans we do not accept.
If you have additional billing questions, please call our office at (206)-763-0352.
Accepted Insurance Providers
Occupational Therapy
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Aetna/Meritain
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*Ambetter
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Cigna
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Community Health Plan of WA (Medicaid)
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Coordinated Care (Medicaid)
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First Choice
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Healthcare Management Administrators (Out-of-Network)
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Heritage
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Kaiser Permanente (PPO plans only)
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*Lifewise
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Molina (Medicaid)
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Premera
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Regence
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Wellpoint (Medicaid)
Speech Therapy
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Aetna/Meritain
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*Ambetter
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Cigna
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Coordinated Care (Medicaid)
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First Choice
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Healthcare Management Administrators (Out-of-Network)
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Heritage
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Kaiser Permanente (PPO plans only)
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*Lifewise
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Premera
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Regence
*Cascade Select plans cannot be billed
Insurance Guide
Deductibles, Co-Pays, and coinsurance
Deductible: the amount you will pay for health services before your insurer starts to pay.
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Co-Pay: the set amount you pay for a covered service after your deductible is met.
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Coinsurance: the percentage of the charges that you pay for a covered services after your deductible is met.
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Most plans require you to meet your deductible and then will have co-pay OR coinsurance due for services
Habilitative, Rehabilitative, and Mental health benefits
Different plans may process claims through different types of benefits. Habilitative benefits are for medical concerns that are developmental in nature. Rehabilitative benefits are for concerns that are due to a loss of function or ability. Some plans may also process claims as mental health depending on your specific diagnosis. We encourage you to contact your insurance provider directly to determine how your claims will be processed.
Authorizations and Referrals
Some plans require prior approval before starting services. When this is the case, our office will request authorization from your insurance provider. A signed referral from your primary care provider and/or documents supporting medical necessity may be requested as part of a prior authorization.
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Given that many insurance plans require a referral from your primary care provider, we will request and obtain a signed referral once you are scheduled for services. Even if your insurance does not require a referral, we still need to have one on file per state regulations.
Exclusions
Some insurance plans may not cover services unless they are for a specific diagnosis or injury. This information is not typically available to us when verifying your benefits, so we strongly encourage you to contact your insurance provider directly in order to ensure your sessions will be covered.
Telehealth
Telehealth services are covered by most payers for a variety of therapy services. We encourage families that are participating in Telehealth therapy to contact their insurance plan directly to ensure this is an included benefit.
Visit Limits
Some plans cover a limited amount of visits per year. If your plan will not approve additional visits and continued therapy is recommended, you will have the option of continuing therapy at an out of pocket cost or resuming therapy after your plan renewal date.