Frequently Asked Questions
My insurance doesn’t require a prescription or a referral. Do I still need to provide one?
Yes. Even if your insurance plan allows self-referrals, a physician’s prescription is still required by our clinic for billing and medical necessity documentation purposes.
How do I refer a patient (or have my doctor refer me) for services?
To initiate services, your doctor’s office or referral clerk will need to send a prescription to us. They can submit it in one of two ways:
- Fax: 559-354-8214
- Mail: ACCESS Speech Therapy, 1150 N. Douty Street, Suite A, Hanford, CA 93230
- Have questions about the referral process? Reach out to our team directly at 559-423-0744 or email info@stonespeech.com.
Does insurance typically cover speech therapy?
Many health insurance plans do provide benefits for speech therapy, but limitations are common. These limits are often based on age, specific medical diagnoses, or a capped number of allowed sessions per calendar year. Because every policy is unique, we highly recommend calling your insurance provider to verify your specific outpatient speech therapy benefits.
What is a deductible?
A deductible is the fixed amount you must pay out-of-pocket for medical services before your insurance company begins to pay. This amount varies by policy and typically resets at the start of your calendar or plan year. If you have an unmet deductible, payment for the session is expected at the time of each visit.
What is a co-pay?
A co-pay is a fixed, flat dollar amount (e.g., $30) that your insurance policy requires you to pay at each visit. Co-pays are due upon arrival at the time of your service.
What is co-insurance?
Co-insurance is your share of the costs of a healthcare service, calculated as a percentage (e.g., 20%) of the total allowed amount. If your deductible has been met, you are responsible for this percentage at the time of your visit.
What happens after I return my new patient paperwork?
Once you return your completed intake packet and we receive the required prescription from your doctor, our team follows a seamless three-step process:
- Insurance Verification: Our dedicated billing specialists will verify your insurance benefits and coverage limits.
- Scheduling: Your packet is passed to our front office team, who will reach out to schedule your initial evaluation.
- Patient Double-Check: Once your evaluation date is set, we highly recommend calling your insurance provider one final time to personally confirm your outpatient speech therapy benefits.
Insurance & Payment Info
At ACCESS Speech Therapy, we strive to make the billing process as transparent and straightforward as possible. We accept health insurance across multiple states as well as private pay options.
In-Network Insurance Providers
We are currently in-network with the following healthcare insurance providers, organized by our physical state locations:
California Location
- Tricare-TriWest
- Blue Cross of California
- Blue Shield of California
Private Pay & Out-of-Network Policies
Financial Policy: The client or legal guardian is responsible for all services rendered. Private pay fees, insurance co-pays, co-insurance, and unmet deductibles are due in full at the time of your scheduled session.
Private Pay / Self-Pay Rates
If you are uninsured, choose not to utilize your health insurance plan, or are seeking services in a state where we do not currently participate with your specific insurance panel (such as Tennessee):
- We gladly welcome private pay/self-pay clients.
- Detailed itemized superbills can be provided upon request for you to submit to your insurance company for potential out-of-network reimbursement.
Contact Our Billing Team
Evaluation and treatment rates vary based on the specific clinical duration, complexity, and specialized nature of the services required—such as specialized pediatric feeding or adult orofacial myofunctional (airway) therapies.
Please contact our front office at 559-423-0744 or email us at info@stonespeech.com for a transparent breakdown of our private pay fee schedule or to verify your plan's specific network status.
Texas Location
- Tricare-TriWest
- Blue Cross Blue Shield of Texas
- Medicare of Texas
Tennessee Location
- Private Pay / Out-of-Network Only
- (In-network insurance paneling coming soon)
Orofacial Myofunctional Disorders
Orofacial Myofunctional Disorders (OMD) are abnormal movements or positioning of the tongue, lips, and jaw during speech or swallowing, or at rest. One type of OMD is tongue thrust, when the tongue rests too far forward in the mouth or moves too far forward during speech or swallowing. While it is normal for a baby's tongue to thrust forward while swallowing, this behavior should gradually go away as they grow.
OMD may not affect speech at all, or it may cause some sounds to be said incorrectly. Tongue thrust most often affects production of s, z, sh, ch, and j, as well as sounds made with the tip of the tongue (t, d, n, l). In addition to speech and swallowing problems, OMD may cause significant issues with teeth alignment and jaw function.
There may be no single cause of OMD. When allergies, enlarged tonsils/adenoids, or other issues cause chronic mouth breathing, a child may develop abnormal mouth postures. Chronic bad oral habits (e.g., thumb sucking, pacifier use, or teeth clenching/grinding) and abnormalities like an overly large tongue or weak mouth muscles can also contribute to OMD. Some children may have genetic tendencies toward these and other factors.
Symptoms of OMD
- Chronic open-mouthed posture
- Tongue pushes against teeth or protrudes out of the mouth when swallowing
- Chewing food with lips open
- Tongue pushes between the teeth during speech
- Speech distortions, especially lisp (e.g., sock is pronounced thock)
- Front teeth that stick out
Assessing and Treating OMD
The speech-language pathologist (SLP) will examine the structures of the mouth and face at rest, and watch how they move during different chewing/swallowing and speech activities. A doctor may need to see the child to rule out airway blockages, and if there are effects on teeth, a dentist or orthodontist may evaluate as well.
The SLP's therapy goals will depend on the results of the evaluation, and will likely target several aspects of OMD. They may work to increase the child's awareness of the tongue, lips, and jaw position at rest and during speech and swallowing, and to improve muscle tone, strength, or coordination. Various exercises will be used to retrain patterns of muscle movement for articulation and/or swallowing. The SLP may also work on eliminating any negative behaviors that contribute to OMD (e.g., thumb sucking).
Explore Our Library of Supporting Tools & Professional Resources
ASHA: Public Information
The American Speech-Language-Hearing Association provides comprehensive resources on communication disorders, developmental milestones, and clinical guidelines for all ages.
The IAOM: Myofunctional Association
Dedicated to the improvement of health through myofunctional research, this directory offers deep insights into airway health, tongue-tie impacts, and swallowing patterns.
Zero to Three: Early Intervention
A leading national resource focused explicitly on the critical development of babies and toddlers, offering tools for healthy social-emotional and language growth.
National Stuttering Association (NSA)
The largest non-profit organization in the world dedicated to providing support, education, and advocacy for children and adults who stutter and their families.
Feeding Matters: Support Network
Specialized guidance for clinicians and families dealing with Pediatric Feeding Disorder (PFD), focusing on collaborative care and nutritional health through therapy.