Information Form
Please complete the Information Form on the following pages as soon as possible and as detailed as possible so we are able to start your child's file. There is no need to print this form out. Please enter information directly onto this form from your computer, and when you have completed the form in its entirety and hit "submit", it will be emailed to our office.
Other Documents Relevant To Your Child
Please fax (858) 746-4113 or email Info@SanDiegoCenterForSpeechTherapy.com us a copy of any prior Speech/Language, OT, PT, Psychological, dental/orthodontic evaluations or reports (including IEPs or any other pertinent reports) that your child has had. This will be important for us to receive before we begin our speech/language, myofunctional, OT, or academic evaluation or therapy.
Office Locations
We have two offices, one in Carmel Valley and one in Mission Beach.
Carmel Valley Office
Our Camel Valley office address is: 12707 High Bluff Drive Suite #200 (inside the Regus Suite), San Diego, 92130 . We are located in Suite 200, which is inside the Regus Suite located on the second floor. When you enter Suite #200, at the time of your appointment, turn left and walk directly back to our Room #239 which is a bit of a walk down the hall. If the door to room #239 is shut, please wait outside the room until the therapist is done with the prior appointment. If you arrive to the office early, you may wait in the “Business Lounge” waiting room area which is to the left of the front desk (the second room on the left). Then, at the time of your appointment, please proceed to Room #239. NOTE: If you have an appointment after 5:00 pm, the glass suite doors lock at about 5:00/5:15. Sometimes you are able to get into the suite after that time when other people are entering or leaving. If you are not able to get into the suite, please do not worry, as the therapist will meet you at the glass doors at time of your appointment (or a few minutes after if the therapist is running behind).
Mission Beach (located inside Water and Sports Physical Therapy)
Our address in Mission Beach is: 2999 Mission Blvd Unit 101 San Diego, CA 92109. Note: our office is located inside Water and Sports Physical Therapy. Water and Sports Physical Therapy is just past the Belmont Park parking lot, across the street. You will see the blue painted wall on the outside of the building. You can park next to the building (in the parking lot next to the blue painted wall), on the street, or in the large parking lot adjacent to the building. When you enter the office, please check in with the receptionist at the front and she will direct you where to go. Your therapist will come to get you at the start of your appointment time.
Payment, Insurance, Superbills
We will keep your credit card securely on file for payment for sessions that apply. See the details below for speech therapy, occupational therapy, and myofunctional therapy (self-pay evaluations, and insurance covered vs. out-of-network sessions). If you are a self-pay patient, your credit card will automatically be charged by our office after the session or the next business day. If you have any questions about payments/finances, please contact our Office Manager, at (858) 488-4810 or email Info@SanDiegoCenterForSpeechTherapy.com. Please do not discuss any payment questions with the therapist, as our therapists are solely responsible for the care and treatment of you. Also, if your child receives our services through San Diego Regional Center (SDRC) and you would like to continue speech or occupational therapy with us after your child’s SDRC services expire, you must pay privately, on your own accord, for our services.
Speech Therapy & Occupational Therapy Payment Details:
For speech therapy and occupational therapy, we are not an in-network provider, meaning that we do not accept or bill insurance, and we are considered "out-of-network" for insurance companies. You are expected to pay us in full for each session. However, we are able to provide you with an insurance receipt ("Superbill") that has the insurance codes for your sessions. You can then submit this Superbill to your insurance on your own accord to seek reimbursement according to your "out-of-network" insurance benefits. Please let our office manager know if you would like her to send you the Superbills, and she can do so on a monthly basis. A referral from a physician/MD can be included from you when you mail the Superbill to your insurance, as this sometimes helps with reimbursement. Although we are not in-network with insurance for speech or occupational therapy services, many insurance companies will apply a portion of your payment to your insurance deductible or will reimburse you according to your out-of-network benefits. You may potentially apply these charges towards your FSA. Please contact your insurance company for details. We are not responsible for working with insurance companies or for any insurance reimbursements to you. This next section describes in detail our payment and insurance policy for speech and occupational therapy sessions. Please sign the highlighted areas below showing you understand the policy:
SAN DIEGO CENTER FOR SPEECH THERAPY PAYMENTS AND INSURANCE/SUPERBILLS
NOTE: If you are seeking Myofunctional Therapy services and you have insurance, please see the document below titled FOR MYOFUNCTIONAL THERAPY PATIENTS INTERESTED IN ACCESING MYOFUNCTIONAL THERAPY TREATMENT IN-NEWORK WITH THEIR INSRUANCE.
San Diego Center for Speech Therapy (SDCST) does not accept insurance for payment of services. You will be considered a self-pay patient. However, some of the services you receive may be covered under your insurance plan (e.g., “out of network” speech therapy) and you could submit information to your health plan for recoupment of some of the portion you will pay SDCST out of pocket.
If you have commercial or Federally funded health coverage, recouping monies from your health plan will work in the following way:
- You will pay SDCST out-of-pocket for treatment
- SDCST will provide you with a superbill that lists procedure codes and diagnosis codes for your sessions.*
- The superbill provided to you can be sent into your health plan for the insurance allowable recoupment.
- Any monies received back from insurance belong to you.
* NOTE: Not all portions of your session have a “procedure code” associated with them. This would mean that portion may be considered “non-coverable” by your insurance, and may not be able to be recouped so there will not be a selection on the superbill for these portions. Possible non-covered services by some insurance companies may include but not limited to, myofunctional therapy, experimental or investigative techniques, services without objective measurements, services for maintenance. We are able to use speech therapy codes for myofunctional therapy assessments and treatments, but some insurances may not cover a full amount of such services.
You have put your trust in SDCST to bring about the best successes for you or your child. You will want SDCST to utilize the best treatments for you or your child, and not just those covered by insurance. SDCST has opted not to take insurance because of the unfair restrictive nature of insurance and what would be allowed with insurance is not what is the best treatment.
Myofunctional Therapy Payment Details:
We may accept your insurance for myofunctional therapy treatment sessions! This next section describes in detail our payment and insurance policy for myofunctional therapy sessions. Please sign the highlighted area below showing that you understand the policy:
FOR MYOFUNCTIONAL THERAPY PATIENTS INTERESTED IN ACCESING MYOFUNCTIONAL THERAPY TREATMENT COVERED BY THEIR INSURANCE
If you have an insurance that our affiliated physical therapy company Water and Sports Physical Therapy, Inc. (Mission Beach/Poway) accepts, you may be able to access our myofunctional therapy treatment services utilizing your in-network insurance benefits. This does not apply to most HMO patients. Please speak with our office manager to determine which insurances our Myofunctional Therapist/Doctor of Physical Therapy at Water and Sports Physical Therapy (Mission Beach/Poway offices) accepts.
If you intend to receive your myofunctional therapy treatment services utilizing your in-network insurance benefits through our affiliated physical therapy company, please note that your initial assessment will be done by our speech therapy company, which is not in network with any insurances. The initial assessment is self-pay, however we can provide you with an insurance superbill to seek reimbursement for this assessment as to your out-of-network speech therapy benefits. See the document above: San Diego Center For Speech Therapy Superbills.
After your initial assessment by our Speech-Language Pathologist and Certified Orofacial Myologist from our speech therapy company, if you have insurance that Water and Sports Physical Therapy accepts and there is medical necessity for physical therapy, you can have your PT/myofunctional therapy treatment sessions at the Mission Beach or Poway offices with our Doctor of Physical Therapy, as per your insurance benefits for PT. For patients under the age of 5, this will be determined on a case-by-case basis. If at any point your insurance does not cover your treatment, you can continue your myofunctional therapy with the physical therapist or one of our other Myofunctional Therapists as a self-pay patient and we can provide you with insurance superbills accessing our services as “out of network” providers. NOTE: As a self-pay (non-insurance patient), you are responsible for paying our office directly 100% of the session cost, and we are not responsible for any amount your insurance does not cover if you were to submit a superbill,
Please note that we only have the ability to treat you as an in-network insurance patient (directly billing your insurance according to the above listed description) if you are seen by our Doctor of Physical Therapy/Myofunctional Therapist at the Mission Beach/Poway offices, and it has been determined that your insurance will cover the services. Our Speech-Language Pathologists who are Certified Orofacial Myologists are not in-network with insurances, and you would be a self-pay patient given insurance superbills if treated by them at any time.
It is extremely important for you to understand that if you are being treated for myofunctional therapy by the physical therapists, your myofunctional therapy treatment plan may continue beyond your insurance coverage, and if for some reason you no longer qualify for insurance coverage, we strongly encourage you to continue your treatment until the therapist determines it is not longer necessary, even though you may have to pay out-of-pocket. The completion of treatment is determined by your therapist and should not be determined by insurance coverage. In order to have success in myofunctional therapy, the sessions typically entail 8-10 visits of a “Learning Phase” where we teach you the exercises and correct functioning, and then you continue on a monthly basis until treatment goals have maintained and stabilized at an unconscious level (i.e., until carryover on a daily basis, day and night, outside of the therapy session is achieved). Terminating therapy early can result in the loss of achieved skills and failure in ultimately achieving therapy goals. It is a benefit that we may accept your insurance, but we hope you will commit to therapy regardless of your insurance status.
