Complete the appropriate case history form relevant to the age of the person needing diagnostic and/or speech therapy services.
CHILD CASE HISTORY FORM (Ages 0 – 4)
SCHOOL-AGE CHILD CASE HISTORY FORM (Ages 5 – 18)
FEEDING CASE HISTORY FORM
ADULT CASE HISTORY FORM
WHAT TO EXPECT
Everyone is unique and develops at his or her own rate. Over the years researchers have created norms, which describe an approximate age of acquisition and performance for communication milestones. Norms, as well as objective measures, provide guidance for speech-language pathologists to make a determination regarding the presence or absence of a communication disorder.
Sometimes results of the assessment can be relayed on the day of, but in most cases the speech-language pathologist will need to analyze the responses and later interpret. A completed written evaluation will be available for your review 14 days after the initial assessment. If needed, a plan of care will be sent to your primary care physician for signature.
If evaluation results determine therapy is required, some insurance carriers require pre-authorization to be completed prior to the start of therapy. A written report, signed plan of care, and referral prescription will be submitted to your insurance carrier for approval of therapy. The approval of therapy sessions may take upto 14-21 days from date of submission. Find out more about how to use your insurance benefits to cover speech therapy visits.
If therapy is determined necessary, immediately after the assessment, the therapist will perform a therapeutic assessment to determine the most appropriate goals for the plan of care and to gather baseline data.
You can provide a copy of your previous evaluation to us by uploading the document(s) to the case history form or by asking the evaluating therapist or your pediatrician to fax a copy to 888-975-7556.
*If your child has an active IEP or IFSP, this document is required to be submitted to complete this process. This can be uploaded to the case history form mentioned above.
*Amerigroup requires submission of a hearing evaluation before therapy will be approved. This does not include evaluations completed in your pediatrician’s office.
Therapy is guided by individual needs and areas of weakness, as determined by assessment. Our services are provided in our Alpharetta office. Therapy is usually scheduled for two half-hour visits per week for a 3-6 month period. Regular attendance is important to demonstrate progress.
*Group therapy sessions may be available for private pay clients depending on homogenous peer availability.
- Insurance Card is required to verify coverage if insurance will be billed. Upload to case history form.
- Doctor Referral/Prescription is required when claims will be filed with insurance. Please ask your doctor’s office to fax to 888-975-7556 before your scheduled appointment date or if you already have a copy, upload to the case history form.
- Hearing Evaluation is required for Amerigroup members. Amerigroup will not authorize therapy without this document. Contact Children’s Healthcare of Atlanta Audiology 404-785-7100 or North Fulton ENT 770-343-8675. Please ask your audiologist or otolaryngologist to fax to 888-975-7556, bring to your initial visit or upload to the case history form. The hearing evaluation performed at your pediatrician’s office does not count towards this requirement.
- Individualized Education Plan (IEP) copy is required by Amerigroup, Peach State and Medicaid before services can be initiated. This is only for those students receiving services via public schools.
- Classroom Teacher Questionnaire
- Getting Help When Your Toddler Isn’t Talking
- Your Childs Speech and Language Evaluation
- Talking Points: What to Ask When Contacting Your Insurer