Thank you for giving me and TALK SLP the opportunity to work with you!

Please review the following information and policies so that you are more familiar with the operations of the practice.

Please note: A hard copy of this information must be signed and returned to me by or before our first session together. To print the form, click here.

General information

When you arrive please stay in the waiting area until I come to collect you. I am happy to have parents join our sessions at any time. If siblings are also present, however, please keep in mind that it may be distracting to the child receiving treatment. If you must bring siblings to the appointment, please plan on staying with them in the waiting area near the treatment room, and feel free to enjoy the books provided.

Sessions are approximately 45 minutes in length unless otherwise discussed and agreed upon. If you do not plan on observing or staying in the adjoining waiting room, please be prepared to arrive to pick up your child 10 minutes prior to the end of the session. The next appointment is often as soon as 10 to 15 minutes later, and time is needed to pick up and write chart notes.

Cancellations

Cancellations are accepted with notice at least 24 hours prior to the scheduled time. A call placed to (206) 228-8530 will ensure that your request is received without delay. Please do not use email to cancel an appointment that is less than 48 hours away.

If a cancellation is made less than 24 hours prior to your scheduled time, the missed session will be billed in full to you and cannot be billed to your insurance company. In case of sudden illness, a call to cancel must be placed within 24 hours or by 8 am the day of the appointment. Should you cancel the day of the session after 8 am, you will be charged in full unless another mutually agreed upon arrangement is made. If an appointment is missed due to a “no-show,” the full amount of the session will be charged to you and cannot be billed to your insurance company. An attempt to make up cancelled or missed appointments will be granted as the schedule permits. Cancellations made with at least 48 hours notice made may be emailed to laura@talkslp.com.

All appointments begin at the agreed-upon time. Should you arrive late, the appointment will end at the originally scheduled time as a courtesy to the next client. Additional time of up to 10 minutes will be provided should the schedule permit. 

Payment and Insurance

Payment is expected in full and is collected the day of the session by either check or cash unless Talk SLP LLC is billing directly to an insurance company. All insurance co-pays are collected at the time the services are rendered. We can provide you with a monthly receipt upon your request.

Talk SLP LLC currently accepts or participates in the following networks:

• Premera
• Regence
• Blue Cross/Blue Shield
• Lifewise
• Aetna
• Kaiser Permanente
• First Choice Network
• Uniform

Insurance that we do not participate:

• Aetna
• Cigna
• Molina
• United

It is your responsibility to know the scope of coverage and limitations or restrictions of your insurance benefits regarding speech/language therapy. Prior to initiating services with Laura S. Smith/TALK SLP Services, it is required that you provide insurance information and obtain any required referrals or prescriptions from your physician. You are also responsible for monitoring the number of visits allowable by insurance and/or PCP prescription/referral and the maximum dollar amount allowable by insurance. I am available to inquire about the scope of your benefits at your request. You can provide insurance information to TALK SLP using this form.

Understanding your insurance

For more help navigating your insurance coverage, please refer to these helpful overviews:

Understanding Your Explanation of Benefits Statement

Common Insurance Terms

 Our payment terms

By signing this document you authorize the release of any medical or other information strictly for purposes of processing medical claims for insurance or government agencies.  Authorization of payment to Laura S. Smith of TALK SLP Services for services in speech/language pathology is also provided.

Any insurance payments denied to Laura S. Smith/TALK SLP Services become your responsibility to pay in full within 30 days, regardless of whether or not you choose to appeal the insurance company’s decision. Appeals are not made by Laura S. Smith/TALK SLP Services. Should you appeal and win and payment is issued to Laura S. Smith of TALK SLP Services, you will be reimbursed immediately.

An outstanding balance older than 30 days will be subject to interest of 1.5% per month on the unpaid balance. Returned checks are subject to a $35.00 fee. Overdue bills can be sent to collection per Washington State Law R.C.W. 19.250, with collection costs added as allowable by law. If you chose to end services, any and all charges to date are due in full immediately.

I have read and agree to the aforementioned policies and procedures and understand they become effective on the date of my signature below. Please bring a signed copy of this document to your first session and keep one for your records.