Medical Insurance Reimbursement
In order to provide the best possible care, Social Thinking® San Jose is a “private pay” clinic, meaning that all of our services must be paid for by the guardians of the client, or the adult client themselves.
We do not accept 3rd party reimbursements. We recognize that obtaining insurance coverage may be a difficult process and will do what we can to make this difficult process easier.
Getting reimbursements from your medical insurance
Some insurance companies will reimburse for services provided by Social Thinking San Jose, please check with your insurance provider to see if your sessions can be covered. SOCIAL THINKING CANNOT GUARANTEE THAT YOU WILL RECEIVE REIMBURSEMENT FROM YOUR INSURANCE COMPANY. We strongly encourage families to keep their own copies of their invoices and any reports or written updates we send to them each month so they can be used for potential reimbursement.
RECEIVING RECORDS FOR INSURANCE CLAIMS
While we do not process insurance claims on behalf of a client or family, we can provide records when and if they are requested by a family in order for the client/parent to submit such claims to their respective insurance company.
Some insurance companies will only reimburse for specific Diagnostic Codes. On your monthly billing statement, if specifically requested by the client, we include the diagnostic code from medical reports provided by the client. We cannot enter a medical diagnostic code based on an educational classification alone. Our statements also include a procedure code to reflect the service provided. The procedure code is dependent on your assigned Social Cognitive Specialist.
Group SPEECH therapy 92508
Individual SPEECH therapy 92507
Group OCCUPATIONAL therapy 97150
Individual OCCUPATIONAL therapy 97129; 97130
Due to the intensive time and cost related to gathering information for an insurance claim, we will charge an administrative fee based on $40.00 per hour for any administrative requests which include copies of previous invoices, reports, therapy notes, or calls to insurance companies.
We will not sign any contract offered to us by an insurance company that states that we agree to be paid a lesser fee than what we have established as our fee for service, even if the parent has paid our insurance administrative fee.