We contract directly with public and charter schools, Medicaid, many major health insurance companies, regional centers, as well as other publicly funded organizations. Please contact an office in your region to determine the appropriate funding source.
TES is an in-network, preferred provider with many insurance companies, including a variety of PPOs and HMOs, as well as Medicaid. We guide families in understanding the insurance process and obtaining the necessary documentation to receive therapeutic services.
Before Services Begin
In order to process your request in a timely manner, TES will need:
- A prescription from your pediatrician/family doctor prescribing the services deemed medically necessary. Required information includes: patient information, date of referral, medical condition necessitating services, an ICD-10 diagnosis code, recommended duration and frequency, doctor’s signature, and professional information.
- A copy of your child’s insurance card which allows us to verify your child’s eligibility, determine the co-payment and/or deductible, and obtain the necessary pre-authorization from your carrier.
- A completed patient information packet.
- The required authorization from your insurance company.
- All co-payments and/or deductibles are due at the time of service.
Under Your Coverage
What to ask your insurance carrier:
- What therapy is covered? (i.e. Speech/Language, Occupational Therapy, Physical Therapy, and Behavior)
- What services are covered? Evaluations? Ongoing Therapy?
- What conditions are covered? (e.g. Autism, Speech & Language Disorder)
- What are my out of pocket expenses? Do I have a co-payment/deductible?
- What are my policy limitations?
- Maximum visits per year? Coverage Exclusions?
- Is Total Education Solutions an in-network or out-of-network provider? How do my benefits differ for in-network versus out-of-network providers?