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Forum -> Working Women
Would you pay out of pocket for speech therapy?
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amother


 

Post Thu, Jul 24 2014, 1:18 pm
Nice to hear how many of you do private pay. I'm good at what I do, and I have a couple of in-demand specialties, so I think I might be able to make a go of this. Thanks for your responses. Smile
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amother


 

Post Thu, Jul 24 2014, 2:03 pm
I would worry about legal ramifications of providing speech therapy in a private home. I wouldn't hire even if the therapist billed insurance unless I knew 100% it was legal. (No I don't send to backyard camps either)
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MaBelleVie




 
 
    
 

Post Thu, Jul 24 2014, 2:05 pm
amother wrote:
I would worry about legal ramifications of providing speech therapy in a private home. I wouldn't hire even if the therapist billed insurance unless I knew 100% it was legal. (No I don't send to backyard camps either)


It is totally legal, and medicaid and private insurance companies will reimburse for it. The therapist should have liability insurance as well.
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Maya




 
 
    
 

Post Thu, Jul 24 2014, 2:25 pm
amother wrote:
I pay thousands out of pocket for various therapies, and I couldn't care less where they got their degree from. Your attitude is judgmental and wrong. There are great therapists from TTI and there are lousy therapists from the best colleges. Same with any profession, doctors, lawyers etc.
Trusting credentials is getting great recommendations. If patients were satisfied and successful with said therapist, that's all the credentials I need. I never asked which college they graduated from.

Perhaps you don't care which college your doctor went to, but I would. Same with therapists. It may be judgmental, but it's not wrong.

I got my degree from a state university. I'm not under the illusion that it's just as good as an Ivy League degree, no matter how great I am at what I do. (My field of work doesn't require a degree at all, so it doesn't matter which school I went to. But if we're talking medical or any other helping field, I'd want someone who studied at the best schools.)
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amother


 

Post Thu, Jul 24 2014, 2:47 pm
Quote:
Perhaps you don't care which college your doctor went to, but I would. Same with therapists. It may be judgmental, but it's not wrong.

I got my degree from a state university. I'm not under the illusion that it's just as good as an Ivy League degree, no matter how great I am at what I do. (My field of work doesn't require a degree at all, so it doesn't matter which school I went to. But if we're talking medical or any other helping field, I'd want someone who studied at the best schools.)

OP here. For speech, as long as someone went to a decent school, don't worry about it. Being a great SLP is about brains, intuition, creativity, and passion. The stuff you learn in school is mostly theory. Every SLP I know says they learned 90% of what they need to do their job, on the job.

P.S. My dh went to an Ivy and isn't nearly as smart or as intuitive as plenty of people I know who went to less prestigious schools. Some of his friends from college were brilliant, some were moderately intelligent but worked amazingly hard to learn the material and get good grades, some were children of wealthy donors. (He falls into Category #2.)
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debsey




 
 
    
 

Post Thu, Jul 24 2014, 6:01 pm
amother wrote:
I would worry about legal ramifications of providing speech therapy in a private home. I wouldn't hire even if the therapist billed insurance unless I knew 100% it was legal. (No I don't send to backyard camps either)


There's nothing wrong with providing therapy in a home office, as long as OP does things like get liability insurance, a rider on her home insurance policy, and clearly has a policies statement that states that she does not take insurance.
OP - if you don't take insurance, you need to have the clients SIGN a paper that they know this. Otherwise, you could get in trouble with your state board.
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ElTam




 
 
    
 

Post Thu, Jul 24 2014, 6:10 pm
We paid out of pocket for for DD#2's speech therapy. Our insurance only covered speech impaired by a congenital defect discovered within 24 hours after birth, stroke, or serious accident. Her speech wasn't bad enough that she would qualify for state services, but she needed it. I did not ask where the therapist got trained. I asked for references from friends who had used her.

Last edited by ElTam on Thu, Jul 24 2014, 8:27 pm; edited 1 time in total
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amother


 

Post Thu, Jul 24 2014, 6:32 pm
If you don't mind me asking, how much does a private slp charge per session? (I know each charges different, but average I'm wondering because my dd is really delayed, she gets speech in EI center based because of her diagnosis but I'm wondering if I need to supplement also so that she catches up faster?
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granolamom




 
 
    
 

Post Thu, Jul 24 2014, 6:47 pm
Barbara wrote:
No.

There are dozens of SLTs who will accept payment from our local Board of Education to work with children after school hours. There are still more who accept insurance (even if our insurance covers only some sessions). Unless you have some specialized skill that none of these other therapists possess, or offer a special program (e.g, we did pay out of pocket for an SLT to administer Fast ForWord, which was not covered by insurance or the BOE), I would see no reason to pay out of pocket.


I pay privately for my kids who dont qualify for speech therapy through the BOE. I never asked where our SLP got her degree because honestly, I dont care. She is sweet and warm and the kids love her. she's on time, professional and nice to work with. Most importantly, she gets results.
I found her on our local shuls yahoo group, interviewed her and booked her for a trial session. my ins covers so little that it was worth it to me to find someone I liked and just pay out of pocket.
personally, if I was in OP's shoes I wouldnt want the hassle of billing ins either. way back when I did private PT sessions, the parents paid me and I gave them a receipt that they could submit to their ins. not such a hassle.
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granolamom




 
 
    
 

Post Thu, Jul 24 2014, 6:47 pm
amother wrote:
If you don't mind me asking, how much does a private slp charge per session? (I know each charges different, but average I'm wondering because my dd is really delayed, she gets speech in EI center based because of her diagnosis but I'm wondering if I need to supplement also so that she catches up faster?


I pay $35/half hr
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granolamom




 
 
    
 

Post Thu, Jul 24 2014, 6:53 pm
amother wrote:
She's not going to be making any less money by charging insurance. But -in her words - it's such a "hassle". No one is asking for her to donate free services, but it's not unreasonable to allow for parents to find multiple ways to pay her. Sorry it's such a "hassle", but so is trying to borrow money to pay for therapy.

Just because you know a talented person that charges a fortune and wants "cash only" (hmmmm. Tax evasion?) doesn't mean that it's the correct thing to do.


dealing with ins companies is time consuming. I totally understand not wanting the 'hassle', if you count up how many hours the therapist would lose dealing with ins co, and realize that those are pro-bono hours that come at expense of either her earning potential or her family/other commitments maybe you'd find it less offensive.

just because someone is in a 'helping profession' doesnt mean she has to work for free or take on responsibilies that she finds unpalatable. she can choose not to deal with ins and you can choose to hire someone who is willing to do that.
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MaBelleVie




 
 
    
 

Post Thu, Jul 24 2014, 7:07 pm
granolamom wrote:
I pay $35/half hr


That's really low. Lucky you Smile
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MaBelleVie




 
 
    
 

Post Thu, Jul 24 2014, 7:12 pm
And FTR many insurance companies pay poorly, not nearly what a therapist would make privately. Besides which, there is so much time and headache that goes into billing, a therapist loses many billable hours by going that route.

I'm sorry for you, amother, that you struggle so much to pay for your child's needs. But taking it out in the form of being bitter and nasty to those who are relying on this to pay their own kids' bills? That's not ok. This is not a chesed project, it's a job. An often challenging job. There is much chesed to be done along the way, but it doesn't have to come out of her paycheck.
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amother


 

Post Thu, Jul 24 2014, 7:43 pm
Yes I would pay private. Here's why: 90% of therapists are awful to mediocre. 10% are great at what they do. If one of those 10% is private, I'm willing to pay. That said, a private therapist can fall into the 90% category.
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nylon




 
 
    
 

Post Thu, Jul 24 2014, 7:59 pm
I pay $25 a session, IF my insurance approves it, and I get 12 sessions a year, because even though I have mandated coverage for ASD it doesn't override visit caps for therapies. So insurance is irrelevant for me, really (I am in the process of getting a Medicaid waiver, but that's a whole other business).

But if I were to pay privately, you'd better be good. There are a lot of therapists out there that don't want to deal with insurance. But why should I pay more for the same thing? If you want to do private pay, you need to be able to convince clients that you have a proven track record in individual therapy. Frankly, if you are coming from hospital based practice, I would not be convinced. I'd want a solid track record in private therapy first. I dealt with one therapist who had recently switched from preschool to EI and that was enough. She's going to be a great therapist. After she's worked with more toddlers. I wouldn't pay to train her.

My child is younger, but I've only encountered one therapist so far (and I've dealt with a bunch) who I think is special enough that I would pay privately for her. My child's current SLP is solid, but not in a spectacular way. Now, where I live (not NYC) you need to be spectacular to get private pay. In NY/NNJ, the market is different and people think quality and cost correlate.
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sky




 
 
    
 

Post Thu, Jul 24 2014, 9:04 pm
MaBelleVie wrote:
And FTR many insurance companies pay poorly, not nearly what a therapist would make privately. Besides which, there is so much time and headache that goes into billing, a therapist loses many billable hours by going that route.

I'm sorry for you, amother, that you struggle so much to pay for your child's needs. But taking it out in the form of being bitter and nasty to those who are relying on this to pay their own kids' bills? That's not ok. This is not a chesed project, it's a job. An often challenging job. There is much chesed to be done along the way, but it doesn't have to come out of her paycheck.


My insurance gives $95 per session I think. but once insurance stopped paying I paid on a sliding scale (? - is that the word). I think it was $65 for 1/2 hour. the therapist was amazing and in one year the child made amazing progress.
We then decided to stop and do it through the school because everyone thought it would work. We wasted a year and half on that and I think it was total loss of a year.
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amother


 

Post Fri, Jul 25 2014, 9:58 am
Quote:
If you want to do private pay, you need to be able to convince clients that you have a proven track record in individual therapy. Frankly, if you are coming from hospital based practice, I would not be convinced. I'd want a solid track record in private therapy first. I dealt with one therapist who had recently switched from preschool to EI and that was enough. She's going to be a great therapist. After she's worked with more toddlers. I wouldn't pay to train her.

OP here. Just to clarify, I work in a hospital but I do outpatient peds. So it's one-on-one therapy with kids who have ongoing issues. No difference between what I do and private therapy.
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amother


 

Post Fri, Jul 25 2014, 10:02 am
OP again. I just want to say how nice it is to hear so many people who've had great experiences with their private SLPs. Smile I love it when we make a real difference for families!! Hug
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debsey




 
 
    
 

Post Fri, Jul 25 2014, 10:07 am
amother wrote:
She's not going to be making any less money by charging insurance. But -in her words - it's such a "hassle". No one is asking for her to donate free services, but it's not unreasonable to allow for parents to find multiple ways to pay her. Sorry it's such a "hassle", but so is trying to borrow money to pay for therapy.

Just because you know a talented person that charges a fortune and wants "cash only" (hmmmm. Tax evasion?) doesn't mean that it's the correct thing to do.


One second - if her time is worth 60.00 per hour, and she spends HOURS and HOURS on the phone with the insurance company, getting pre-certifications, submitting paperwork, dealing with utilization reviews - so it takes her an extra hour to get paid that 60.00, isn't she now actually working for 30.00 an hour?
Why should she take a pay cut?
Big agencies take insurance because they are big enough to hire dedicated people to do nothing but deal with the hassle (and you're talking about HOURS on the phone, and sometimes it's denied, which means you worked for FREE). Actually, no, you PAID to work for free, because during those hours you spent arguing with the insurance company, you could have worked and made actual money. Instead, you got nothing but heartburn.
It's not just a hassle, it's a total loss for most professionals.
If you want to use insurance, go to a place that is set up for it. Will you get top-quality therapy? Probably not. Will you get a provider who is very invested in your case because you are one of the few she sees? For sure not, places like that are mills. Will you get someone willing to work with your schedule? Rolling Laughter Not even CLOSE.

It's not a "cash only" business, it's a perfectly legit private pay boutique practice. There's no law that says you have to take insurance, and many compelling reasons not to.

If you think about it - this is your attitude: You're mad that someone isn't willing to pay you for the privilege of treating your kid.
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nylon




 
 
    
 

Post Fri, Jul 25 2014, 3:25 pm
Your time is only worth what someone will pay for it. The insurance company is the payer. Can they force you to take less than what you really want to be paid? Sure. Can they be paying less than what you could make privately? Also possibly.

But if you think your time should be worth $90, but people will only pay $60--it isn't worth $90 unless you can find a customer. This is why medical billing is such a mess (not just therapists): providers make up numbers and then insurance makes up new, lower ones. What's anyone "worth" in a free market? Who knows. We don't have it (not always bad).

and you absolutely cannot generalize about private vs contracted therapists. This is a NY attitude I was glad to leave. Some very talented therapists want to be able to work with a bigger variety of clients. Some private therapists are terrible. Some cities, you can't make a living as a private pay therapist, no one will pay enough for it to be worth your while. Outside of big cities, the market for private pay anything is much, much smaller. And even some big cities.

If everyone decided to leave contracted centers/schools for private pay, none of them would be able to make what a private therapist can now, because they would all be chasing the same sector of the market.
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