How do you know if your Speech Pathologist is certified?

Look for the C’s! As you navigate your way through the process of speech therapy, how can you tell if your chosen speech therapist is truly at the top of their field? The “CCC” at their end of their name, just like the MD at the end of a doctors name, can help give you a clue! “CCC” stands for “certificate of clinical competence.” Each speech therapist must earn their C’s after successfully completing graduate school, a 9-12 month supervision year, and passing the Praxis exam. To keep their CCC’s, each SLP must complete ongoing annual learning in a variety of areas.

Why is the “CCC” (ASHA Certificate of Clinical Competence) So Important?

First, what is an ASHA certification? The ASHA Certificate of Clinical Competence (CCC) is a nationally recognized and accredited professional credential in the fields of Audiology (CCC-A) and Speech-Language Pathology (CCC-SLP). When you work with an ASHA certified SLP. you are working with a therapist with a very specialized and dynamic skill set. ASHA certified therapists have a foundation and resources to continue to learn and grow as an expert level therapist. An ASHA certification also ensures that the ongoing education is the top level, newest and most current information available.

Why is this important?

At SAGE Speech & Learning, all our speech therapists have the highest distinction, their CCC’s. In addition, each of our SLP’s has also completed specialized training in one or more specialty areas. Some of our specialized areas include fluency (stuttering), feeding (picky eating and tube feeds), motor speech and articulation, as well as early intervention (ages 0-3 and 4-6). SAGE Speech & Learning values the highest level of education for ALL our therapists. We regularly participate in continuing education individually and as a team. As parents, you are already facing many obstacles as you search for the best possible care for your child. SAGE Speech is proud that you can feel confident that you have chosen highly specialized, experienced, and nationally certified & licensed SLP’s!

See below for previous posts about common concerns when navigating speech therapy:

The Obstacles Atlanta Families Experience with Speech Therapy and Insurance Coverage, and How to Overcome!

Let’s talk about obstacles our families experience with Speech Therapy and Insurance coverage, specifically “Medical necessity”.

Most insurance plans have a “medical necessity” or “injury and illness” clause.

Oftentimes a patient tells me their insurance plan covers speech. However, once we verify their benefits with the insurance company, we often come across this confusing clause. 

What does a “medical necessity” clause mean for my coverage?

Put simply, it often means that if an impairment is not caused by a medical diagnosis, injury, or illness, that your plan does not cover intervention for that impairment. Many developmental diagnoses, such as articulation, receptive and expressive language, wouldn’t be covered...unless they were due to a medical  Diagnosis. Examples of these medical diagnosis might be: cerebral palsy, stroke, brain injury, etc. 

Is there any way to get around this, or to appeal?

Yes. At SAGE, we often take the time to write letters of medical necessity on behalf of our clients, and accompany these letters with a physician’s prescription for speech therapy services.

SAGE Speech & Learning will ask you for a detailed medical history for your child to help build a case for speech coverage. 

Stay tuned for more insurance tips, tricks, and educational information in our blog.

Our next blog will detail important insurance codes. More information on this topic provided by asha.org:

Medical Necessity for Audiology and Speech-Language Pathology Services Health plans, both public and private, cover services that are considered medically necessary.

However, the definition of medical necessity can vary from payer to payer. Although there may not be one standard or generally accepted definition for medical necessity, the following information can help support arguments that speech, language, and hearing services meet medical necessity criteria.

How Is Medical Necessity Defined?

Paul Keckley, a health economist and policy expert with extensive experience in health services research in the private sector and academic medicine, writes in a  blog post "Medical necessity means something slightly different in every part of the health care industry. Varied definitions and interpretations are used by providers, physicians, courts, pharmacy benefits managers, government insurers, private insurers, and consumers."

Medicare defines medically necessary as "health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms, and that meet accepted standards of medicine." Under the Affordable Care Act (ACA), health insurers and group health plans must provide clear, consistent, and comparable information about their health plan benefits and coverage. This information is published in documents called the Summary of Benefits & Coverage and Uniform Glossary of Medical Terms. The Uniform Glossary of Medical Terms[PDF] provides the following definition for medically necessary: Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms, including habilitation, and that meet accepted standards of medicine. This definition is particularly relevant for speech, language, and hearing services because children’s needs are often habilitative—rather than rehabilitative—in nature.