Insurance Coverage by Service

Use this table for a quick answer, then see the detailed breakdown for each service below. Educational services are private pay only.

NC Medicaid is accepted through Partners Health Management, Alliance Health, Healthy Blue, Carolina Complete Health, and AmeriHealth Caritas of North Carolina.

ABA THERAPY INSURANCE

We accept Aetna, Blue Cross Blue Shield of NC, and MedCost for ABA therapy for autism in Charlotte. Out-of-network plans are not accepted for ABA services.

Aetna
Blue Cross Blue Shield of NC
MedCost

BEHAVIORAL HEALTH & PSYCHOLOGY INSURANCE

We accept Aetna, Aetna State Health Plan, Blue Cross Blue Shield of NC, and MedCost for behavioral health and psychology services in Charlotte – including counseling, ADHD testing, autism evaluations, and other psychological services. We can also file with most out-of-network plans.

Aetna
Aetna State Health Plan
Blue Cross Blue Shield of NC
MedCost

OCCUPATIONAL, PHYSICAL & SPEECH THERAPY INSURANCE

Our broadest coverage: we accept Aetna, Aetna State Health Plan, Blue Cross Blue Shield of NC, Cigna, MedCost, UnitedHealthcare, and NC Medicaid for occupational therapy, physical therapy, and speech-language therapy in Charlotte.

Aetna
Aetna State Health Plan
Blue Cross Blue Shield of NC
Cigna
MedCost
NC Medicaid (Partners Health Management, Alliance Health, Healthy Blue, Carolina Complete Health, AmeriHealth Caritas NC)
UnitedHealthcare

EDUCATIONAL SERVICES

Educational services are private pay only. Financing and alternative funding options are described below.

OUT-OF-NETWORK PLANS

If your plan isn’t listed above, we can still help. We file to most other insurance plans on an out-of-network basis, and we can assist families in exploring single case agreements for in-network status with their plan. We also offer some discounts for self-pay services. (Note: out-of-network plans are not accepted for ABA services.)

VERIFYING YOUR BENEFITS

Please contact your insurance carrier to verify your benefit information. Information provided during verification is not a guarantee of coverage or payment; there are often limitations and exclusions to plan benefits, and coverage is not determined until the claim is received and processed by your carrier. Copays, deductibles, and non-covered services are due at the time of service.

While we are in-network with most plans under the carriers listed, there may be plans administered by these carriers in which we are considered an out-of-network provider – for example, EPO plans or hospital-system-only plans (Novant-only or Atrium-only). As a subscriber, you are responsible for confirming network status with your insurance carrier.

INSURANCE QUESTIONS FROM PARENTS

Do you accept Blue Cross Blue Shield?
Yes. Blue Cross Blue Shield of North Carolina is in-network for ABA therapy, behavioral health and psychology services, occupational therapy, physical therapy, and speech-language therapy at Child & Family Development. Some BCBS plan types (such as EPO or hospital-system-only plans) may be out-of-network, so please confirm your specific plan.

Do you accept Aetna?
Yes. Aetna is in-network for all of our insurance-eligible services. The Aetna State Health Plan is in-network for behavioral health and psychology services and for occupational, physical, and speech therapy.

Do you accept Medicaid?
We accept NC Medicaid for occupational therapy, physical therapy, and speech-language therapy, through Partners Health Management, Alliance Health, Healthy Blue, Carolina Complete Health, and AmeriHealth Caritas of North Carolina. NC Medicaid is not accepted for ABA therapy or behavioral health/psychology services.

Do you accept UnitedHealthcare or Cigna?
Yes, for occupational therapy, physical therapy, and speech-language therapy. UnitedHealthcare and Cigna are not in-network for ABA therapy or behavioral health/psychology services, though we can file with most plans on an out-of-network basis.

Does insurance cover ABA therapy for autism?
Yes – we accept Aetna, Blue Cross Blue Shield of NC, and MedCost for ABA therapy. Out-of-network plans are not accepted for ABA services.

Does insurance cover ADHD testing or psychological evaluations?
Yes – ADHD testing, autism evaluations, and other psychological services fall under our behavioral health and psychology coverage: Aetna, Aetna State Health Plan, Blue Cross Blue Shield of NC, and MedCost. We can also file with most out-of-network plans.

Does insurance cover speech, occupational, or physical therapy?
Yes – these services have our broadest coverage: Aetna, Aetna State Health Plan, Blue Cross Blue Shield of NC, Cigna, MedCost, UnitedHealthcare, and NC Medicaid.

What if my insurance isn’t listed?
We file to most other insurance plans on an out-of-network basis, can help you explore a single case agreement with your plan, and offer some discounts for self-pay services. Call our Client Accounts Team at 704-332-4834 ext. 153 to talk through your options.

How do I verify my benefits?
Call the member services number on your insurance card and ask whether Child & Family Development is in-network for the specific service your child needs. Our Client Accounts Team at 704-332-4834 ext. 153 is also happy to help you get your insurance information organized before your first appointment.

ALTERNATIVE FUNDING SOURCES

Therapy is an investment in your child’s future. We recognize that not everyone has access to insurance benefits, and those who do are often left with some out-of-pocket cost. There are a number of organizations that may provide funding for children with disabilities, covering a wide array of purposes such as therapy or equipment. These organizations have certain grant/funding criteria so please be sure to check their websites for funding details. Alternative Funding Sources

ADVANCE CARE CREDIT OPTIONS

Advance Care provides simple and affordable patient financing options, with interest-free periods of 6-18 months, flexible terms, and low interest rates. Call 1-800-432-9470 or visit their website to learn more.

NO SURPRISES ACT – GOOD FAITH ESTIMATE

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance, or who are not using insurance, an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our Client Accounts Team at 704-332-4834 ext. 153.