{"id":167,"date":"2011-06-23T18:41:24","date_gmt":"2011-06-23T18:41:24","guid":{"rendered":"http:\/\/aspeechpathseattle.com\/home\/?page_id=167"},"modified":"2019-08-06T23:00:38","modified_gmt":"2019-08-06T23:00:38","slug":"forms-and-policies","status":"publish","type":"page","link":"http:\/\/aspeechpathseattle.com\/home\/forms-and-policies\/","title":{"rendered":"Forms + Policies"},"content":{"rendered":"<div id=\"left-column\">\n<h2>Forms:<\/h2>\n<p>To allow as much time as possible for your child\u2019s evaluation, please complete the paperwork below prior to your appointment. Your cooperation is greatly appreciated!<\/p>\n<h3>General forms for all patients:<\/h3>\n<ul>\n<li> <a href=\"http:\/\/www.aspeechpathseattle.com\/home\/wp-content\/uploads\/2014\/04\/Parent-Information-Form.pdf\" target=\"_blank\">General Patient Information<\/a><\/li>\n<li> <a href=\"http:\/\/www.aspeechpathseattle.com\/home\/wp-content\/uploads\/2014\/04\/HIPPA-Notice.pdf\" target=\"_blank\">Privacy Practices<\/a><\/li>\n<\/ul>\n<h3>Please choose the appropriate form based on your primary concern or the child\u2019s age:<\/h3>\n<ul>\n<li> <a href=\"http:\/\/www.aspeechpathseattle.com\/home\/wp-content\/uploads\/2014\/04\/Preschool-General.pdf\" target=\"_blank\">Birth-Preschool History Form<\/a><\/li>\n<li> <a href=\"http:\/\/www.aspeechpathseattle.com\/home\/wp-content\/uploads\/2014\/04\/6-18-General.pdf\" target=\"_blank\">Kindergarten-18 years History Form<\/a><\/li>\n<li> <a href=\"http:\/\/www.aspeechpathseattle.com\/home\/wp-content\/uploads\/2014\/04\/Fluency.pdf\" target=\"_blank\">Childhood Fluency\/Stuttering History Form<\/a><\/li>\n<\/ul>\n<h2>Policies:<\/h2>\n<ul>\n<li><a href=\"http:\/\/www.aspeechpathseattle.com\/home\/wp-content\/uploads\/2014\/04\/Privacy-Financial-Policies.pdf\" target=\"_blank\">Privacy &amp; Financial<\/a><\/li>\n<li><a href=\"http:\/\/www.aspeechpathseattle.com\/home\/wp-content\/uploads\/2014\/04\/General-Service-Policies.pdf\" target=\"_blank\">General<\/a><\/li>\n<\/ul>\n<\/div>\n<div id=\"right-column\">\n<h2>Financial Information and Billing:<\/h2>\n<p>As a courtesy, A Speech Path will bill the following insurance companies:<\/p>\n<ul>\n<li> Premera Blue Cross<\/li>\n<li> Regence Blue Shield<\/li>\n<li> First Choice<\/li>\n<\/ul>\n<p>(For all others, appropriate documentation can be provided to submit for reimbursement.)<\/p>\n<p>While A Speech Path is happy to bill the above-named insurance companies for all services rendered, your coverage is an agreement between you and the insurance company. I will work with you and the insurance company to resolve any of your denied claims; however, all unpaid portions are your responsibility and payment is expected within 21 days of billing.<\/p>\n<p>Please <a href=\"\/home\/contact\">contact<\/a> A Speech Path regarding specific questions about financial information.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Forms: To allow as much time as possible for your child\u2019s evaluation, please complete the paperwork below prior to your appointment. Your cooperation is greatly appreciated! General forms for all patients: General Patient Information Privacy Practices Please choose the appropriate &hellip; <a href=\"http:\/\/aspeechpathseattle.com\/home\/forms-and-policies\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-167","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/pages\/167","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/comments?post=167"}],"version-history":[{"count":27,"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/pages\/167\/revisions"}],"predecessor-version":[{"id":267,"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/pages\/167\/revisions\/267"}],"wp:attachment":[{"href":"http:\/\/aspeechpathseattle.com\/home\/wp-json\/wp\/v2\/media?parent=167"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}