Preparing for Insurance Changes in the New Year: A Guide for Parents

Parenthood is a rewarding journey filled with joy, milestones, and countless decisions. One of the most important (and often overlooked) responsibilities is understanding your insurance coverage, especially when it comes to services like speech and occupational therapy. With a new year just around the corner, now is the perfect time to review your benefits, make any updates, and ensure your child continues receiving the support they need.

Why It Matters

Insurance coverage can change from year to year, especially if you switch plans during open enrollment. Benefits for services like therapy may vary, and delays in updating or confirming your benefits can interrupt care. That’s why we’re encouraging all families to check their insurance details and notify us of any changes as soon as possible.

Insurance Terms Made Simple

Insurance language can be confusing, so here’s a quick glossary to help:

  • Insurance Policy: A contract outlining coverage, terms, and limits.
  • Coverage: The medical services your plan will pay for.
  • Premium: Monthly amount paid to have insurance.
  • Deductible: What you must pay before insurance starts covering costs. This amount will typically reset in the new year.
  • Coinsurance: The percentage of costs you pay after your deductible is met (e.g. 30%).
  • Copay: A set fee paid at each visit (e.g. $25 per session).
  • Out-of-Pocket Maximum/Catastrophic Cap: The most you’ll pay in a year for covered services (excluding premiums) — after which insurance pays 100%.

Steps to Prepare for the New Year

1. Review Your New Plan

Start by checking if your plan is changing in the new year. If anything about your plan has changed, or you are unsure, please send us a copy of your new insurance card to frontoffice@smalltalkspeech.com.

2. Understand Your Costs

Check what your benefits and patient responsibility are for speech therapy and occupational therapy. This information is typically listed in the “Benefits” section of your plan summary. Ask your insurance provider about:

  • Copayments
  • Deductibles
  • Coinsurance
  • Out-of-pocket maximums

3. Check for In-Network Providers

Is SmallTalk in-network? In-network therapists generally result in lower out-of-pocket costs.

4. Get a Referral if Needed

Some plans require a doctor’s referral before therapy services can begin. Check with your pediatrician and your insurer.

5. Ask About Pre-Authorization

Certain services require pre-approval before coverage begins. Skipping this step could result in denied claims.

6. Know Session Limits & Rules

Plans may place limits on how many sessions your child can attend or may limit coverage based on diagnosis.

7. What to Do if a Claim is Denied

Denied claims can often be appealed. Don’t give up! Ask your insurer for steps to initiate an appeal if needed.

8. Explore School-Based Services

Your child’s school may also offer therapy services, which can be used in conjunction with or as an alternative to private therapy.

9. Keep Communication Open

Share any insurance changes with us right away so we can help avoid coverage gaps and ensure continuity of care. You can contact us at frontoffice@smalltalkspeech.com or 619-647-6157 ext. 7 if you have any insurance updates or have any questions.

How to Check Your Benefits

When you call your insurance company, here are some helpful questions to ask:

  • Is SmallTalk Pediatric Therapy in-network with my plan?
    • You may need our NPI: 1619298791
  • What are my benefits for these CPT codes?
    • Speech Therapy: 92523, 92507
    • Occupational Therapy: 97166, 97168, 97530
  • Is there a deductible that applies, and how much of it has been met?
  • What is my copayment per therapy session?
  • Are there session limits for speech or occupational therapy?
  • Do I need pre-authorization?
  • Are there any diagnosis exclusions?

Always call the Member Services number on the back of your insurance card. If you are having trouble finding it, you can also try the numbers below:

Insurance ProviderMember Services Number
Anthem Blue Cross (CA)1‑800‑967‑3015
Blue Shield of CA1‑800‑443‑5005
Blue Shield Federal (FEP)1‑800‑411‑2583
Kaiser Permanente1‑800‑464‑4000
Sharp Health Plan1‑858‑499‑8300
TRICARE West (TriWest)1‑888‑874‑9378
UnitedHealthcare1‑800‑577‑8539

Final Thoughts

Understanding and preparing for insurance changes doesn’t have to be stressful. Taking the time now to review your benefits, ask the right questions, and share updates with us ensures that your child’s therapy can continue uninterrupted. Please contact us at frontoffice@smalltalkspeech.com or 619-647-6157 ext. 7 if you have any insurance updates or have any questions. We’re here to support you and your family every step of the way.

Let’s work together to make the new year a successful one for your child and their care.

Should My Child Start Speech Therapy? What Parents Should Know

When you’re worried about your child’s speech development, it can feel overwhelming to know what to do next. Maybe you’ve heard well-meaning advice like, “They’ll grow out of it,” or “Just wait and see.” But how do you know if waiting is the right choice? What if early speech therapy could help your child thrive?

At SmallTalk Pediatric Therapy, we often meet parents who aren’t sure whether to seek support or give their child more time. Here’s what you should know to make an informed decision.

Understanding Speech and Language Milestones

All children develop at their own pace, but there are general milestones most kids reach around certain ages. For example:

  • By 12 months: Babbling, using gestures, responding to their name.
  • By 18 months: Saying about 10–20 words.
  • By 2 years: Using two-word phrases (“more juice,” “mama help”).
  • By 3 years: Speech is clear enough for familiar adults to understand most of what they say.

You can read more about specific milestones with our Developmental Checklist. If your child is significantly behind in these milestones, it may be time to consider an evaluation.

The “Wait and See” Approach

Many parents are told to wait and see if their child will “catch up.” While this can be appropriate in some cases, especially when there is steady progress, delaying help can also mean missing the window when therapy is most effective.

Should My Child Start Speech Therapy? What Parents Should Know

Research shows that early intervention leads to better outcomes in speech and language development. If a delay is identified early, therapy can help build skills before gaps widen.

A 2011 meta-analysis published in the American Journal of Speech-Language Pathology found that parent-led early speech interventions significantly improved expressive language in young children—especially those under age 3 (Roberts & Kaiser, 2011). These findings support the importance of not delaying care when communication concerns arise.

Benefits of Starting Speech Therapy Early

Here are a few reasons why acting early can be so powerful:

  • Brain Plasticity: Young children’s brains are more adaptable, making it easier to learn new communication skills.
  • Confidence: Kids often feel frustrated when they can’t express themselves. Therapy helps reduce this frustration and build self-esteem.
  • Social Connection: Communication delays can impact play and peer relationships. Early support helps kids engage more successfully with others.
  • Family Support: Therapy gives you tools and strategies to help your child at home.

When to Seek an Evaluation

You don’t need a referral to have your child evaluated by one of our speech-language pathologists. If you notice any of the following, it’s a good idea to schedule an eval:

  • Your child is not meeting speech milestones for their age.
  • They appear frustrated by not being understood.
  • They rarely imitate sounds or words.
  • You have a gut feeling that something isn’t quite right. Trust your instincts—you know your child best.
When to Seek an Evaluation

How SmallTalk Pediatric Therapy Can Help

At SmallTalk, we believe in early, compassionate, play-based therapy that meets kids where they are. Our licensed speech-language pathologists will:

  • Assess your child’s speech and language skills.
  • Create an individualized treatment plan.
  • Guide you on how to support your child at home.
  • Celebrate every success, big and small!

You Don’t Have to Wait and Wonder

If you have concerns about your child’s speech, you don’t have to navigate them alone. Early intervention doesn’t mean something is “wrong”, it means you’re giving your child every opportunity to communicate confidently.

Contact us today to schedule a speech evaluation. We’re here to help.

How Virtual Speech and Language Therapy Can Support Your Family

As the world continues to expand its abilities to connect with other people, so has our ability as therapists to connect with you in ways that are flexible, effective, and fun! Virtual visits are a great method of speech-language services that ensure your child’s ability to make progress on their communication goals, while simultaneously supporting your family navigating busy schedules and lives.

What can be accomplished virtually?

There are a variety of benefits that a virtual visit can provide, much like in-person visits:

  • Assessments: Standardized assessments to determine the diagnosis of potential speech-language delays, as well as implementation of a comprehensive treatment plan are entirely achievable by meeting virtually. Virtual assessment sessions usually include a combination of standardized testing, particularly if your child is of age to participate. Another effective measure is parent interview, hearing from you exactly what your concerns and observations are of your child in their home environment.
  • Treatment: Virtual speech therapy sessions can be designed to meet the communication-specific needs of your child. Whether it is articulation, expressive/receptive language, social/pragmatic skills, or related areas, tasks developed through various online games, interactive stories, and songs/videos help support the progress of your child. Not to mention, they are designed to be fun and engaging so that your child will want to continue to attend these virtual visits!
  • Parent Education and Collaboration: Parents are just as important to the process of speech-language development as the therapists that work with your child. Virtual visits allow for private, constructive conversations to give parents suggestions, resources, and in-the-moment opportunities to demonstrate language facilitation strategies with their children right in the comfort of their own home!

So what now?

If your child might need a little guidance in speech and language, receiving services virtually is an effective way to support the communication journey of your child. SmallTalk offers virtual sessions all-week long, including several therapists, like me, who have dedicated an entire day to virtual sessions to connect with more families around the San Diego community. Please consider giving it a try – I hope to see you online!

By Alex Maloney, SLP

Great Games for Gifts from a Speech Therapist

…and fun ways to target speech and language

The holiday season brings festive lights, cozy family time, and a welcome break from busy school routines. With kids home and more time together, it’s the perfect opportunity to slow down, unplug, and connect through play. Whether you’re looking for thoughtful gift ideas or fun ways to spend screen-free time at home, games can be a wonderful way to keep your child engaged and learning.

As a speech therapist, we love using games in our sessions because they make learning fun and meaningful. Play is one of the most powerful ways to support speech, language, and overall development and it doesn’t have to stop when therapy ends. Below are some of our favorite games that bring joy and skill-building together this holiday season along with goals you can target while you play!

Pop the Pig (ages 4+, 2-6 players) 

  • Turn taking
  • Two step directions (e.g., roll the dice, then feed the pig; feed the pig, then press his head)
  • Speech sounds (e.g., say a word before every turn)
  • Simple “what” questions (e.g., what color did you get?; what number is it?)

Feed the Woozle (ages 3-6, 2-5 players)  

  • Following directions 
  • R words in phrases (e.g., chocolate covered flies, moldy macaroni, spider egg pudding)
  • L words in phrases (e.g., liverwurst popsicle, lemon flavored underwear, iced garlic
  • S words in phrases (e.g., sugar coated sardines, baseball sandwich, soggy sausage)

Zingo (ages 4+, 2-6 players)  

  • Naming objects in pictures
  • Turn taking 
  • Answering yes/no questions for facts (e.g., do you have a tree?)

Tell Tale (ages 5+, 1-8 players)  

  • Using story telling elements 
  • Maintaining conversation topic
  • Answering wh- questions
  • Retelling stories

I Spy Eagle Eye (ages 5+)  

  • SP blends in phrases (e.g., I spy…)
  • Naming objects in pictures 
  • Where questions (e.g., where is it?)

By Jess Wi MS, CCC-SLP

The holidays are the perfect time to reconnect, play, and make meaningful memories together. Whether you choose a game that encourages conversation, teamwork, or problem-solving, each moment of play can support your child’s speech, language, and developmental growth in a natural, joyful way.

At SmallTalk Pediatric Therapy, we believe that learning happens best when it’s fun. If you’d like more ideas for play-based learning or have questions about your child’s progress, our teams in La Mesa, Mission Valley, and Scripps Ranch are here to help.

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