UNDER CONSTRUCTION
UNDER CONSTRUCTION
UNDER CONSTRUCTION
UNDER CONSTRUCTION
UNDER CONSTRUCTION
GOOD FAITH ESTIMATES
GENERAL SUMMARY OF Your Good Faith Estimate (GFE): CLICK TO GO TO GFE FORM
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NOTE: Full Document DETAILS regarding the GFE and patient rights under federal law may be reviewed at the bottom of this page. This GFE is not a contract but an estimate to help you gauge the cost of healthcare for your condition or diagnosis.
GENERAL SUMMARY
90-minute initial assessment
$585.00-
$753.00
(1)$166.50
per visit for telepractice or in-person clinic visit
60-minute initial assessment
$390.00-
$558.00
(2)$177.00
for off-site, in-person visits at The Dome
60 minute
re-assessment
$146.25-
$292.50
​​(3)$334.50
Follow-up therapy date of service will not exceed
Average Number of Visits based on confirmed diagnosis:
***(average suggestion is not a guarantee or recommendation, but an estimate you can use to gauge the costs per visit)
1.
VCD/ILO non-exercise related 4-5 visits + 1 evaluation
2.
VCD or EILO exercise-related 5-7 visits (3-4 of these visits often required exercise challenges at the DOME rate; other visits are clinical visits either in-person or through telepractice) + 1 evaluation
3.
Voice phonation disorder 7-14 visits +1 evaluation
4.
Chronic cough or throat clearing 4-5 visits + 1 evaluation
5.
Choking, apnea or functional swallowing disorder 3-5 visits + 1 evaluation.
OTHER CONSIDERATIONS
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GFE excludes the cost of products sold
GFE excludes costs associated with another facility (referral to specialist or fee for entrance to a facility:
SLP Facility usage fee for the SLP at the Dome $9.00-12.00 per visit paid by the patient.
Patient user fee for the Dome is purchased by the patient ahead of scheduled time.
Drop-In and Package options available:
GFE for treatment varies depending on:
(1) actual diagnosis
(2) stimulability to therapeutic trials
(3) patient participation during follow-up visits
Summary for Late Cancellation and No-Show Fee Policy (check for specifics as there are reasonable exceptions to this charge):
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Late Cancellation and No-Show Fee for a reserved 90-minute evaluation or time slot: $150.00
Late Cancellation and No-Show Fee for reserved 45-60-minute treatment or re-evaluation time slot: $50.00