New Beginnings | NB1-Office

Patient Name: Tristan

Patient Information:

Patient ID: 9947

Patient First Name: Tristan

Patient Date of Birth: 08-31-2008

Gender: male

Assigned Office: NB1 east side

Primary Care Physician: Osama, Naga

Patient Status: Active

Primary Attendance / Assigned Therapists:

ST - Speech Therapy:

FD - Feeding Therapy:

OT - Occupational Therapy:

PT - Physical Therapy:

Patient Primary Authorizations:

Auth. ID	Status	Start Date	End Date	Insurance	ST-Units	FD-Units	OT-Units	PT-Units
23542	Active	03-16-2026	03-31-2026	Self Pay	2	0	0	0

Speech and Language Evaluation:

ID	Date	Type	Evaluation Diagnosis
26246	02-13-2026	Speech Initial Evaluation	F80.0
Speech Background History: Tristan is a 17-year, 5-month-old male who was referred for a speech-language evaluation in anticipation of an upcoming lingual frenectomy. Tristan and his mother were present during the evaluation. It was reported that Tristan has compensated well for the lingual restriction and does not currently carry any speech, language, or feeding-related diagnoses. Mother stated that they sought the evaluation following a recommendation from the dental provider, who suggested therapy prior to the frenectomy due to the possibility of developing speech or swallowing concerns after the procedure. Mother and Tristan reported that he sleeps at an inclined position, as it is harder for him to fall asleep in a flat position. Mother reported a visit to a gastroenterology specialist due to concerns related to air swallowing and frequent belching. At this time, endoscopy was not recommended, as the specialist plans to monitor symptoms following the scheduled lingual frenectomy before determining the need for further diagnostic assessment.
Speech Medical History: Per parent report, medical history is not remarkable
Speech Medications: None
Speech Behavioral Observations: Attending Skills: Adequate, Response Rate: Appropriate, Level of Activity: WNL, Cooperation: WNL, Communicative Intent: Adequate, Awareness of Others: Present, Reliability of Scores: Adequate, Social Interactions: ,
Speech Communication Strengths:
Speech Communication Weaknesses:
Speech Background Summary: Tristan demonstrated age-appropriate pragmatic language skills during the evaluation. He maintained appropriate eye contact, engaged in reciprocal conversation, and responded to questions in a relevant and organized manner. Topic maintenance, conversational turn-taking, and social awareness were observed to be within functional limits. No concerns were noted regarding social communication skills at this time.
Speech Diagnosis/Impressions: At the time of evaluation, Tristan demonstrates age-appropriate articulation skills and effective lingual compensation strategies despite the presence of a significant tongue-tie. No speech sound errors, distortions, or intelligibility deficits were observed that would warrant skilled speech-language therapy services. Overall speech production is within functional limits. Regarding feeding and swallowing, both Tristan and his mother denied current concerns. He is tolerating an age-appropriate diet without signs or symptoms of dysphagia. Oral intake appears efficient and functional, with no reported or observed limitations affecting nutrition or hydration status. Although a severe lingual restriction is present and a surgical release is scheduled, there is no current evidence of a speech, feeding, or swallowing disorder. Skilled speech-language pathology services are based on present functional impairment rather than the potential for future concerns; therefore, intervention is not medically necessary at this time. Re-evaluation is recommended following the frenectomy should speech, feeding, or swallowing concerns arise during the healing process or after changes in lingual mobility occur.
Speech Diagnosis/Impressions: At the time of evaluation, Tristan demonstrates age-appropriate articulation skills and effective lingual compensation strategies despite the presence of a significant tongue-tie. No speech sound errors, distortions, or intelligibility deficits were observed that would warrant skilled speech-language therapy services. Overall speech production is within functional limits. Regarding feeding and swallowing, both Tristan and his mother denied current concerns. He is tolerating an age-appropriate diet without signs or symptoms of dysphagia. Oral intake appears efficient and functional, with no reported or observed limitations affecting nutrition or hydration status. Although a severe lingual restriction is present and a surgical release is scheduled, there is no current evidence of a speech, feeding, or swallowing disorder. Skilled speech-language pathology services are based on present functional impairment rather than the potential for future concerns; therefore, intervention is not medically necessary at this time. Re-evaluation is recommended following the frenectomy should speech, feeding, or swallowing concerns arise during the healing process or after changes in lingual mobility occur.

Completed Appointments:

ID	Plan of Care

Appt-ID	Service	Start-Date	End-Date	Therapist	Location	Status
887451	92523: Artic & Language Eval	02-13-2026 02:30 PM	02-13-2026 03:30 PM	Daniella Anchondo	NB1 east side	Completed

Payments History:

Date	Service Description	$Credit	$Debit	$Balance
2/13/26	Patient visit charged - Artic & Language Eval: Artic & Language Eval	0.00	90.00	-90.00
3/6/26	Card payment for ST visit, 2/13/26, Ref# fPiH	90.00	90.00	0.00

Billing History:

Date	Service Description	Units	$Amount	$Status
2/13/26	92523: Artic & Language Eval	1	345.00	EDI Submited

Paient Notes:

Date	Posted By	Description
03-10-2026	Shekinah Velasquez	Therapist has been notified for scheduled visits. Both visits will be selfpay starting 03/16/2026
02-14-2026	Daniella Anchondo	Mother came in for an evaluation to seek speech therapy, as patient will be having a frenectomy. She provided dentist referral seeking services due to concerns for possible future speech or swallowing difficulties. Based on clinician assessment, patient has been compensating well and has no speech impediments, cognitive deficits, or reported/observed swallowing difficulties despite severity of tie. Clinical judgment indicates that speech-language intervention is not medically necessary at this time, as services are based on current functional impairment rather than potential future concerns. Mother shared that the dentist recommended initiating speech therapy due to the possibility of developing a lisp or swallowing difficulties in the future. This information was acknowledged; however, it was explained that therapy qualification cannot be based solely on preventative or hypothetical outcomes. It was discussed that the dentist or surgical provider should provide post-procedure exercises to support healing and mobility. Re-evaluation following the release procedure was recommended if any speech or feeding concerns arise at that time. Clinician offered to email parent plan of care to bring to dentist and for her records, as she began requesting a letter. Clinician offered to email patient strategies to work on if problems arise.
02-06-2026	Julie Mora	Parent informed the front office that her son's oral surgeon is requiring 2 sessions before the procedure. They are aiming for procedure ( tongue tie release) date to be March 9. Parent wanted to schedule the treatments via telehealth before the IE. Parent was informed that we can not schedule before knowing the therapist recommended POC.
02-04-2026	Julie Mora	BCBS, Ref# 1110709493, No deductible, OOP ind. $8,150/$0 met, fam $18,400/$0 met, Calendar year, Co-payment $90.00. No pre-auth required for 92523, 92507,S9152.

Paient Messages Admin:

Date	Posted By	Message
02-03-2026 11:16 AM	Avery Fontenot	Please fillout the form https://patient.newbeginnings-elp.com/Registration/default.aspx?sid=2593
02-03-2026 11:44 AM	Shekinah Velasquez	Tristan has been added to our Speech & Language Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9947&type=1&wid=538
02-03-2026 03:52 PM	Caleb Tullius	🌟 You’re Invited! 🌟 Join us as we celebrate the unveiling of the Sensory Nook we proudly donated to the library! Come see the space, explore, and enjoy this special moment with us. 📅 February 7th, 2026 ⏰ 4:30 PM 📍 Esperanza Acosta Moreno Public Library We’d love to see you there! 💙 🌟 ¡Están invitados! 🌟 Acompáñenos a celebrar la inauguración del Rincón Sensorial que con orgullo donamos a la biblioteca. Vengan a conocer el espacio y compartir este momento especial con nosotros. 📅 7 de febrero de 2026 ⏰ 4:30 p.m. 📍 Biblioteca Pública Esperanza Acosta Moreno ¡Esperamos verlos! 💙
02-05-2026 09:10 AM	Julie Mora	Good morning, this is Julie from New Beginnings front office. After reviewing Tristan's registration we are pending a St referral. If you can send us a copy at your earliest convenience we would greatly appreciate it. Thank you.
02-05-2026 09:12 AM	Tristan Nieto	Yes ma'am. What is the email you would like me to send it to?
02-05-2026 09:22 AM	Julie Mora	Please send the referral to jmora@newbeginnings-elp.com Thank you
02-05-2026 12:29 PM	Tristan Nieto	Please confirm receipt of the referral please 🤗
02-05-2026 01:23 PM	Julie Mora	This is Julie from the New Beginnings front office. We received the speech therapy referral via email; however, we are unable to use it. The referral lists Rio Grande Therapy Group as the provider and UnitedHealthcare as the insurance. Unfortunately, New Beginnings is not in network with UnitedHealthcare. Because of this, we are unable to coordinate benefits and can only use BCBS for services. Please request a new referral from your primary care provider listing New Beginnings as the provider and BCBS as the insurance. We do accept BCBS PPO, which is the insurance you uploaded during registration. If you have any questions, please feel free to contact us at 915-855-0601.
02-05-2026 03:36 PM	Tristan Nieto	We have BCBS
02-05-2026 03:54 PM	Tristan Nieto	Dr. Naga is updating the referral. They said they would fax it to your office.
02-06-2026 08:46 AM	Julie Mora	Good morning. Thank you
02-06-2026 12:48 PM	Tristan Nieto	Hi Julie, we just spoke regarding Tristan Nieto. Appt. Feb. 13. The oral surgeon is requiring 2 sessions before the procedure. Would it be possible to schedule those 2 appointments now? We are aiming for procedure date for March 9.
02-06-2026 01:48 PM	Julie Mora	Unfortunately we can not schedule appointments before the initial evaluation. Our therapists schedule their appointments depending on their availability. I can send a message to the therapist that will be seeing Tristan to let her know your requests.
02-06-2026 01:55 PM	Tristan Nieto	Thank you Julie.
02-13-2026 07:31 AM	Shekinah Velasquez	New Beginnings just sent you an invoice for Tristan Nieto. Click this secure link to make your payment online https://st-pros.com/newbeginnings/stripe/default.aspx?transId=39293. Payment is due at the time of service. Thank you for allowing us to serve your child! 🙂
02-14-2026 07:30 AM	Shekinah Velasquez	REMINDER: You have an outstanding invoice for Tristan Nieto from therapy on 02-13-2026. We don't want your balance to delay therapy for your child. Please click this secure link to make your payment online https://st-pros.com/newbeginnings/stripe/default.aspx?transId=39293. Thank you for allowing us to serve your child! 🙂
02-16-2026 05:27 PM	Caleb Tullius	Join us this Wednesday!
02-16-2026 05:48 PM	Stephen Tullius	Please join us for the next New Beginnings free Parent Training: Introduction to AAC (Augmentative and Alternative Communication). This session introduces AAC in a simple, supportive way on why it's used and how it helps children communicate. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=19&pid=9947
02-18-2026 04:16 PM	Stephen Tullius	For those of you that would like to attend our parent training: Introduction to AAC, but are not able to attend in person, we are setting up a webinar. This will be our first attempt at a webinar so I hope it goes well :) Here is the link: https://webinar.getresponse.com/JvvC9/introduction-to-aac/
03-06-2026 11:19 AM	Patricia Bussell	Good morning Ms. Nieto. This is New Beginnings sending you a friendly reminder that there is a balance of $90.00 for the visit on 02/13/2026. Payment link has been sent. Thank you again for allowing us to serve your child.
03-06-2026 11:54 AM	Julie Mora	Hello, this is Julie from New Beginnings. Please disregard the previous message. Your payment of $90.00 was received on 2/13/26, We apologize for the inconvenience. Thank you,
03-09-2026 07:23 PM	Stephen Tullius	Please join us for the next New Beginnings free Parent Training: Sensory Play. In this session learn how to create safe, engaging sensory experiences that help hypersensitive children regulate their responses to touch, sound, and movement. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=20&pid=9947
03-11-2026 05:40 PM	Stephen Tullius	Hello, for anybody who would like to attend our Sensory Play parent training today but can't, we will be attempting a webinar version. You can register to see it online at https://webinar.getresponse.com/JvvC9/sensory-play/

Paient Messages Therapist:

Date	Posted By	Message
02-12-2026 06:30 PM	Daniella Anchondo	Hi, this is a just a reminder that Tristan has a Speech Evaluation appointment scheduled tomorrow at 02:30 PM. See you soon! - New Beginnings 🙂
02-13-2026 07:35 AM	Daniella Anchondo	Hi, this is a just a reminder that Tristan has a Speech Evaluation appointment scheduled today at 02:30 PM. See you soon! - New Beginnings 🙂
02-13-2026 02:15 PM	Daniella Anchondo	Tristan Nieto : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=887451
02-13-2026 02:16 PM	Tristan Nieto	Tristan is CHECKED IN for: 2:30PM-2/13/2026 92523: Artic & Language Eval
02-13-2026 03:18 PM	Daniella Anchondo	Hello, this is Daniella - the speech language pathologist at New Beginnings. I spoke to the front desk and they're going to contact the insurance to try to see if we can complete the next evaluation on zoom, so that you don't have to drive all the way out here. I will keep you posted. If that is the case, I can complete the second evaluation unless you prefer a different therapist. Thank you. I'll be in touch with the information I have pending to provide
02-16-2026 11:21 AM	Tristan Nieto	Tristan (Prim) Replied: Hi Daniella! Thank you. Zoom is an option. We would love for you to continue with his follow up after the procedure. I do understand it might be out of pocket. No worries, we just need to make sure he doesn't develop any changes. We look forward to move forward with you if possible 🤗
03-12-2026 12:38 PM	Stephanie Escobar	Hello my name is Stephanie Escobar I am the SLP who will be working with Tristian. I can see him this Monday at 4:30? :)