Strides Occupational Therapy is a private occupational therapy clinic. We provide services on a fee-for-service basis, and are out-of-network for all insurance companies. Strides OT will provide you with invoices and requested documentation to submit to your insurance company to assist in reimbursement.
It is not necessary to have a doctor’s referral to initiate occupational therapy services, but this can be helpful if you plan to seek reimbursement depending on your insurance provider. Insurance companies require medical necessity when providing reimbursement for treatment services, which may be established with a specifically designed treatment plan or doctor referral/prescription for diagnosed issues which create functional limitations in daily activities (such as dressing, bathing, eating, and safety)
If you plan to submit to insurance for reimbursement, it is recommend that you find out the following information:
1) The diagnosis code for any established diagnosis. Examples include Autism, low muscle tone, Cerebral Palsy, developmental delay, fine motor delay, etc.
2) Does your insurance requires pre-authorization for occupational therapy?
3) Is there is a lifetime or per-calendar year limit on coverage for services or specific diagnoses?
4) What documentation is required for reimbursement? Examples include requests for pre-authorization, initial evaluations, progress notes, referral from a doctor.
The client is responsible for letting Strides OT know the specific documentation that is required and must provide any forms that the insurance company requests to be filled out by Strides Occupational Therapy, Inc.