Strides Occupational Therapy Services utilizes unique treatment strategies to assist with the therapeutic process. The first step is an initial evaluation. Once this is completed, a treatment program is recommended, and Strides OT will work with the family to establish the most beneficial intervention plan possible.
The intervention process may include weekly occupational therapy services, parent or caregiver training, community outings, or home program development. Goals are developed with client, family, and therapist collaboration. A re-evaluation is conducted every six months to determine client progress and ensure that treatment remains focused on achievement of goals.
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.
When speaking to an insurance representative or billing entity, it is important to record the name of the person you spoke to and the information provided. Try to speak with the same representative each time you call to ensure that the information you receive is consistent and correct. If you cannot obtain the necessary information from the representative, ask to speak to a person in the Medical Management department for specific information related to the coverage outlined in your policy and procedures
necessary to obtain reimbursement.
It is recommended that you notify your child’s physician that your child is receiving therapy services and the diagnosis code being used.
Some insurance companies require a doctor’s prescription to obtain pre-authorization for services.
Please request any documentation required by your insurance carrier two weeks in advance of expiration of the pre-authorization to ensure uninterrupted continuation of therapy services.
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 Services, Inc.
Strides OT will not give back-dated insurance progress reports because of failure to obtain this information from the insurance company prior to the start of therapy.
Communicating with insurance carriers is a time consuming process. If Strides OT is required to contact your insurance carrier and the contact lasts longer than 15 minutes, you will be assessed a $20.00 fee for every additional 30 minutes.