Referral
insurance dependent
pediatrician can refer or parent can reach out to request evaluation
Evaluation
intake form completed
SPM/SP-2 completed
billing dept will let OTP know about dx coverages, etc.
Treatment
OTR decides if tx is needed
client comes based on insurance coverage/clinical reasoning
Re-evaluation/discharge
insurance dependent
OTP will assess progress & determine if discharge is needed
Developmental coordination disorder
Down syndrome
Fine motor/gross motor delays
Feeding disorders
Many kids without any diagnosis
Can treat variety of ages from few weeks to 21 yrs
Collaborative goal setting with the family
COAST/SMART format
DO NOT need to be academically relevant
can focus on many areas
ADLs (dressing, feeding, hygiene)
play & social skills
school readiness
fine & gross motor strength/skills
sensory regulation
executive functioning
emotional regulation
life skills
leisure
written based on insurance coverages
daily tx note in an EMR (electronic medical record)
re-evaluation or re-authorization as required by insurance company/payor
can be once a year, once every three sessions, or anywhere in between
discharge notes
creatively collaborating if needed for the client based on insurance coverage
scheduling every other week
co-treatments or back-to-back sessions
incorporating goals, equipment, strategies, etc., utilized by each member of the team
private insurance companies: AETNA, Blue Cross Blue Sheild, etc
Medicaid: MassHealth in MA, HUSKY in CT -- varies by state
OOP = out of pocket - if family can afford it, they will private pay