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Here at Willow Pediatric Therapy, we want to provide you with the highest quality of care possible focused on your goals rather than being restricted to what insurance companies believe is important. Therefore, we do not bill insurance and are not in-network with any insurance companies at this time.
We require payment at the time of service then we will provide a simple invoice/ "superbill" to those with private insurance plans who have "out-of-network" benefits so that you can submit it to insurance for reimbursement. Often, occupational therapy services are also frequently reimbursable through HSA (Health Savings Account) and FSA (Flexible Spending Account) arrangements. Plans that exclude out-of-network visits will not be eligible for reimbursement (this often includes plans from Medicaid).
Reimbursify
Reimbursify is a company that facilitates individuals with submitting claims to insurance companies. This could be an option to consider to help with your claims to help simplify the process. It is free to try then only $2.99 per claim.
https://reimbursify.com/individual-page/
Questions to consider asking your insurance carrier prior to initiating services if you are planning on seeking reimbursement:
Do I need a physician's referral and/or pre-authorization prior to my evaluation or treatments? Who should complete these forms (physician or provider)?
Is a Plan of Care signed by my child's primary care provider required for ongoing therapy?
What coverage does my child have for out-of-network occupational therapy evaluation? Treatment?
Are there any exclusions I should know about such as:
A limit to the number of visits
Certain diagnoses?
Location code (such as home visits location code 12) for out-of-network reimbursement?
What out of pocket expenses can I expect? This might include asking:
Do I have a copayment (generally a set dollar amount the patient covers) or coinsurance (covering a percentage of the bill)
Do I have a deductible to be paid before coverage begins? If so, how much? Is it per individual or a family deductible? Does it start over at the beginning of the calendar year?
Do I have an out of pocket maximum per year?
How do I submit for reimbursement?
Is there a form I need to submit or just submit the superbill provided by my provider?
Is there a fax number I can use or to what address should I send it?
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