Evaluations
Determining the foundations structure.
An evaluation is like figuring out a puzzle, what pieces fit together well, which ones aren't quite fitting, and which ones are missing. A comprehensive evaluation may consist of standardized testing, checklists, clinical observations of movement and play. After Misti collects all the pieces, she puts them together in a detailed report, along with a treatment plan that sets the stage for progress.
Therapy
Rebuilding the Foundation.
Treatment sessions consist of 3 main activities: reflex repatterining and sensory motor activities to address foundational skill development, time to use the skills in fun and meaningful ways, and time to develop and communicate home program activities. Home programs are critical to success in therapy, and they are designed to enhance relationships while improving motor skills and functioning.
Payment and Scheduling
Living your best life is worth your time and investment; you can bring about real neurologic changes based on over a century of research on how the body and the brain work together.
A FREE 30-minute initial phone consultation is provided to discuss your needs. Peppler OT does not directly bill medical insurance, though you will be provided with a simple invoice, or “superbill”, tht you can submit directly to your insurance company to seek out-of-network provider reimbursement. Medicare, All Children and insurance plans that exclude out-of network visits will not be eligible for reimbursement. It is up to you to investigate your coverage and you are responsible for any charges insurance does not cover. Therapy is also frequently reimbursable through HSA (Health Savings Account) and FSA (Flexible Spending Account) arrangements.
For those patients with extreme financial circumstances, a payment schedule or sliding-scale charge may be arranged. The arrangements must be made prior to any services being provided. Qualification will be determined on an individual basis.
Questions to ask your insurance carrier before your appointment:
What is my child’s coverage for out-of-network pediatric occupational therapy visits?
Is my provider required to be credentialed as an out-of-network provider for me to receive reimbursement? If yes, please let Misti know.
Are there any diagnosis exclusions for out-of-network reimbursement?
Do I have a co-payment or is there a percentage of the bill I will be responsible for?
Does my plan require a deductible to be paid for the calendar year before the coverage begins? If so, what is the dollar amount?
Does my child have an out-of-pocket maximum that I pay per calendar year?
Does my insurance plan only cover a limited number of sessions for each calendar year?
Am I required to have a doctor’s referral or pre-authorization before my child sees a clinician? If so, who do I contact?
If pre-authorization is required, can forms be emailed to Misti@PepplerOT.com or child's primary care provider?
Is a Plan of Care signed by my child's primary care provider required for ongoing therapy?
Is there a fax number I can use to submit therapy superbills (Misti will provide superbills to you)?* If not, what address should be used?
Is there an additional form to be submitted with superbills?
* When submitting superbills to insurance please be sure to specify that you would like direct reimbursement.