If you are interested in learning more about your insurance’s out-of-network reimbursement options, upon request, you will provided with a list of codes that you can reference for reimbursement depending on the information you provide me. These are ICD codes that your insurance company will need to process claims. Prior to starting therapy, call the member services number on the back of your insurance card and ask the person on the phone about what the coverage for occupational therapy is with an out-of-network provider. Once you have reviewed your out-of-network coverage and policies, and have confirmed your potential for reimbursement, you will be provided with documentation to submit after our session meeting. Please remember that it is your responsibility to keep/file all evaluations, progress reports, and billing documents for insurance and reimbursement purposes.

Some recommended questions to ask your insurance company are:

Does my plan cover visits to out-of-network providers?

Does my desired out-of-network provider need to register with you?

Are occupational therapy services included in my coverage?

What ICD-10 codes are accepted for my diagnosis?

Do I need pre-authorization from a physician for occupational therapy?

What is the coverage amount for each occupational therapy session?

How does my deductible apply to out-of-network services on the superbill?

Does my health insurance plan cover a certain number of therapy sessions? or timeline?

What forms do I need to submit when filing a claim?

Do I need to submit SOAP (therapy notes) for reimbursement purposes?

What is the typical timeframe for processing and reimbursing claims based on submitted superbills?

What can I expect after submitting a superbill?