Do you provide in home therapy?
Yes, we do, depending on location and therapist availability. It is not guaranteed, but we try our best to accommodate the needs of our clients.
EPSDT & Private Insurance – do you accept these and how does it work?
We do have the ability to bill for EPSDT services through some of our providers. We are also able to bill private insurance companies, as an out-of-network provider. We are required to bill private insurances first (if you have it). If you do not have private insurance, we can proceed through EPSDT.
Please see below for details on how to get therapy going through EPSDT with us.
Steps to get therapy going through EPSDT & Private Insurance :
1 – If you have private insurance, call your insurance carrier to find out if your insurance policy will pay for IN HOME therapy with an out-of-network provider. Write down the date, what they said, who you talked to, and sign and date the note (e.g., per Stephanie at Humana, our policy will not cover in home physical therapy, sign and date, listing your name and client/child’s name).
(The order has to be written by a full MD (not ARNP) and cannot be stamped – it has to have an actual signature.)
4 – Once we get an opening, the doctor’s order from you, and the information we need from the case manager, we will process and send for approval from Medicaid.
5 – After we receive a PA (prior authorization) from Medicaid (you will receive a copy too – often before we do), a therapist will contact you to schedule a date, time, and place to complete the evaluation. Please feel free to contact us (and send us the PA!) if you receive a PA in the mail before we contact you!
6 – After the evaluation is completed, you will need to get ongoing therapy orders from your doctor. The therapist will give you information on what exactly that needs to say (e.g., ongoing PT for 1 visit per week for 6 months).
7 – After we receive the ongoing orders from you, we will process and send for ongoing therapy approval from Medicaid. Once we receive the PA (prior authorization) from Medicaid for ongoing therapy, the therapist will contact you to schedule the ongoing date & time of appointment.
Please let your therapist or us know if you have any questions during this process!!
If you are interested in therapy services
for yourself or a loved one,
please fill out the form below and
fax or email it to info@PIChealth.com
Yes, we do, depending on location and therapist availability. It is not guaranteed, but we try our best to accommodate the needs of our clients.
EPSDT & Private Insurance – do you accept these and how does it work?
We do have the ability to bill for EPSDT services through some of our providers. We are also able to bill private insurance companies, as an out-of-network provider. We are required to bill private insurances first (if you have it). If you do not have private insurance, we can proceed through EPSDT.
Please see below for details on how to get therapy going through EPSDT with us.
Steps to get therapy going through EPSDT & Private Insurance :
1 – If you have private insurance, call your insurance carrier to find out if your insurance policy will pay for IN HOME therapy with an out-of-network provider. Write down the date, what they said, who you talked to, and sign and date the note (e.g., per Stephanie at Humana, our policy will not cover in home physical therapy, sign and date, listing your name and client/child’s name).
- If you do NOT have private insurance, we will ask you to provide this to us in writing. We will send you permission forms to fill out that will include this document.
- If your private insurance will NOT pay for therapy, we DO have the capability to proceed with service, once we get an opening.
- If your private insurance WILL pay for therapy, we will proceed with service, once we get an opening. If you have EPSDT, we will bill that after private insurance has been exhausted. If you do not have EPSDT, you may be responsible for charges that the private insurance denies.
(The order has to be written by a full MD (not ARNP) and cannot be stamped – it has to have an actual signature.)
4 – Once we get an opening, the doctor’s order from you, and the information we need from the case manager, we will process and send for approval from Medicaid.
5 – After we receive a PA (prior authorization) from Medicaid (you will receive a copy too – often before we do), a therapist will contact you to schedule a date, time, and place to complete the evaluation. Please feel free to contact us (and send us the PA!) if you receive a PA in the mail before we contact you!
6 – After the evaluation is completed, you will need to get ongoing therapy orders from your doctor. The therapist will give you information on what exactly that needs to say (e.g., ongoing PT for 1 visit per week for 6 months).
7 – After we receive the ongoing orders from you, we will process and send for ongoing therapy approval from Medicaid. Once we receive the PA (prior authorization) from Medicaid for ongoing therapy, the therapist will contact you to schedule the ongoing date & time of appointment.
Please let your therapist or us know if you have any questions during this process!!
If you are interested in therapy services
for yourself or a loved one,
please fill out the form below and
fax or email it to info@PIChealth.com
