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 EPSDT AND private insurance, call your private 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).
2 – Contact us to be placed on the waiting list. Please let us know who your case manager is! We will need information from him or her.
3 – AFTER we contact you or your case manager with an opening:
4 – Once we get an opening, the consent forms, doctor’s order, 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, we will need to get ongoing therapy orders from your doctor.
7 – After we receive the ongoing orders, 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 EPSDT AND private insurance, call your private 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 have EPSDT and do NOT have private insurance, we will ask you to provide this to us in writing. We will send you consent forms to fill out that will include this document.
- If your private insurance will NOT pay for therapy, but you have EPSDT, we DO have the capability to proceed with service through EPSDT, 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 does not cover.
- If you have private insurance ONLY - call your private insurance carrier to find out if your insurance policy will pay for IN HOME therapy with an out-of-network provider.
- We also offer self-pay options that might be reimbursable by your private insurance.
2 – Contact us to be placed on the waiting list. Please let us know who your case manager is! We will need information from him or her.
3 – AFTER we contact you or your case manager with an opening:
- we will send you consent forms for therapy
- we will need an order from your doctor for an ST, OT, or PT evaluation
4 – Once we get an opening, the consent forms, doctor’s order, 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, we will need to get ongoing therapy orders from your doctor.
7 – After we receive the ongoing orders, 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
CONTACT US VIA:
Telephone: 502-550-2525
Toll-Free Fax: 1-877-212-2525
Toll-Free Fax: 1-800-525-7900
Mail: Please contact us to obtain a mailing address.
Email: info@PIChealth.com
OR via the comment form below.
