What to Expect From Us
Step 1: Complete the Allied Health Intake Form and Schedule an Evaluation.
The AH intake form provides a detailed account of important developmental milestones which will give the evaluator an idea of the concerns that need to be addressed during the evaluation. The evaluation is about an hour long. A parent will need to be present for the clinical interview, and to complete any evaluation forms. If you child has an IEP or 504 plan, we will need it during this session. Availability for these sessions can depend on seasonality, but we can typically schedule within two weeks of the Intake Form being received. For most insurance companies, the evaluation is a billable service every 6 months.
Step 2: Evaluation Complete, Plan of Care Created, Qualification for Services.
Once the appointment has been completed, the evaluator then scores all materials and creates a write up of the Evaluation. If the patient qualifies for services, a Plan of Care (POC) is created by the evaluator. This POC outlines recommended treatment goals and a recommended frequency of treatment. At our practice, the average frequency of treatment for Occupational Therapy is 1 hour per week. Intensive programs average at two 1 hour sessions a week. This frequency is subject to insurance approval. The average timeframe for a Plan of Care is around 6 months.
Step 3: Primary Care Physician Approval, Insurance Authorization.
We send the completed Evaluation and Plan of Care to your Primary Care Physician (PCP) for their review, their signature on our Plan of Care, and a prescription for the service. More often than not, insurance authorization is required for this service. We send the reviewed Evaluation, and Plan of Care to your insurance company for prior authorization. If your child has an IEP or 504 plan, we will need to send that as well. This step in the process can take up to 2 weeks depending on your Primary Care Physician and insurance company.
Step 4: Insurance Approval and Scheduling Reoccurring Therapies.
Once we receive the insurance authorization, a member of our team will reach out to update you on the outcomes of the request for services, frequency recommended and expected out of pocket charges for each session. Insurance authorizations are subject to any requirement the insurance company deems necessary.
Frequently Asked Questions
When do I receive a copy of the evaluation report and plan of care?
A final copy of the evaluation and plan of care with goals will be provided to the client during their first therapy session. If you would like this information sooner, please let us know!
Will the evaluator be the ongoing Therapist?
We do our best to coordinate schedules with any other services you may receive at our practice. As a result, the client’s evaluator may not be the client’s ongoing therapist. You will be notified of this during scheduling. Please let us know of any preference while we are scheduling!