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Frequently Asked Questions

Does OT-Kids accept Insurance?

OT-Kids is not in-network with any insurance plans. We are a private pay facility. We do however have a Medical Biller on staff that provides support and assistance to our families that participate with certain insurance plans and have out of network benefits. The therapists at OT-Kids are committed to helping families afford therapy for their children and will provide any documentation that your insurance carrier may request to help you through the claims process. It is important to note that insurance coverage is NEVER promised. To better understand if your insurance plan will cover any portion of our intervention we strongly suggest calling your carrier prior to the first appointment and asking the following questions:

  • What are my out of network benefits for occupational/physical therapy?

  • What is my out of network deductible? How much has been met to date?

  • How many visits will be covered per year?

  • Is prior authorization required?

  • What percentage of the billed amount will my plan cover?                                                      

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What are your fees/rates?

Occupational and Physical Therapy sessions are either 60 min or 45 min in length.  Our current private pay rate for a 60 min session is $200 and a 45 min session is $150.  The out of pocket cost for each family is dependent upon the amount of insurance coverage and billed after your insurance pays their portion, however a families cost will never to exceed $200/hour. OT-Kids goal to keep intervention affordable for all who need it, therefore we offer a payment reduction application which is available to all families upon request. If you would like to complete a payment reduction application please contact Kristi.OTKids@gmail.com.

What is a Good Faith Estimate?

According to the No Surprise Act of 2020, all private pay/uninsured individuals have the right to receive a Good Faith Estimate that explains how much your medical services will cost. Under this law, ALL health care providers must provide the total expected cost and charges to ALL patients who are not using insurance for medical services (private payers) prior to the first appointment. If you receive a bill from a provider who gave you a Good Faith Estimate that is $400 more than the original estimate, you can dispute the bill. If you are charged more than your Good Faith Estimate and you would like to dispute a charge you have the right to contact the U.S. Department of Health and Human Services (HHS). You must start the dispute process within 120 calendar days of the date of the original bill in dispute. Please note that the HHS may charge you a fee to initiate the dispute process. A copy of OT-Kids Fee structre/Good Fiath Estimate will be provided to you in your intake packet and can also be found in your patient portal on Fusion.  Should you have any further questions or want additional information about the No Surprise Act or Good Faith Estimates please visit www.cms.gov/nosurprisess or call HHS at (800) 985-3059.

Would My Child Benefit from OT or PT?

The best way to determine if your child would benefit from OT or PT interventnion is to set up and appointment for a screen or evaluation, but some questions you might want to ask yourself first are:

  • Did my child miss any of their infant developmental milestones (rolling, crawling, cruising)

  • Does my child appear to seem over or under responsive to sensory input (sound, touch, movement, smells or taste)

  • Does my child have difficulty keeping up with their peers physically or socaily

  • Does my child often miss auditory information or appear lost or spaced out during school or other activities that require focus and listening

  • Does my child get easily overstimulated in less structured environments (recess, sports games, birthday parties)

  • Does my child have extreme difficulty handling changes in routine or schedules 

  • Does my child trip/fall often or do they seem more clumsy then their peers

  • Does my child struggle at school academically/socially 

  • Does my child appear to have poor endurance, balance, coordination

  • Is my child struggling behaviorally in school (hitting, difficulty attending, playing too rough with peers, frequently getting in trouble)​​​

What is sensory processing?

In short, sensory processing is a persons ability to take information from the environment and their ability to respond to it.  Difficulty processing sensory input may impact a persons ability to respond appropriately or effectively to one or more types of sensory information. As occupational therapists we focus on the five common senses that we learn about when we are children (touch, taste, hearing, sight and smell) but the foundation of all sensory processing stems from two other sensory systems in the body that you may not be familiar with.  The proprioceptive system (located in our muscles and joints and is responsible for giving us a sense of body awareness and lets us control our use of force and pressure) and the vestibular system (located in the inner ear, and is responsible for our ability to process movement, spatial orientation and head position as well as balance)

When a person is not able to process information (input) to one or more of these seven systems effectively, then they may have sensory processing difficulties. Here are a few red flags of what a sensory processing difficulties may look like in a child.  

  • Cover his/her ears when presented with auditory input that does not seem to bother others (vacuum cleaner, sirens, babies crying, fans or other low frequency background noises)

  • Appear clumsy or trip and fall more often then their same aged peers

  • Avoid certain textures in clothing or food, or avoids messy play or getting hands dirty

  • Appear to have less energy or too much energy as compared to peers

  • Seeks or avoids certain movements (spinning, inversion, constant linear motion)

  • Play too rough, too loud, too fast

  • Appear to over or under react to sounds, touch, sights or movement 

  • Have difficulty forming and maintaining relationships with peers

  • Avoid or crave certain types of food based on texture, taste or temperature​

These are just a few examples, sensory processing difficulties can present in many other ways!​​​​​​

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How do I get started?

Give us a call today! We will conduct an intake phone call during which we will gather some information from you and tell you a little bit more about us and the services that we offer. During that conversation we will schedule an evaluation or your first appointment! 

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