Frequently Asked Questions about Therapy Evaluations and Treatment
My child was recommended to have a therapy evaluation by his/her pediatrician. Now what?
Contact Pediatrics Plus and tell us that you need to make a referral for your child to receive therapy. We will take in all pertinent information for your child and then contact your pediatrician’s office for a prescription for the evaluation if you do not have one. We will verify your funding source for eligibility and coverage of therapy evaluations. If you have TEFRA, AR Medicaid, SSI or AR Kids A, therapy evaluations are covered. If your funding is through AR Kids B, insurance, or Early Intervention, a representative from the Pediatrics Plus team will contact you to explain your benefits and provide additional funding options for you if needed. When we have received the prescription and approved funding, the referral manager or a therapist will then contact you to schedule the evaluation.
Why do you contact my insurance company to verify benefits?
Pediatrics Plus is committed to providing the best care for all families, and this includes being sure that your family is not put under financial stress due to receiving therapy for your child. We want all families to be aware of any out-of-pocket costs that may occur before services are rendered. We will do everything possible to provide additional funding options for you if your insurance company does not cover the therapy that your child needs.
My child qualifies for therapy. Now what?
After your therapist performs the evaluation, they have one week to turn the report into our administration office. If your child qualifies for therapy, we will send a copy of the report to you in the mail, as well as to your pediatrician for a prescription for treatment. If you have TEFRA, AR Medicaid, SSI or AR Kids A, recommended therapy sessions are covered. If your child has insurance or Early Intervention, we will then go through the steps to ensure proper funding for therapy services. This may mean several phone calls between you and our office; please remember that the prompt return of calls will ensure that your child’s services are started as soon as possible. After we have approved funding and received a new prescription for treatment, a therapist will contact you to set up the therapy sessions. Please note that the therapist who performed your child’s evaluation may or may not be the same therapist that will provide treatment.
My child qualified for therapy, and it has not started yet. What do I do?
Sometimes it can take up to 3-4 weeks after your child has been evaluated for therapy sessions to begin. The best way to keep this process moving is to stay in contact with our office. We are always happy to address any concerns or answer any questions that you may have.
How often will my child receive therapy?
The amount of therapy that your child will receive is based on your child’s specific needs that are determined by the evaluating therapist. The therapist will include recommendations for therapy in your child’s report; this report will also include specific goals that your child will be working towards during therapy sessions.
My child did not qualify for therapy but was recommended to be re-evaluated. What do I do?
If a child does not qualify for therapy services at the time of the initial evaluation, the therapist may recommend the child return in 3-9 months to be re-evaluated. If your child receives these recommendations and your pediatrician is in agreement, we will contact you at the recommended re-evaluation date to see if you feel that the re-evaluation is necessary. In order for us to perform the re-evaluation, we will have to request a new prescription from your pediatrician’s office. However, if at any time you feel that your child needs to be re-evaluated, please contact our office and we will be happy to assist you.