1. Does my insurance plan cover Occupational Therapy?
    
2. Do I have to get a letter from a licensed medical provider (Physician or Physician’s Assistant) to state this is medically necessary?
    
3. Do I need to send the letter from the medical provider before seeing the Occupational Therapy provider OR can it be submitted with the first bill?
    
4. Is a diagnostic code required for reimbursement?
    
5. What is the reimbursement scale for Occupational Therapy?
    
6. What is the deductible on the plan? $__________ (amount)
    
7. Is there any deductible left to meet this year?
   $__________ (amount)
    
8. What is my co-payment per visit? $__________ (amount)
    
9. Is there a limit on the total amount that can be paid out each year? $__________ (amount)
    
10. Is an Occupational Therapy Evaluation covered by my insurance? $__________(amount)
     
11. How many Occupational Therapy sessions will be covered by insurance in total per year?     $__________(amount)
     
12. Does my coverage extend to the services of a non-network provider?
     
13. What is the maximum covered cost per Occupational Therapy session?    $__________(amount)
     
14. What is the Co-payment per Occupational Therapy session?  
    $__________(amount)
     
15. Must we be referred for Occupational Therapy by a medical doctor or is an OTR sufficient?
     
16. If we are already in Occupational Therapy with another provider, what is my remaining coverage for Occupational Therapy this year? $__________(amount)
     
17. Does my insurance cover the following codes:
    • 315.4    coordination disorder
    • 728.9    disorder of muscle ligament/muscle hypotonicity
    • 781.3    motor incoordination
    • 781.92  abnormal posture

Copyright 2004/2005 by The Creative Group, San Jose, CA for Simoneon Pediatric Development Center, San Jose, CA
All rights reserved.  Last updated on: 08/24/05 03:25 PM.