Kids Abilities accepts most insurance plans. We are currently considered ‘out of network’ with the Medica plans.
Many Insurance plans will cover speech, occupational and physical therapies. The amount of coverage you will receive is dependent upon each individual plan. If an insurance plan is deemed “out of network” you may be subject to a higher deductible, copay and/or coinsurance.
Your insurance benefits for therapy services will be verified before your first visit to Kids Abilities. We will inform you of any costs related to the therapy services that will be your responsibility. Please be aware that often the cost information that we receive from your insurance company is an estimate and may actually be more or less than the estimate.
Please remember that you are ultimately responsible for any services not paid by your insurance company; therefore, you should call your insurance company to verify your benefits as well. You will receive more specific information regarding your plan since you are the policy holder. Reading your policy will also define your individual benefits regarding therapy services.
Insurance companies will often put restrictions on how your benefits can be used. These restrictions could apply to your child’s diagnosis, type of treatment and/or the number of therapy sessions that they will cover.
Kids Abilities will submit all claims to your insurance company and work with them to maintain coverage for your child’s therapies. We are happy to go the extra mile and make every effort to advocate for you and your child to get the benefits that you and your child need from your insurance company.
You should receive information directly from your insurance company regarding your coverage of therapies. Please read over any Explanation of Benefits (EOB) letters when you receive them in the mail. These letters will provide you with detailed information on what charges your insurance company has paid, what your co-payment/co-insurance was for that session, how much of their payment and yours went towards the deductible, etc. If you have any questions regarding your EOB, we will do our best to help you, and will frequently contact the insurance company on your behalf for any additional concerns.
Additionally, if your insurance company requires a referral from your primary physician for therapy services, NOT a doctor’s prescription for PT, OT or Speech services, It is not only your responsibility to acquire this referral, it is part of your contractual agreement with your insurance company to do so. While our billing specialists are willing to give you direction, they are unable to directly obtain a referral. If referrals are not received, insurance may not cover services and the patient will be financially responsible for the billed services.
If you have any questions or concerns you are always welcome to call us and we will work with you and your insurance company to resolve any issues that arise.