Frequently Asked Questions

What forms of insurance do you accept?

 

All Care accepts all types of insurance as form of payment, but we are currently “in-network” with the following companies:

 

Aetna

BCBS

Cigna

Humana

Tricare

United (Optum)

Multiplan

Scott and White

 

Medicare/Medicaid Plans:

Traditional Medicare

Traditional Medicaid

Amerigroup

BCBS Medicaid

Sendero

Scott & White Right Care

Superior

 

In some cases, we are not considered "in network". This means that while we will still submit claims to your insurance company, your benefits will be “out of network”. If this is the case, you may be subject to a higher deductible and are responsible for a greater percentage of the total therapy charges.

 

 

Is Therapy a part of my Insurance Benefits?

 

While many health insurance plans do provide benefits for Occupational, Physical, and Speech Therapy, there may be limitations for this coverage. These limitations may be related to the patient's age, diagnosis, or for the number of therapy visits a patient may receive per year. Your insurance benefits will be discussed with you in detail before your first visit to our clinic to check the types of therapy services for which your insurance provides benefits.

 

Please note that while your insurance may provide benefits for therapy, there is no guarantee that they will cover the cost of therapy. Your loved one's diagnosis and plan of care are unique, so never assume that having benefits will mean payment for services rendered. Please remember that you are ultimately responsible for any services not paid for by your insurance company.

 

We will submit claims to your insurance company on your behalf and upon receiving any denial for therapy, we will appeal, submit documentation, and make every effort to allow for therapy coverage to continue.

 

 

Where can I find how much my insurance company is paying?

 

Your Explanation of Benefits (EOB) provides detailed information on what charges  your insurance company paid, what your co-payment/co-insurance was for that session, how much of each payment went towards the deductible, and more. Reading over this information when you receive it in the mail is a very helpful way to keep track of payments received for therapy services. If you have any questions regarding your EOB, we will do our best to help you. If it is possible, we will frequently contact the insurance company on your behalf if you have any additional concerns.

 

Is there anything I should do if I call the insurance company myself?

 

We highly recommend taking detailed notes any time you call your insurance company. Notes should include the date, the name of the representitive you spoke with, information that the representative provided, and the call number or service ticket, if one is provided. Not all insurance companies provide a call/ticket number, but those that do can pull up conversation notes with greater ease if you provide that number to them. This information can be helpful to us in filing our appeal in cases of denial.

Can I bring my children or other family members to therapy appointments?


We would prefer that patients attend their first appointment/evaluation at the clinic with the minimum amount of people present. For example, if your child is receiving therapy it would be beneficial if their siblings remain at home, or if you are the patient please only bring your spouse or a caregiver to accompany you on your first trip. We will need your undivided attention as we gather developmental and medical history and try to get a clear picture of you or your loved one's concerns for therapy. For regularly scheduled appointments, patients are more than welcome to bring additional people to accompany them such as siblings, children, spouses, parents, or skilled caregivers. There are toys and books in the lobby provided for young children, or items can be brought from home for entertainment while waiting. We do ask that parents/guardians keep watch of their children while they wait for their loved one to finish therapy. Please do not leave unattended children in the lobby.

Do I have to stay in the building during my loved one's session?

We request that parents remain in the building for the entire duration of their child’s therapy treatment. This is for your child’s protection and benefit, in case of medical emergency, assistance with personal needs (such as toileting or feeding), or in case a therapist needs to demonstrate an intervention technique. We request that family members/caregivers remain in the building during treatment when accompanying adult patients who are unable to independently address their own medical or personal needs. 

Is it possible for me to get an after/before school or work appointment for my child or myself?

 

We will always do our best to accommodate your schedule. Please keep in mind, though, that these spots are in high demand and fill up fast. If your child has to miss school time for therapy, or if you miss work due to your appointment or your loved one's appointment, we will provide school and work notes upon request so it is not counted against you or your loved one.

 

 

I've suspected for a long time that my loved one has a specific diagnosis and I want to help them. What would you suggest?

 

We would recommend starting with a general pediatrician or primary care physician visit. A diagnosis of any kind must come from a doctor. Ask to have their vision, hearing, diet, and general health examined to eliminate other possiblities. Share your concerns with your doctor. Sometimes, obtaining a diagnosis can require trips to specialists including developmental pediatricians, neurologists, psychologist, geneticist, etc. From there, you and/or your loved one and your doctor can discuss the appropriate course of treatment. 

 

Having a diagnosis is helpful and, more often than not, necessary for obtaining school special education services or for your medical insurance to provide or pay for treatment. It is not, however, necessary for treatment. We focus on a patient's individual needs, conditions, and deficits, which are present regardless of a formal diagnosis. This means that we are able to assist you and/or your loved one before and after a diagnosis is given.

 

Although receiving a diagnosis can sometimes be scary, it is never a life sentence! Our team has seen countless stories of individuals overcoming their diagnosis through treatment to achieve their most functionally independent life possible. We will be with you every step of the way during this sometimes daunting process.

Do I need a referral to start therapy?

 

A referral or a prescription is needed from the patient's primary doctor before regularly scheduled appointments can begin for most disciplines. Physical therapy can initiate treatment for up to 10 business days without a referral due to Direct Access in the state of Texas, however, some insurances still require a referral. We encourage you to contact our front office staff for more details on Direct Access if this is something you are interested in for physical therapy. Although a referral is required prior to initiation of treatment, you do not need a referral for an evaluation, with the exception of feeding therapy. You can, however, request that you or loved one be put on our waitlist without a referral. From there, our staff can help facilitate any referrals or prescriptions needed to help schedule an evaluation for you or your loved one as soon as possible. You will be contacted as soon as a referral comes in to schedule the first appointment.

 

Please be aware that while an evaluation can be completed without a referral, insurance companies may not pay for an evaluation without a referral. You will be required to pay for any charges that the insurance company does not cover. 

What Should I Do to Get Started With Therapy?

Whether you're seeking therapy with or without a referral, please contact our office at 512-256-7627. You are also welcome to come in person to our office, located at 4402 Williams Drive, Suite 115, in the 78628 area code of Georgetown. Our friendly office staff will do their best to answer all of your questions and determine what is needed for your first appointment, which is typically an evaluation, and help you schedule it. They will also discuss your insurance benefits with you prior to your first appointment, and assist in obtaining a referral, if one is needed. You will be asked to complete our New Client Information packet, which can be printed from our website or picked up in person.

 

What Does An Initial Evaluation Look Like?


We ask that you arrive 10 minutes before your or your loved one's scheduled appointment time for the initial evaluation and check in with our front desk. At this time, you should submit the patient's insurance card, any paperwork we asked to be filled out (such as Intake Paperwork), and the referral/prescription for therapy. This allows our front desk time to look over the paper work and assist in clarifying points or to ask for corrections.

 

The initial assessment varies depending on the patient's endurance, attention, participation, and number of disciplines (Speech, Physical, or Occupational Therapy) being requested. The general rule of thumb is 60 minutes per discipline requested. We request that parents or care givers remain present for the beginning of the evaluation in order to discuss current concerns with the patient’s development. Following this discussion, we will complete a variety of diagnostic testing, based on the patient's concerns, strengths and weaknesses. If the patient is your dependent and you would like to observe a portion of or all of your loved one's assessment, please just let us know. Patients are also allowed to invite spouses or loved ones if they feel more comfortable with another person present.                                  

 

However, while some patients feel a loved one presents is supportive, others are distracted  by having multiple people in the room while testing. If your loved one isn't performing up to what you feel is their best ability, we may ask you to leave the treatment room to see if that yields more accurate results.

 

Upon completion of the assessment, the therapist will discuss any areas of suspected delay about the patient with you, if doing so is appropriate, and make recommendations for therapy. On-going therapy sessions may be scheduled at this time, including length of session, time, and treatment days. We will do our best to accommodate your scheduling needs and to coordinate multiple disciplines if this is necessary. Our comprehensive assessment will be provided to the patient and/or to you if the patient is your dependent within one week of of the evaluation in order for the therapist to accurately score and report on all testing material. A plan of care and goals will be included in the evaluation report. We strongly encourage all parents, care givers, and patients to share with us personal goals you would like to see yourself or your loved one achieve as well so that these may be included in the evaluation report.

What Does a Regular Therapy Session Look Like?


Please arrive at least 10 minutes before your or your loved one's scheduled therapy session. This allows time before the session to make any payments, ask our friendly front desk staff any questions, take a restroom break, and do any tasks that are needed to prepare before your treatment time. While we have smocks and aprons available, and will try our best to keep your clothing or your loved one's clothing clean, we may sometimes recommend that patients dress in "play clothes", referring to clothing that is allowed to get a bit messy or sweaty. We will always try to give advanced notice if we have an activity planned that could stain clothes or make clothing too messy to wear back to school or work. Arriving early should give time for the patient to change into "play clothes" before the session if need be. For adults in physical therapy, we recommend wearing clothes comfortable to exercise and move around in. We also recommend wearing clothes that would allow you to easily expose the treatment area (i.e. shorts or loose pants than can be rolled up to expose a knee if you are being treated for knee, or tank top or loose sleeves if we are treating your shoulder). We also recommend wearing athletic or tennis shoes

When are my co-pays due?

Payments for therapy, including all co-pay’s, co-insurance, and deductibles will be collected before the start of each therapy session. Payments for therapy services that are not covered by your insurance company, or for individuals without health insurance coverage, will also need to be collected before the start of each therapy session..

 

How long is each session?

 

Therapy sessions are between 30 to 60 minutes in length, with the last 5-10 minutes set aside for patient/caregiver education and discussion of progress in therapy that day. The length of therapy will be discussed at the intial evaluation visit, and depends upon each individual patient's needs.

 

Can I observe my loved one's therapy session?

If the patient is your dependent, then yes you are welcome to observe part or all of a session any time you ask. At times, we may even request your presence at your loved one's session so that you can observe specific problem areas and to provide a better understanding of how to address behaviorial issues. However, it should be noted that often children participate at a greater level, and/or transition more easily between activities without their parent present.

 

If the patient is not your dependent, then we would recommend discussing with your loved one about whether or not they feel comfortable having another person in the treatment room with them. While you may wish to support your loved one, a patient has their right to privacy and may wish to attend treatment alone. These issues should be discussed with your loved one before treatment begins.

How long will my loved one or I need to attend therapy?


This question will be more easily answered once the patient's evaluation is complete. Every patient and diagnosis is unique, so there is no flat answer for this question. After a patient's intial evaluation is complete, a frequency and tentative time line will be established, along with a plan of care and goals to be achieved on both a short-term and long-term basis. We will periodically do additional testing and progress updates to assess how close a patient is to achieving their short term and long term goals, as well as to address any new concerns that may have arisen. Treatment, therefore, generally continues until all goals have been met, all concerns have been addressed, or age appropriate standardized test scores have been achieved.

 

Occasionally, a patient who has a long-term need with more severe deficits may need to “take a break” from therapy. They may experience frustration with their delays and overall difficulties with therapy activities, choose to take a little time off, and then resume therapy after a period of weeks/months. We also feel it is important to assess whether a patient is able to maintain their level of function and continue to progress without direct services after a period of time in therapy. A patient take a break for this reason as well. A break of this type may last for a month or longer, but can be shorter if a caregiver or the patient observes a decline in skills after a few weeks.

 

When Will Therapy Services End?

 

Therapy services are recommended to cease for different reasons, including when a patient has met all their goals, achieved age level skills, or is no longer benefiting from direct service. We encourage all patients and family members to be actively involved with all parts of the therapy process, including setting goals, establishing a plan of care, carrying out recommended home exercise program activities, and with discharge planning.

ADDRESS

4402 Williams Dr.

Suite #115

Georgetown, TX 78628

 

CONTACT

Tele: 512-256-7627 

Fax: 512-375-3291

E-mail: info@allcaretherapygt.com

 

HOURS

Mon-Fri: 8 am-6pm

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© 2020 by All Care Therapies of Georgetown