Therapy
What are the updated policies due to COVID-19?
When should I start therapy with my child?
Can I bring my other children to the first visit or evaluation?
It is preferred that your child attend the first appointment/evaluation at the clinic without siblings present. We will need your undivided attention as we gather developmental history and get a clear picture of your child and your concerns for therapy.
I have a referral for an evaluation from my daughter’s doctor. Does my insurance cover this type of visit?
What does a therapist do during the evaluation?
The pediatric therapist will review the reported medical history, concerns, and doctor referral with the parent and decide what type of testing and measurements can be helpful to determine an appropriate treatment plan. Standardized testing is a way to provide an assessment of your child’s level of functioning in terms of age and relation to other children of the same age. Testing and measurements for children often incorporate play and parental help. Depending on your child’s age and ability to follow directions and demonstrations, additional skills and functions will also be assessed. The evaluation write-up will include test results, scores, a summary, recommendations, treatment goals, and an anticipated frequency of treatment. A copy of the report will be available to you typically 3 weeks after the date of the evaluation.
What happens during therapy at aMAYZing Kids?
When should my child start therapy?
How long is a typical therapy session?
Will I have to do anything at home, or will the therapy appointment be enough to help my child catch up?
What ages do you treat?
My child goes to school. Is it possible for me to get an after-school appointment?
My daughter is going to get physical therapy at school. Does this mean that I can stop outpatient therapy?
Billing
What types of commercial insurance do you take?
We have 2 different insurances and you take both. Can we choose to use only the one we want?
Unfortunately not. If you want to utilize insurance, then whichever plan is considered primary will be your main coverage. Note: if you have Medi-Cal coverage from California for your child, we can only use that coverage if the Medi-Cal is through Monarch Healthcare HMO. Please call our office for assistance with insurance questions.
I am enrolled in a local HMO medical group. Can I use my insurance for my child at aMAYZing Kids?
If you’re a non-profit clinic, why am I charged with a co-payment?
I have coverage, but it’s limited to “medical necessity.” What does that mean?
Medical necessity means that the services provided must be reasonable and appropriate based on current clinical knowledge and accepted practices. Insurance will review the diagnosis provided by your doctor and will then decide to cover payment of therapy services, typically for short-term needs, due to illness or injury, or as long as significant progress is being made. In other words, the insurance company will want to know that the therapy we give your child is in line with what is accepted in the medical community. Difficulties may arise when medical necessity guidelines are designed around adult needs, rather than pediatric needs. We will know more about your financial responsibility when the first insurance claim has been processed. While there is never a guarantee that your insurance company will cover the visits, our educated staff of therapists and billing department work closely with insurance payers to meet the requirements showing medical necessity for your child’s therapy. If your coverage is denied for reasons of medical necessity, we cannot continue to bill your insurance for those services.