Insurance billing:

Currently, we accept Blue Shield of California, Midcoast Care, Tricare (military families) and are working to add others.  This list may change at any time so please call us to verify we still accept your insurance plan.

Prior to the first evaluation session, please contact your insurance company and ask , at a minimum, these two questions:

1. Under what circumstances do you cover Occupational Therapy (OT) services i.e., what are the allowable diagnostic codes?

2. What CPT codes for OT services are covered? 

Answers to the above questions allow us to ensure that we only provide services that are covered by your insurance plan.  You may still elect treatment for a "non-covered" service and pay for it yourself.

Many insurance plans cover occupational therapy only when it is determined to be "medically necessary."  Only your doctor can make that determination and some insurance plans such as HMOs may require independent verification of this prerequisite before authorizing treatment. 

Most insurance companies in California require a doctor's prescription before they will pay for services so it's important that you have this in hand BEFORE your first appointment.

Out of Network Provider:

If we are not currently listed with your insurance plan, your insurance company may still authorize treatment with us under its "out of network provider" clause.  Blue Cross is a good example of an insurance company where we've had a lot of success doing this. 

Review your insurance agreement or call your insurance company to see if this is an option for you.  Your insurance plan may require additional documentation or verification from you.  Getting this authorization can take as little as a single day or up to several weeks so it's important that you don't delay if you choose to pursue this option.

Insurance Reimbursement:

If you choose to take the "pay first, get reimburse later" route, it's important that you know all the requirements, limitations, and conditions described in your insurance agreement BEFORE you start treatment. We can provide the necessary documentation, but only if you tell us the requirements of your insurance plan.  We're not responsible if you haven't fulfilled the reimbursement requirements of your insurance plan.

You'll be glad to know that some of our previous clients have reported up to 80 percent reimbursements when they've submitted their claim to their insurance company (your insurance company may reimburse differently).  The cash discount mentioned below applies if you chose this option.

Cash Payment:

We offer a substantial discount for cash payment since we don't have to deal with the hassle of insurance company rejections, re-submittals, and the tedious work of insurance claims processing.

Just let us know what option works best for you.