Westfall OT Services Insurance Reimbursement Page

I do not submit invoices directly to medical insurance companies, nor do I accept payment from them. If you wish to submit invoices for insurance reimbursement, the insurance charge codes for treatment will be included if advance notice is provided. This information must be included on the invoice if you plan to submit it for reimbursement.

Insurance issues:

If a family wishes to attempt reimbursement from medical insurance on their own, the proper information may be included on the invoices if requested in advance. The pediatrician must provide a written prescription including diagnostic insurance code, level of service, frequency, and duration of treatment being requested.

Parents are advised to contact their medical insurance company to ask for the following information:

· Do they cover OT services for children?

· What pediatric diagnoses are accepted for OT services?

· What insurance CPT codes are accepted for reimbursement?

· Do they reimburse for evaluations?

· Do they reimburse for “out of network” providers?

· What amount or percentage of the service fee will they cover?

· Is there a predetermined number or limit to the number of treatment sessions that they will cover?

· What information do they require from the physician and the OT for authorization of reimbursement?

· What paperwork or forms do they require, and when do they want them?

It is also strongly recommended that the parents attempt to get the name and phone number of one representative at the insurance company to serve as the main contact person. This reduces the need to repeat information multiple times and improves your chances of receiving consistent information.

WestfallOT@pacbell.net

(925) 443-6383

220 Wright Brothers Ave., Suite B, Livermore, CA 94551