Today let’s talk about the importance of consistency and compliance with the treatment plan that’s given to you after your evaluation. Did you know that this is not only important from a clinical aspect, but also from an administrative aspect? That may seem silly. Why would you need to be compliant from an administrative standpoint?
How We Develop a Treatment Plan
When we do an evaluation we do a series of standardized tests and determine what the patient’s needs are. At that time the therapist will determine what the treatment plan is. The treatment plan is also based on consistency because there are goals that have to be met before moving to the next goal. This is nothing new—you’ve heard all this before.
What To Know About Your Insurance
From an administrative standpoint, your insurance will typically approve a certain number of visits in a year. Some insurance plans will let you have unlimited visits or will approve more visits as a medical necessity. Your evaluation is your letter of medical necessity. We can submit that to your insurance company, they can read everything the therapist has done, and determine that there is a medical necessity to continue. Plus, they can see the goals and how we intend to meet those goals. And of course, the therapist has in mind what the treatment plan is, and how many times a week it’s been suggested that the child come in for therapy, and that’s how the goals will be met.
Importance of Consistency
If your child misses sessions or doesn’t makeup appointments, we are then out of compliance and out of consistency. At that point, the insurance company can come back and say that your therapy is not meeting goals. If you request a certain amount of therapy visits from the insurance company and you are not being seen that number of visits, they can decide to not approve the therapy services. This can leave you in the pretty crummy position of being stuck with the bill.
Why We Offer a Flexible Model
We strive for not only the best clinical care but for your experience, as well as your child’s to be exceptional. We want to be sure that we are helping you get the best out of your insurance benefit. This is one of the reasons we offer the flexibility model. Your child will be very familiar with all the therapists that we have at our clinic. If your child’s regular therapist is not available for a rescheduled appointment, they can see anyone in the clinic and be familiar and comfortable with them, so the transition is not so difficult. This also keeps them in compliance with their treatment plan.
Our goal is to give you the best service in the industry. We live by our philosophy that we treat the family, not the patient. the We’re so glad you choose Cutting Edge for your child’s treatment needs!
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