Frequently Asked Questions
Your family is our number one priority here at Cutting Edge Pediatric & Adult Therapy. Below are answers to some frequently asked questions that we hope are helpful. If you have any additional questions, please do not hesitate to contact us.
How do I know if my child needs therapy services?
- Developmental Checklist – This will be a series of questions that target milestones for ages 1-6 that address fine/gross motor skills, speech and sensory concerns. At the end it will let you know if your child is on target for their age, if you need to check back in a few months, or if seeking services is recommended.
- Screenings – Screenings are a brief overview to help determine if your child needs a full assessment. If you have concerns, please let us know on your screening form, so that our therapist can look at those areas while screening.
- Evaluation – An evaluation is a formal comprehensive assessment to determine your child’s needs. Evaluations provide in-depth details regarding areas of concern and development, along with recommendations to help your child prepare for the future.
If your child has previously been in therapy services then typically a screening will not be warranted, we would recommend scheduling the evaluation. Don’t forget to consult with your doctor, so that we may coordinate care if therapy is recommended.
Do I need a referral from our doctor?
Some insurances may require a referral for an evaluation, or even an authorization to proceed with treatment. Our administrative staff will keep you updated upon checking benefits. For OT/PT services, we must have a prescription on file.
What if my child isn't feeling well?
Our priority is your child, our families, our staff, and everyone who passes in and out of our building. Please review our wellness policy so that you can best determine your course of action. Please leave us a message if it’s after hours to avoid a late cancel or no show fee.
Do I have to stay & wait while my child is in treatment?
During an initial evaluation, we ask that you stay close by. During treatment sessions, you can either wait in our lobby or step out for a moment! We ask that you return to the clinic 7-10 minutes before your child’s appointment ends, so our clinician can review their session with you.
Can I let my therapist know when I need to reschedule a session?
Our clinicians often see kids back-to-back and do not have the ability to make any schedule changes. Anything schedule-related goes through our administrative staff. If you are unable to stop by the front desk, you can reach them by calling, texting, or emailing them. If it is outside our business hours (Monday through Friday 9:00am-6:00pm & Saturday 8:00am-1:00pm) please be sure to leave them a message, and they will get back to you as soon as they can. Our administrative staff will get your child’s appointment rescheduled. Please keep in mind our Flexibility Model — all our therapists work together to provide the best outcome for your child.
What is the difference between therapy in the school setting and therapy in a clinic setting? Does my child need both?
Eligibility criteria in the school setting are based on federal guidelines and also take into account whether an educational need for therapy services is present. In many cases, moderate to severe delays and disorders justify a need for school services, but mild delays and disorders without educational impact do not. Some individuals may not need therapy in the school setting but may still need support in other settings, in which case they might benefit from private therapy through the medical model. Some individuals demonstrate a need for both and benefit from receiving services in both settings. In the educational model, the evaluating and treating clinician works closely with teachers, educational staff and caregivers to create and target goals through an educational lens to support academic performance. In medical settings, the evaluating and treating clinician will be writing a treatment plan based off of needs across home and community environments, with parent input.
What if I already had an evaluation done elsewhere?
We can review outside evaluations that are based on the medical model to see if services are transferrable. A few things to consider would be the date of the evaluation and if the certification dates are still active, the time frame in which the last visit took place with the previous company, if an authorization is in place with another company, if goals are written, or if upon checking benefits insurance recommends that we do our own evaluation.
Do you diagnose Autism?
No, our therapists licenses do not allow them to diagnose for Autism. We recommend that you consult a developmental pediatrician.
What does insurance cover?
There are a wide variety of policies available for each insurance provider. Some good questions to ask your insurance provider are:
- What are my deductible, out-of-pocket, coinsurance and co-pay amounts that apply?
- Do I have a visit limit for therapy services?
- If my child has an autism diagnosis, does my plan follow the autism mandate?
- Do I need a referral or an authorization?
- Are there any diagnosis exclusions that I should be aware of?
We also recommend that when you speak to a representative you write down their name, the date you spoke to them, and ask them for a reference number. We do the same when we call. Should there be conflicting information, they have the capability to review the call.
My spouse and I both have medical insurance. Can we choose which one you use?
No, but if your child is covered on more than one plan the “Birthday Rule” will take effect, it can also help determine which one is primary & which one is secondary. The Birthday Rule states that primary coverage comes from the plan of the parent whose birthday, month & day, comes first in the year. The other parent’s health plan then provides secondary coverage. The birthday rule is part of a longstanding model act from the National Association of Insurance Commissioners, it has been adopted as a uniform, unbiased means of determining primary & secondary coverage.
If your child is on more than one insurance policy, please let the front desk know which one is primary or secondary. You would need to do a coordination of benefits with your insurance carriers by notifying them of additional coverage. Insurance follows specific rules when it comes to multiple policies that provide coverage. This also includes any Medicaid policy where the child may be the policy holder. If a coordination of benefits is not done or we are not aware of additional insurances, this could result in claim denials. It is imperative you inform us of multiple policies, primary and secondary coverage, & any policy changes as they happen to avoid any balances due to non-payment from insurance.
How does the initial evaluation process work?
Our five-step process makes it easy to get your child started with our therapies:
- Contact us: Your doctor can call us, or you can request care through our online form.
- Received a signed referral: Before proceeding, we will need a signed referral from your doctor.
- Provided evaluation: A personalized evaluation for your child will determine whether they can benefit from our services.
- Wait for insurance approval: We will send your final paperwork to your insurance company and wait for approval, if needed, before starting therapy sessions.
- Begin therapy: Your child can now begin sessions in their therapy program.
What ages do you see?
We evaluate and treat clients who primarily range in age from birth to 30 years. Our adult clients are often neurodivergent and/or have a developmental disability.
What are co-treatments, and how do they benefit my child?
Co-treatment occurs when two therapies are provided at the same time. This would be recommended based on your individual child’s needs and goals, if appropriate for your child. Co-treatment allows the therapists to work together on goals and brainstorm strategies together in the moment that will best serve the client. This does minimize your child’s overall time in treatment, but it maximizes the benefits of treatment and allows us to collaborate in real-time, often leading to better treatment outcomes.