Click on the question below to show the answer:
Do you take insurance?
Yes we are in-network with several PPO plans and we have a contract with Kaiser.
What if we are out of network?
If you are out of network you have a few options.
First you need to find out what the out of network benefits are with your plan. You can ask if your plan will do a network deficiency exception or clinical gap exception where they will apply your visits with us to your in-network benefits.
This does not mean you are in-network but rather your insurance will apply your out-of-pocket costs and deductibles to your in-network totals rather than your out of network. For all out of network plans we offer two options. One is to pay our cash pay rate and we provide you with a superbill at the end of the month to submit to your insurance.
The second is that you will pay our insurance rate and we will submit for you. If you have out-of-network benefits for therapy and/or you are using an exception as mentioned above, the insurance company generally reimburses you for the visit.
If they send the money to us, we work with you to apply it as credit to your account or send it to you.
What if I have an HMO?
We have had several HMO’s willing to create one time contracts with us. This happens by having your primary care doctor submit a referral for the service.
You can request to be referred to us and then we can work with the contracting company to set up a contract for services.
What forms will we need to fill out?
We have several intake forms for you to fill out and we ask that it is returned prior to the evaluation to allow your therapist to best prepare for your child.
- Intake
- Past Medical History
- Authorization for Information Release
- Canadian Occupational Performance Measure
Please check out this video for an explanation!
Do I need a referral to come to therapy?
This will depend on your individual insurance plan. If you have a PPO you generally do not need a referral. If you have an HMO then yes you will need a referral.
In the state of California we are allowed to see kids for physical therapy for 45 days or 12 visits without anything from the doctor. If you are coming to us to see if your child may need therapy we will then send the report to the doctor and ask for a script or a diagnosis.
If your child has already seen their doctor for either their underlying condition that they are coming to physical therapy for, or you have old reports from a doctor, that is sufficient. This is why we will often ask for an MD diagnosis.
How long are appointments?
Initial evaluations are generally 1 hour long. After that the therapist will make a recommendation based on what they think your child can tolerate and what will be most beneficial for making gains.
How long will my child need to come to therapy?
This can vary from child to child.
After the evaluation the therapist will work with you to develop a plan of care. This is how long each session will be, how often you will have a session, and any other recommendations they might make.
While the therapist may have a recommendation based on what they think your child will do best with, we talk with you as a family to determine if this is doable for you. We know that life is busy and your family may have multiple obligations which can impact time and finances.
This is why the plan of care is based on the therapist’s recommendations and the family and child’s needs. We base our decisions on the current research as well as experience. Often times we will recommend decreasing therapy to less frequently.
This is because your child is doing well and our goal is to continue to make sure they stay on track without as much help from PT.
Also because growth spurts can impact their function and they may need a little extra help. As much as we love to see our kids and families we don’t recommend you keep checking in just so we can see you, there is a purpose!
My child is doing so much better now, should I cancel any future visits?
This goes along with the question above about how long your child will need to come to therapy.
We recommend if you are feeling like your child has met the goals that are important to you that you talk to your therapist about this. This way you are having a team discussion about what is best for your child and your family.
They may recommend a few follow up appointments spread out over several months to ensure that your child’s progress doesn’t slow down and to make sure they aren’t impacted by growth spurts, as well as to update their home exercise program.
They may also agree that they are doing well and recommend just doing a discharge visit so they can document progress and provide you with a home exercise program to support your child’s continued development.
The important thing is communication with your therapist! Also please see the question above about how long your child will need therapy for.
What should my child wear to therapy?
We recommend shoes and clothes that they can easily move around in.
For school age kids it might be what they would wear for sports or PE class. For babies it should be loose and flexible. We may occasionally ask to see your baby in just their diaper.
This is so that we can make sure we are seeing the whole body to make sure there aren’t asymmetries we are missing. Clothing can hide a lot and we don’t want to miss something when it comes to helping your little one.
We also recommend shoes like running style shoes to make movement easier. And, if your little one wears braces or orthotics please bring them with you!
Who can come to the visit during COVID times?
We ask that you limit the number of people who come to the visit with your child during COVID.
Our waiting room is currently not open so they are not able to sit out there and wait. If it is necessary for multiple people to attend, or it is your preference then they will be required to stay in the room with the child. We also ask that siblings do not come.
Again, if it is necessary, they must stay right with the parent and are not able to play with toys and equipment. Please don’t hesitate to ask your therapist or our admin team any questions.
All people attending will be asked to follow our COVID screening and precautions.
What if my child is exposed to COVID or has COVID? How long before they can come back?
If your child is exposed to someone who has COVID and they are up to date on their vaccine/booster then they are not considered exposed and need to monitor symptoms for 5 days and test on day 5. They can continue to attend therapy unless they develop symptoms and/or test positive during that time period. Masks need to be worn during this time period. If your child is unable to wear a mask they need to do virtual services until after day 10 of last known exposure.
If your child is exposed to someone who has COVID and they are not vaccinated, then they need to quarantine until day 5 after last exposure and test. If they test negative and don’t have symptoms they can return to in person therapy if they are able to mask through day 10. If your child is unable to wear a mask they need to do virtual services until after day 10 of last known exposure.
If your child tests positive for COVID they need to isolate through day 5. If symptoms resolve and they have a negative rapid/home test or a doctor’s note by day 5 they can return to in person services and must be masked at all times. If your child is unable to wear a mask they need to do virtual services until after day 10.
reference: CDC