Insurance Options for Pediatric Therapy

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Insurance

Accepted Insurances & Payment Expectations:

Our clinic is in network with Blue Cross Blue Shield, Blue Care Network, United Healthcare, Auto, Macomb County Community Mental Health and Medicare.

We are out of network with all other commercial insurances and we accept private pay. A fee schedule is provided to prospective patients during the intake as conducted by our Patient Care Representative and also is reviewed with our billing department during the patient’s first visit.

Patient Admission and Discharge Information:

Admissions:

CWJR provides PT, OT, and SLP to all ages from birth to end of life. Due to the open environment of our clinic, we are unable to take patients who are unsafe or are who are likely to become a safety risk to other patients, families or staff. Risk assessment is conducted at the time of the patient’s intake with oversite done by lead therapists and executive team. Additionally, we take any etiology of spinal cord dysfunction that can improve/benefit with PT, OT or SLP intervention. We also take all levels of patients with incomplete spinal cord levels and patients with complete spinal cord injuries below level C4. In addition, we take patients with spinal cord injuries whose comorbidities are cleared by a physician for outpatient PT, OT or SLP.

Policy for Patients Who Require Advanced Respiratory Management (example Suction or ventilation)

CWJR staff is responsible for communicating responsibilities and requirements for assistance of patient populations requiring advanced respiratory management. Patients entering the program on a ventilator are required to have a nurse present at all times while in the building. Patient’s nurse is responsible for all ventilator management during therapy sessions. Patients entering the program with respiratory management needs are required to have a caregiver or family member present at all times in the building. Caregiver or family member is responsible for all advanced respiratory management, including: cough assistance devices, suctioning equipment, CPAP/BIPAP, oxygen.

Discharges:

A patient will be discharged once they meet one or more of the following criteria: has met all long term goals, when patient is not progressing towards their short term goals for more than 1-2 interims without identified reason/plan modification, when patient becomes unsafe or becomes a safety risk to other patients/families/staff, when doctor requests discharge because a contraindicated co-morbidity is found or when patient/family chooses to discharge.

For Clients Using Insurance:

Have a documented diagnosis from a medical professional.
Determine your insurance. Understand your coverage, if you have a deductible or copays, and the amount of visits you receive.
Send script(s) from your physician(s) to us.
Speak with us to schedule an evaluation in one, or multiple, disciplines. Come for your evaluation and meet our team. You are now an official member of our Crawl Walk Family!

Script Information for Physical Therapy: For Physical Therapy Clients in Michigan, a script is not necessary for therapy; however we still recommend you follow our suggested guidelines listed in Steps 1, 2 and 4 below.

For Private Paying Clients: A script is not needed. Simply call us for private pay pricing, and schedule an evaluation in your requested discipline(s).