Insurance and Billing
We are committed to providing the best possible care and that includes filing insurance claims to your insurance company for therapy services. We understand that sometimes the most confusing part of treatment can be working out the billing and insurance details. We will work with you and your insurance company to obtain payment for our services; however, keep in mind that we are considered a third party to your relationship with your insurance company and with the ever-changing insurance climate, situations may arise that are out of our ability to predict. The Insurance and billing department is dedicated to working with you and your insurance company so payments are made in a timely manner and we will work with you to resolve issues that arise.
Occupational, Physical and Mental Health Therapy Benefits
Most insurance companies do help cover the cost of therapy services. We will help you receive the maximum allowable benefits through your insurance carrier and, as a courtesy to our clients, our insurance specialist will contact the insurance company to verify benefits. While we are not able to guarantee coverage, however, we are committed to helping you understand your plan’s benefits and assist in utilizing the existing benefits available.
Verifying Insurance Benefits
It is your responsibility to be informed of your insurance benefits prior to the initial visit. Contacting the insurance company directly will help you to better understand your plan and how benefits may be applied. The customer service number is usually located on the back of the insurance card. Depending on the services you are seeking at our clinics, here are a few questions that can help you understand your plan are:
- What are my out-patient Occupational and/or Physical Therapy benefits? Mental Health Therapy Benefits?
- Do I need pre-authorization to see an Occupational or Physical Therapist? Mental Health Therapist?
- What is my deductible (the amount that is paid out of pocket before benefits begin)?
- When do my benefits renew (per calendar year or plan year)?
- What are my in-network and out-of-network benefits?
- What’s my copay/percentage per visit?
- How many therapy visits are covered?
- Is this a combined benefit with Occupational, Physical and Speech Therapy?
- Are there any exclusions for Neurodevelopmental Therapy or for Developmental Delay?
- Are any diagnoses excluded that I should be aware of?
- Is Neurotherapeutic Pediatric Therapies Inc. an in-network or an out-of-network provider? (Tax ID# is 208439757)
- Be sure to note the person’s name and date you spoke with them
In-Network Insurance Companies for out-patient Occupational and Physical Therapy*
- Health Net
- Kaiser – Sensory Integration Treatment Only
- ODS/Moda Health Plans
- Oregon Health Plans – DMAP, Willamette Valley Community Health, Tuality Health Alliance and Care Oregon.
- Pacific Source
- Providence Health Plans – McMinnville and Medford Clinics ONLY. We are out-of-network at Oregon City, Hillsboro and NE Portland Clinics.
- Regence Blue Cross Blue Shield
- Tricare – Health Net Federal Services
In-Network Insurance Companies for out-patient Mental Health Therapy*
Listed below is the full list of In-Network Plans for Mental Health Therapists at our clinic. Individual therapists may not be in-network with all plans on this list.
- Oregon Health Plans – DMAP and Health Share (New clients with Health Share will need to contact our Insurance Specialist at 503-657-8903 for additional information).
- Regence Blue Cross Blue Shield
- Reliant Health (includes Peace Health and A & I Benefit Plan)
- United Behavioral Health
*This list is subject to change without notice as insurance contracts may be added or changed periodically. To verify our current in-network status for our organization and/or individual therapist, contact your insurance company directly.
Out-of-Network or Out of Benefits?
Even if we are not contracted with your insurance company, we can still file claims for therapy services which may still be covered at an out-of-network rate. If you are out of benefits, we have cash or credit card payment options available as well. We want to work with you to find a solution! Call or talk with us to discuss options available for your family.