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General Parenting
can an Occupational Therapist (OT) refuse to treat your child due to possible behavior issues?
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<blockquote data-quote="susiestar" data-source="post: 633693" data-attributes="member: 1233"><p>Unfortunately the Occupational Therapist (OT) is a private business and can refuse service if they want to. I don't know if going in without him to talk abuot this would help or not. If they won't see him, you can ask your insurance to approve another Occupational Therapist (OT) in your area. Insurance companies generally have a provision to approve vendors if you cannot find one in your area. I think it may be called an exception, but I am not sure. It takes some patience and time to get all the paperwork done and the process can be frustrating. </p><p></p><p>I used to have to do this for a few things, esp for Occupational Therapist (OT). First you have to go ahead and find an Occupational Therapist (OT) who is willing to treat your child. Then you get the Occupational Therapist (OT) to agree to take your ins if the ins co will approve them. That can be the really hard part because part of being an ins approved provider is accepting what the ins co will pay as the fee for the service. This can be substantially lower than what they would charge if you just paid for their services out of your own pocket. Once the Occupational Therapist (OT) is willing to accept the ins co payments, there is paperwork. Calling the cust svc line should get you to someone who can help you with htis, though you may need a supervisor. If you cannot get someone to help with this, ask your employer's HR dept to help with this. If your employer is of a fairly large size, the HR dept has probably had to do this before. If they have not, they still have more clout than you do and can be helpful. Once you have the process figured out, you have to get the Occupational Therapist (OT) and the doctor ordering the Occupational Therapist (OT) services to do whatever paperwork is needed and then you have to wait to hear what the ins co says. </p><p></p><p>The ins co wait is the hardest part for me. I can remember thinking that they were just waiting to see if I would go away before they ahd to approve it and pay for it. If the ins co was doing that, they didn't know me. For the first week or two, I called once a week to check on things. Then I called more often and I documented the name of each person I spoke to on every call. After about 3 weeks, I start calling every day, asking for the status. It is VERY true that the squeaky wheel gets answers and gets stuff done, at least that is my opinion.</p></blockquote><p></p>
[QUOTE="susiestar, post: 633693, member: 1233"] Unfortunately the Occupational Therapist (OT) is a private business and can refuse service if they want to. I don't know if going in without him to talk abuot this would help or not. If they won't see him, you can ask your insurance to approve another Occupational Therapist (OT) in your area. Insurance companies generally have a provision to approve vendors if you cannot find one in your area. I think it may be called an exception, but I am not sure. It takes some patience and time to get all the paperwork done and the process can be frustrating. I used to have to do this for a few things, esp for Occupational Therapist (OT). First you have to go ahead and find an Occupational Therapist (OT) who is willing to treat your child. Then you get the Occupational Therapist (OT) to agree to take your ins if the ins co will approve them. That can be the really hard part because part of being an ins approved provider is accepting what the ins co will pay as the fee for the service. This can be substantially lower than what they would charge if you just paid for their services out of your own pocket. Once the Occupational Therapist (OT) is willing to accept the ins co payments, there is paperwork. Calling the cust svc line should get you to someone who can help you with htis, though you may need a supervisor. If you cannot get someone to help with this, ask your employer's HR dept to help with this. If your employer is of a fairly large size, the HR dept has probably had to do this before. If they have not, they still have more clout than you do and can be helpful. Once you have the process figured out, you have to get the Occupational Therapist (OT) and the doctor ordering the Occupational Therapist (OT) services to do whatever paperwork is needed and then you have to wait to hear what the ins co says. The ins co wait is the hardest part for me. I can remember thinking that they were just waiting to see if I would go away before they ahd to approve it and pay for it. If the ins co was doing that, they didn't know me. For the first week or two, I called once a week to check on things. Then I called more often and I documented the name of each person I spoke to on every call. After about 3 weeks, I start calling every day, asking for the status. It is VERY true that the squeaky wheel gets answers and gets stuff done, at least that is my opinion. [/QUOTE]
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can an Occupational Therapist (OT) refuse to treat your child due to possible behavior issues?
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