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Payment & Policies - Theory to Practice

To discuss fees for services, please contact me through the contact page or email me to set up a conversation.

 

Payment Policies:

Theory to Practice cannot bill insurance providers directly and does not accept payment through insurance companies.  If you wish Theory to Practice to provide an invoice (superbill) that your insurance may accept, please:

  • notify me for each needed superbill in advance

  • provide a DSM IV or ICD-10 accepted diagnosis from your pediatrician

  • supply any CPT codes that will be needed by your insurance to cover services provided by a developmental specialist and/or educator. I cannot accept codes related to occupational or speech therapy.

If you are pursuing insurance reimbursement, it is recommended that you contact your insurance prior to services to inquire about approved CPT codes.  Payments are dues at the time of service or within 30 days of receipt of invoice, regardless of insurance requests.

Timely Payments:

  • All services will be invoiced within 2 days of service provision.  Payment for services is expected within 14 days of the invoice and will be considered delinquent after 15 days. Delinquent bills will accrue a 5% charge every 30 days.  Ongoing services cannot be provided if you have an invoice(s) with delinquent charges over 30 days.

 

I am always available to discuss billing concerns/payment options.  If you have special circumstances or would like to consider a payment plan, please do not hesitate to speak with me

 

Cancellations and Missed Appointments: 

  • If you need to cancel an appointment, please notify me as early as possible, preferably 24 hours in advance. No shows, absences or cancellations without sufficient notice will be charged $50.00 at my discretion. This fee is non-reimbursable and cannot be included on your itemized invoice/superbill.  Each session requires preparation and set-up or possible drive time that cannot be regained for missed appointments without notice.  Services will not be pro-rated for arriving late or leaving early for a scheduled appointment.

 

I understand the unpredictable nature of working with busy families and young children and strive to be as accommodating as possible to schedule changes and cancellations.  If you need to modify your child’s schedule, or need to discontinue services for any length of time (vacations, illness, etc.) please speak directly with me to discuss options.

 

Payment and Policies - Upendo

Upendo accepts payments from private parties and Insurance providers specifically OHP and Pacific Source. Please contact me directly to discuss billing questions, concerns, or accommodations.

 

Insurance Billing

  • Services require prior authorization/ approval by your insurance provider.

  • Upendo requires a copy of your insurance card at the onset of service.

  • Upendo can bill for Applied Behavior Analytic Services that falls under the following:

    • Functional Behavior Assessments

    • Behavior Identification and assessment

    • Treatment plans and implementation

    • Group behavior treatment

    • Supervision and treatment modification

    • Parent training and family guidance

    • Attending medical conference/ meetings with family/ their physician

    • Sign language/ oral interpreter services

 

Private Billing – I’d prefer if the billing policy is the same as what you have now for private parties.

Upendo will provide you all the necessary information for billing purposes at the onset of service.

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