Question about occupational therapy, SPD, insurance, etc.

[Anonymous]

Anonymous wrote:We have BCBS. We pay out of pocket, submit the invoices to BCBS and then get reimbursed.

This is exactly what we do with Carefirst. We pay in full and get a superbill. We submit that and get about 60-70% of their allowable for each procedure code. I have not found an OT who works with children and accepts insurance in MD.

[Anonymous]

How does this work? Does this mean you have out of network coverage? We have a CareFirst HMO and not a lot of choice in health care as we both work for small employers.

How much do you end up owing per session after reimbursement?

Man this stuff is expensive.

[Anonymous]

If you're in Virginia, Good Beginnings takes many types of insurance. DD went there for over 2 years and we were very happy.

[Anonymous]

Thanks for the tip! I'm in NE DC so hoping for the District or Maryland.

[Anonymous]

Hi everyone,

I'm a speech therapist, so know a lot about the health care system. If you are looking to go out of network and there is no one in network, ask your insurance company for a waiver. They legally will have to let you go out of network, but pay using your in-network price. They will NOT tell you about it, but will need to honour it if you ask. Goodluck.

[Anonymous]

I have just started on this frustrating journey to find an OT for my 7 year old son. We live in MD and also have Cigna. Any advice on good therapists? The one our Dr. Recommended is no longer in the area.

[Anonymous]

Anonymous wrote:I have just started on this frustrating journey to find an OT for my 7 year old son. We live in MD and also have Cigna. Any advice on good therapists? The one our Dr. Recommended is no longer in the area.

We go to Barbara Bassin on Democracy Blvd. near Montgomery Mall. Carefirst reimburses us 80% of the cost for 30 visits per year.

[Anonymous]

Connections in Lanham (mentioned upthread).

Rehabilitation Services Inc in Silver Spring or Bowie.

MD is a big place, where are you?

[Anonymous]

Anonymous wrote:Bump. Looking for OT, ideally in DC, that takes CareFirst. Am I dreaming? Any help appreciated.

If you find one, please share. We have a crappy Carefirst plan, see an OT who is out of network, and don't get a penny in reimbursement. (Ditto for our DC's therapist, who charges $190 a session for CBT.) It truly sucks. So please share if you find a good OT who is in network.

[Anonymous]

Pediatric Development Center, Rockville. Awesome therapists (speech and OT). They take insurance, and submit claims. Call them. Pdcandme.com

[Anonymous]

Connections has an office in DC and takes CareFirst. It's in far SE though.

[Anonymous]

I would recommend the Pediatric Development Center in Rockville and Children's Therapy Services in Annapolis. They both take insurance we have BCBS and only pay a $35 copay. We also use our health flexible spending account to pay for private speech which is not covered by our insurance.