In light of drastic changes in our world today, getting out and about may become more limited for many families, impacting the ability to receive important therapeutic intervention. That is where a new means of providing therapy, telehealth online therapy, comes to the rescue. Your child can receive therapeutic services from their current treatment providers without ever having to leave the house! Sounds too good to be true? It’s not! Advancements in technology now allow treatment providers to visit you electronically.
We need you to call your insurance and verify that telehealth will be covered. Why do you need to call? Because you are the customer of the insurance company and they will listen to you far more closely than they will listen to us. Also, we will need your documentation of that call to help claims get paid.
If the representative tells you that telehealth is not covered under your plan... Do not take no for an answer! Ask to speak to someone who has the ability to authorize an exception based on the fact that...
A- Your child's services have been confirmed as medically necessary and since the CDC is advising social distancing or even quarantine (if that is true for your family based on your child's circumstances or based on one of your family member's circumstances) your child will need to receive those services from home via "Synchronous video conferencing" (which is the insurance's term for a live video call).
B- Your provider is ready to provide this with a HIPAA compliant platform (it will protect your privacy).
C- Your child will likely regress if services are not provided and will need MORE services later if they don't approve this now.
D- We will bill with the same codes we would typically bill with for therapy (the representative can look up a past claim if you were previously receiving services, or we can provide those codes if you need them), but a "GT modifier" would be attached to the line of service and a "02 place of service code" will be used. The representative should know what this means, but these are the details on the claim that indicate that your child received the services from home via "Synchronous video conferencing."
Please be sure to write down:
1-Name of person you spoke with
2-Date and time of the call
3-Reference number for the call if they have one they can give you
4-Details of their response including an authorization number if a specific authorization has been entered