Updated Payment Policies and Procedures (April 2019) Amanda J Gretsch, Inc. (AJG) is considered an out-of-network provider for all insurance companies and therefore, does not bill insurance companies. Payment is due at the time of treatment.
As an out-of-network provider, some insurance companies will reimburse you for a portion of the fees paid for occupational therapy services. It is highly recommended that if you are seeking reimbursement from your insurance company that you call to verify your benefits. Please be aware that policies change from time to time, so it is strongly advised that you call them every month while receiving treatment.
Patients will be provided a “Superbill” (invoice that contains all necessary insurance codes) after payment is received. These invoices can then be submitted to your insurance company, if you choose. Please be aware that to avoid a fee when requesting that AJG rebill invoices due to insurance company requirements, AJG must be made aware within two months of the date of the invoice.
Recommended Questions to Ask Your Insurance Provider:
What is my out-of-network deductible? How much has been met this year?
What portion of my services will be reimbursed?
Does my plan allow reimbursement for each of the following therapy codes?
Evaluations: 97165, 97166, 97167
Treatment: 97530, 97112, 97110, 97535
Do I need a referral from a physician to obtain reimbursement?
Do I need pre-authorization to obtain reimbursement?
What are the benefits of private pay? Insurance companies require a diagnosis and often have policies regarding reimbursement that restrict the type, length, frequency, and duration of services. We have found that without the limitations and restraints placed by insurance providers, patients are able to allay themselves of the most up-to-date, evidenced-based interventions for a duration that helps maximize outcomes. Finally, if confidentiality is a concern, the information will not become part of an individual’s permanent medical file.
While receiving treatment, patients may elect one of the following payment options: 1. Cash or Check We are happy to accept payment by cash or check at the time of the appointment. However, please be aware that if you wish to schedule ongoing therapy sessions through our online scheduling system, you will be required to keep a valid credit card on file. The credit card will not be charged unless there is a no show/ late cancellation or if the patient chooses to use it to pay for treatment. 2. Credit Cards For your convenience, we accept payment via Visa, MasterCard, and American Express. All information is maintained securely through our electronic medical records (EMR), scheduling, and billing system. 3. Health Savings Account (HSA) or Flexible Spending Account (FSA) Via issued HSA or FSA credit card (this allows for services to be paid using or Flexible Savings Account (FSA) pre-tax dollars.) Please be aware that patients will also need to keep a credit card of their choice on file in the event that there are insufficient funds in the HSA or FSA account.
Cancellation Policies AJG strives to provide you with the best, most consistent care possible. Scheduling is often consistent in nature with standing appointments on an ongoing basis. Attending these appointments is an essential part of treatment and patient management. With the exception of illness, for a more immediate cancellation or change, a minimum of 24 hours’ notice before the scheduled appointment is required (please note that if your appointment is on a Monday, the 24 hours EXCLUDES the weekends). If you do not cancel your appointment online within 24 hours, you will be charged a “late cancellation/no show” fee of $175.00.