The following is a statement of our financial policy which we require you to read and sign prior to any treatment.
Medicaid as the primary insurer:
- Medicaid continues to be the primary insurer. Medicaid card should be shown monthly to the therapist.
- Carolina Center for Medical Excellence (CCME), who provides approval for the treatments, continues to approve the therapy.
- Dynamic Therapy for Kids has sufficient staff to provide the treatments needed by the patients.
Private Insurance is the primary, Medicaid is the secondary:
If Medicaid is the patient’s secondary insurance, we will bill the primary insurance and one of two things will take place:
- Within 60 days of treatment, the primary insurance company pays at least what Medicaid would have paid. In this case, there is no additional patient responsibility for the treatments;
- Within 60 days of treatment, the primary insurance company pays some but less than what Medicaid would have had it been the primary insurer. In this case, Dynamic Therapy for Kids bills Medicaid for the balance due. The patient pays nothing.
- Within 60 days of treatment, the primary insurance company provides no denial of payment. Since we cannot bill Medicaid without a denial or proof of partial payment, we may have to discontinue therapy.
- Dynamic Therapy for Kids must be informed of ANY changes of private insurance due to Medicaid billing laws. Dynamic Therapy for Kids must be an approved provider by your insurance company.
Private insurance only:
We file all claims whose payments can be assigned to Dynamic Therapy for Kids. If, within 60 days of treatment, the primary insurance company pays some portion of the bill to Dynamic Therapy for Kids, the responsible party will be billed the balance due. If the insurance company has not provided any payment, the entire bill becomes the responsibility of the responsible party. If the patient pays and the insurance company pays Dynamic Therapy for Kids, later, a credit or refund is issued to the responsible party. Dynamic Therapy for Kids must be informed of ANY insurance changes. Insurance will be verified at time of first visit and your co-payment/coinsurance amounts will be determined at the first visit for all in-network therapies. All co-payments/coinsurance amounts are due at the time treatment is rendered. If your child is seen at the home/daycare, your invoice will be mailed to you. Please make payments promptly upon receipt of claim.
Wake County Early Intervention Contract
Dynamic Therapy for Kids is a contracted provider with Wake County Early Intervention who will pay a portion of the therapy based on their sliding scale.
Usual and Customary Rates
Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.