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A FREE 15-minute initial phone consultation is provided to discuss your child’s needs and determine if Gather & Grow is a good fit.

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Gather & Grow is currently accepting Oregon Health Plan and Regence BlueCross Blue Shield.  

 

We do not directly bill other insurance companies,  though each visit you will be provided with a simple invoice, or “superbill" you can submit directly to your insurance company to seek out-of-network provider reimbursement.  Plans that exclude out-of network visits will not be eligible for reimbursement. It is up to you to investigate your coverage and you are responsible for any charges insurance does not cover.  Therapy is also frequently reimbursable through HSA (Health Savings Account) and FSA (Flexible Spending Account) arrangements.

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For those patients with private insurance who have financial circumstances that may limit access to therapy, a payment schedule or sliding-scale charge may be arranged.  The arrangements must be made prior to any services being provided. Qualification will be determined on an individual basis. 

 

Questions to consider asking your insurance carrier prior to your appointment:

• What is my child’s coverage for out-of-network pediatric occupational therapy visits?

• Is my provider required to be credentialed as an out-of-network provider for me to receive reimbursement? If yes, please let Sarah know.

• Are there any diagnosis exclusions for out-of-network reimbursement?

• Does my insurance exclude home visits for occupational therapy (location code 12)?

• Do I have a co-payment or is there a percentage of the bill I will be responsible for?

• Does my plan require a deductible to be paid for the calendar year before the coverage begins? If so, what is the dollar amount?

• Does my child have an out-of-pocket maximum that I pay per calendar year?

• Does my insurance plan only cover a limited number of sessions for each calendar year?

• Am I required to have a doctor’s referral or pre-authorization before my child sees a clinician? If so, who do I contact?

• If pre-authorization is required, can forms be emailed to sarah@gatherandgrowpdx.com or child's primary care provider?

• Is a Plan of Care signed by my child's primary care provider required for ongoing therapy? 

• Is there a fax number I can use to submit therapy superbills (Sarah will provide superbills to you)?* If not, what address should be used?

• Is there an additional form to be submitted with superbills?

 

* When submitting superbills to insurance please be sure to specify that you would like direct reimbursement.

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Flexible Option: 

Gather & Grow provides parents with the option of group sessions for up to three children. In order to be most effective for all participants, groups need to be determined by Sarah. Insurance does not reimburse for group sessions and a superbill will not be provided for insurance submission. Initial evaluation needs to be completed for each child in order to determine individual needs within group context.