Frequently asked questions
How can I prepare for my child’s initial visit?
Often we will speak with you by phone prior to the initial visit to prepare for your child's evaluation or screening. If there are previous reports or written information available, please send them for our review when you return the New Patient Information Packet. We request that you complete and return the detailed parent information packet and online Sensory Profile at least 3 days prior to the initial evaluation, screening or treatment session. By taking the time to complete this material before the initial visit, your therapist’s understanding of your child during the first visit will be greatly enhanced. It will also help you formulate thoughts regarding your concerns about your child's strengths and weaknesses.
What happens during the initial visit?
On the day of the appointed first visit, you and your child will enter our parent and child- friendly waiting area. Please make yourself comfortable until your therapist greets you. You will then go to a private room where the therapist will begin getting to know you and your child. If your child is school age, you may opt to remain in the waiting area while the therapist is meeting with your child.
Assessment with children often looks like play. Young children often do not realize that they are being evaluated and many leave the session asking when they can come back and play. The first sessions(s) are designed to assess your child's level of functioning and to determine factors that may interfere with age appropriate skill acquisition. Generally the sessions are about 1-2 hours and combine structured and unstructured activities. At the end of the session the therapist will make recommendations, and if therapy is indicated, you can set goals that reflect your priorities for your child.
Do I need a prescription from my child's physician?
All of our therapists are licensed by the State of New Jersey and do not require written physician's prescription for assessment and treatment, but we DO prefer a written prescription prior to your first visit. A written prescription may be helpful to assist you in collecting reimbursement from your insurance carrier. We suggest that you make a copy of the prescription to save the copy for your records. A prescription does not guarantee reimbursement.
Do you do Independent Occupational Therapy Evaluations?
Yes, under certain circumstances. We reserve the right to accept or reject these requests depending on our availability and timing requirements.
Do you administer the Sensory Integration & Praxis Tests (SIPT)?
We are certified to administer the SIPT. We do so upon request, when we judge that the results of testing will be critical to guide your child’s therapy.
Am I allowed to sit in the room during an evaluation or screening?
You are the parent, and you know best how your child will function in a testing situation. You are always welcome to accompany your child into the testing rooms. With younger children we encourage you to sit in to minimize separation issues. We are especially happy to have you in the testing room if your child will pay full attention to the examiner and follow his/her instructions. We ask that you sit as quietly as possible so the examiner can develop rapport with your child and begin building a therapeutic relationship. You can leave the room at your discretion, if you feel you are a distraction to your child.
Many rooms have one-way mirrors, so that you can observe the assessment if that is your preference, or you can relax in the waiting room. In either case, we will leave a few minutes to spend with you after the session. We do not like to discuss children in front of them, so if the situation or timing does not permit a full discussion, please make a phone appointment before you leave the office and we will discuss the results of testing with you as soon as possible.
Our goal is to help you and your child feel as comfortable and playful as possible. While we understand that the process is stressful for all, we do our best to minimize stress and maintain open communication.
What specific skills will you assess?
Depending on the reason your child was referred, we might evaluate:
Postural control and core strength
Fine motor skills including dexterity, grasp, coloring, and cutting
Gross motor skills, strength, endurance, and coordination
Self-help skills, such as dressing, grooming, toileting and feeding
Sensory processing (how your child processes sound, sight, touch, movement, and other sensations, and responds to them)
Activities of Daily living
Speech, language and oral motor skills
What is the difference between an “Evaluation” and a “Screening”?
A screening is conducted over 1-1½ hours depending on your child’s age, directly targets your areas of concern, and includes limited standardized testing. Specific tests are selected to meet your child’s unique needs. The follow-up consists of a phone call or in-person meeting to discuss our recommendations and establish goals, but does not include a written report.
An evaluation is more comprehensive. It requires two hours and examines your child’s postural control, gross and fine motor skills, eye-hand coordination and sensory processing. Specific tests are selected to meet your child’s individual needs. In approximately 6 weeks, you will receive a comprehensive report that summarizes the information gathered, an analysis of the testing data, recommendations for home and/or school and goals for occupational therapy, if recommended.
What does therapy look like from intake to discharge?
THE POTS PROCESS BEGINNING TO END
The first step in helping your child is gathering information about your concerns and your child’s medical and developmental history through written intake forms. We are also happy to review any prior reports that are relevant.
Before your first appointment, please have your pediatrician, neurologist or other physician provide a prescription for occupational, physical, speech or feeding evaluation and treatment, with the appropriate diagnostic code. We will make a copy for you for your records.
A pre-evaluation phone interview to review your paperwork so we can maximize our face-to-face time with your child.
An initial evaluation or screening in-person or remotely will take between 45 minutes and an hour and 15 minutes depending on your child’s age and the complexity of the presenting problems. A comprehensive evaluation my require a second evaluation session.
Informing conference: Within 3 days we will meet with you on the phone or through video-conferencing to review the results of the evaluation, make recommendations, prioritize goals and schedule therapy, if warranted.
Re-evaluation: A re-evaluation will be scheduled a minimum of every 6 months to review your child’s progress and update his/her goals. If your child has not been at POTS for 3+ months an initial evaluation or re-evaluation will be required.
Discharge: When your child has met his/her goals we will celebrate the hard work and success and make recommendations for community and home based activities to keep up his/her skills
After discharge: The POTS team is always here for you to consult with
How many sessions will my child need per week?
Typically children come once or twice a week for 45 minutes, but more or less may be recommended based on the results of the evaluation or screening.
How long will my child need OT?
We wish we could answer that question! Length of treatment depends on numerous variables including the child’s age, the child’s strengths, scope and complexity of the problem, and frequency of attendance, to name a few. In my experience I have found that when therapy is indicated twice a week, children who come twice a week generally improve more than twice as fast as children who have therapy once a week. We can not predict in advance how rapidly an individual child will respond to treatment, but as a rule of thumb, when the child is improving rapidly, that is the time to provide more therapy, rather than back off.
Do you have a waiting list?
There is high demand for therapy after school hours. Children with flexibility in their schedules can usually be accommodated more rapidly. Contact us (and leave your email and daytime phone number and our office manager will work with you to find an available time slot(s).
At POTS, to ensure our standard of care, we do most of our therapies on a one-to-one basis with highly skilled and experienced therapists. We are committed to providing the best treatment for your child's specific needs. Scheduling is based on the time of day the child is available, child's needs, family schedule, therapist's schedule and therapist's areas of specialization.
What are your hours of operation?
Monday through Thursday: 7:45 am - 6:30 pm
Fridays: 7:45 am-3:00 pm in the winter and 6:00 pm in the summer.
Sundays, 9:00 am- 12:30 pm
POTS is open 12 months a year. Summer schedules are sometimes altered to accommodate children’s camp schedules, vacation schedules and therapist vacations
What is your policy regarding attendance and cancellations?
All appointments must be cancelled 24 hours prior to your scheduled appointment time or you will be charged a cancellation fee. If you do not show up for an appointment you will be billed in full for the session.
Effective care requires a commitment from the child's family and therapist. Regular attendance is crucial for therapy sessions to be meaningful and effective. Working together as a team, we can accomplish the best outcomes for your child and family.
Reasons for absence should therefore be limited to parent or child illness or other family emergencies. If you or your child is ill, we prefer that you cancel rather than spread illness. Exposure to upper respiratory, flu, chicken pox and other infectious diseases is potentially dangerous to other children and therapists. Cancellations should be made as far in advance as possible, and a minimum of 24 hours prior to your child's designated therapy time. If you have any questions about whether or not you should bring your child for therapy, please call and ask your child’s OT. While it is often difficult for your therapist to find other openings each week, missed sessions should be rescheduled whenever possible.
If your child is absent from therapy 25% of the time, or more, for two consecutive months, or there is an extended pattern of non-attendance, POTS may discontinue your appointed time. We encourage you to communicate frequently with your therapist in order to best accommodate your child's particular needs and to try to prevent disruptions in your child’s care.
How can I get my school district to cover the services?
A parent interested in attempting to get occupational therapy services covered by their school district will first have to contact their child’s case manager with their concerns. Upon approval, our office will then contact the special services department to obtain a purchase order. Once we receive the purchase order, you can schedule your child’s evaluation and/or treatment sessions.
Do you accept insurance?
We are an out-of-network provider and do not accept insurance. Payment in full is due at the time services are rendered, including but not limited to evaluations, screenings, treatment sessions, and school observations.
Can I submit a claim to my insurance carrier?
Yes. In order to be reimbursed, you would need to have out-of-network benefits and also have met your deductible if applicable.
How does the submission to the insurance company work?
You would obtain an insurance claim form directly from your insurance carrier and complete it as directed. You would then submit the claim form along with the PAID statement/s you receive from our office to your insurance carrier. The claims address will be located on the back of your insurance card.
Do you submit insurance claims for me?
No. Because we are an out-of-network provider we DO NOT submit insurance claims on behalf of our patients.
What forms of payment do you accept?
Cash, credit card or check. Credit cards issued by a health spending account are also accepted.
Do I have to pay at each session if my child comes more than once a week?
Payment needs to be made at the time of each session or at the beginning of the week, for all sessions that are scheduled for that week.
Can you bill be weekly, monthly, etc.?
We bill each session individually, but you can remit payment at the beginning of the week or month for the following week or month.
Can I submit payment over the phone?
Yes. If your child comes with someone other than a parent, payment can be submitted over the phone the same day as the session.
Can I keep my financial information on file for you to bill me after each session?
Yes. the information can be kept securely in encrypted software, but we prefer to swipe your card at each session.
What is Co-pay?
A fixed amount ($20, for example) you pay for a covered health care service
after you've paid your deductible. Let's say your health insurance plan's allowable cost
for a doctor's office visit is $100. Your copayment for a doctor visit is $20.
What is deductible?
The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services.
What is Co-Insurance?
Coinsurance is the percentage of costs you pay after you've met your deductible. A deductible is the set amount you pay for medical services and prescriptions before your coinsurance kicks in
What is a medical necessity?
Medical necessity is the concept that healthcare services and supplies must be necessary and appropriate for the evaluation and management of a given disease, condition, illness, or injury. The care must be considered reasonable when judged against current medical standards of care
What is Out-of-network?
Out-of-network” providers have not agreed to the discounted rates
What is INE ( in network exception) Gap exception?
A coverage gap exception is a waiver from a healthcare insurance company that allows a customer to receive medical services from an out of network provider at an in network rate.
A coverage gap exception is not the same as appealing a denied claim. A gap exception is a preemptive request for known benefits.