In an effort to help families with insurance reimbursement for therapy expenses, Skills on the Hill will obtain authorizations for therapy services (when required) and submit claims electronically to your insurance carrier on your behalf. This does not mean we have a contract with every insurance, as we are still Out-Of-Network with most insurance. However, your claims submission will be timely and our billing department will follow up on any unpaid claims issues. After insurance reimbursement, you will never be out-of-pocket more than our current self-pay rate for services (please see Fee Schedule).
Using the Verification of Benefits form, our billing office will verify your insurance benefits and talk to you about them via phone. Our billing staff is experienced with therapy services and they will be able to answer all your questions related to benefits, claims processing, as well as your billing statements. Please be available to them so that you can have all of your questions answered.
You will not be billed until your claim has been processed by your insurance. You will receive a statement from us every 28 days if you have a balance due. You will then have (5) days to review the statement and call the billing department with any questions/concerns about the charges. Unless there are corrections, your credit card will be charged for the full amount shown on your statement.
It is our pleasure to provide high quality pediatric OT services to your child(ren). We know that submitting the claims to your insurance for you relieves you of having to work on your own for insurance reimbursement.
For all questions related to your claims and billing statements for services, please contact our Billing Office at 202-424-2718 or firstname.lastname@example.org. Our regular therapy staff will not be able to answer your questions or discuss your insurance claims or your statements as they are not involved with insurance processing.
In most cases, the payment for services will be sent directly to you. Please be looking for your payment and deposit the check directly into your bank account. The billing office will verify with the insurance company the specific amount of the reimbursement paid to you, then they will send you a statement to reflect payments and charge your credit card.
You must inform our billing office if your child has more than one insurance policy. The practice will verify with both policies to confirm which policy is primary. This is critical to getting any necessary authorizations and having your claims process correctly.
Please be aware that, if you have or decide to obtain secondary insurance, one plan will be primary for all claims. The determination of which plan is primary and whether any payment would be made by a secondary plan depends on the rules specified in each insurance plan.
Keep in mind that our practice will not bill secondary insurance for you. You can use your primary insurance EOB/EOP (billing statement) to submit to your secondary insurance per your secondary insurance instructions.
If you do not notify our billing office of more than one policy, you may end up being responsible for the cost of any services that are denied or processed incorrectly.
For questions, please contact our Billing Department at 202-424-2718 or email@example.com.
Gap is not always an advantage to the family; particularly if there are out of network benefits available. Gap does not mean the family will have no patient responsibility or even a “lower” patient responsibility and in fact, the out of network benefits may result in less patient out of pocket responsibility if a high number of visits are anticipated. Everything depends on variables that are dictated in each plan policy; no two are alike.