Financial Barriers? Lets break them down!
Therapy OPS is passionate about making sure that finances are not a barrier for your child to receive the services that they need and deserve.
What does Therapy OPS do to help make insurance easier to understand?
A Therapy OPS staff member will call your insurance company to determine your benefits.
We ask that you also call your insurance company to hear your benefits as well. Often, patients report back with different information than what was provided to the TOPS staff member, so it is best to have both parties call to ensure we get all sides of insurance coverage information.
To help you understand insurance in easier language, we will share with you what we learn about your insurance coverage and benefits.
What insurance companies is TOPS in network with?
TOPS is in network with nearly every insurance company, including state plans.
What do I do if I can’t afford therapy or therapy is not covered under my benefit plan?
TOPS has helped many families find alternative funding to help pay for therapy. We offer discounted private pay options and we can connect you with resources that may be able to assist. Please call or email us, we are happy to help you too.
What if I run out of visits?
Some insurance plans have a visit limit per lifetime or calendar year. If your policy allows more visits to be authorized, TOPS will handle requesting additional visits.
What if my policy does not allow more visits to be approved?
If it is a hard cap, we will work with you to find options that best fit your family’s needs.
Why does my insurance say therapy is covered but I am still paying for the sessions?
This is a question many of our families come to us with. Many insurance plans have a deductible and an out of pocket and that’s where the costs are coming from. A deductible is the amount of money that you must personally pay before insurance begins paying their portion. While it may seem like you are paying full price with your deductible for services, just by billing insurance, you are receiving a discount for services. After your deductible is met, insurance will begin their coverage in full, which will be different for each plan. For example, if you have a deductible of $500, you will pay $500 yourself. Once you pay that $500, insurance will begin paying the amount covered by your benefit plan, such as 80% or 70% and you become responsible for the 20% or 30% (again this number will be different for all benefit plans). We will walk you through your specific benefits before your appointment occurs so you will have a better idea of what to expect and plan for before you begin services.
At TOPS, we do not only provide help during treatment sessions, we help throughout entire process and that includes billing and scheduling.
If you have any questions about insurance, please call us at 651-455-0561 and we will help in any way that we can!