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Payment & Insurance

As a courtesy to our families, Restored Hope Therapy will bill network insurance directly per request. Families are responsible for monitoring and tracking their benefits and keeping our office up to date on any changes to their plans or policies. Clients are responsible for co-payments, deductibles or any other charges not covered by their insurance at the time of services.

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If we do not specifically accept your insurance, we will provide you with a comprehensive billing statement that you can submit to your insurance provider for potential reimbursement

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We do offer private pay options - please speak to our office staff if you are interested in our private pay rates.

We are in-network with the following insurance:

  • Aetna

  • Blue Cross Blue Shield (BCBS) - excluding Blue Local

  • Cigna

  • Medcost

  • Medicaid

  • NC Direct Medicaid, NC Medicaid's PHPs: Carolinas Complete Health, Healthy Blue, UHC- Community Health, Amerihealth Caritas. NC Medicaid- Tailored Plan: Partners, Alliance, Trillium and Vayahealth.

  • Tricare

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We are out-of-network with the following insurance:

  • United Healthcare (UHC) -  limited plans are in network

QUESTOS TO ASK INSURANCE

Questions To Ask Your Insurance

  • What are my benefits for  OT? 

  • Do I have to meet a deductible? 

  • How much of my deductible has already been met?

  •  Once the deductible is met, what portion is my responsibility (co-insurance/co-payment)? 

  • Does my plan require a referral from my primary care physician? 

  • How many visits are allowed per calendar year? 

  • Is prior authorization required? If yes, who do I need to contact? 

  • Does my plan require pre-certification or medical review at any point while accessing therapy services?

Private Pay

Below are some of the benefits of our Private Pay option:

  • Insurance companies require a diagnosis and Physician to sign evaluation/care plan in order to pay for treatment.

  • Insurance companies have the right to access session documents when billing under them. This means that confidentiality would no longer be strictly between the therapist and client. With private pay, the client is reassured that any records of the therapists are secured and private.

  • The relationship between a client and therapist is sacred. Finding a therapist, you connect with is vital to your growth. Many insurance companies give their members a list of providers that are in network with their benefits. This does not give clients autonomy to see a therapist who may have been personally recommended to them, or with whom they feel connected due to limitations of insurance providers.

Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act, in effect as of January 1, 2022, health care providers and facilities are required to inform individuals who are not enrolled in a plan or coverage or a federal healthcare program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

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You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

·     You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

·     Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

·     If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

·     Make sure to save a copy or picture of your Good Faith Estimate.

·     For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises

Family in Nature

Grants And Scholarships

There are many grants and scholarships made available to help families cover for therapies services. Check out our list of resources below.

Unlocked Inc  (www.unlockedinc.org)

  • We created Unlocked with a mission to fund adaptive or medical equipment for families raising children with disabilities. Every child has value. Every child has potential. Please join us as we work together to unlock the potential of these special kids with special abilities.

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Educational Student Account  NC  (www.ncseaa.edu/k12/esa)  

*Restored Hope Therapy IS A NEW VENDOR FOR THE GRANT!!

  • The ESA+ program provides scholarships in the amount of up to $9,000 a year, and to cover expenses related to educating a child with a disability* in Direct Payment Nonpublic Schools.  ESA+ parents, if your school is not listed, see information here.  Students with certain designated disabilities may be eligible to receive $17,000 a year.  Covers tuition and fees at Direct Payment Nonpublic Schools.  No out-of-pocket expenses (provides families with an electronic debit account).  Funds can be used for expenses such as speech or occupational therapy, tutoring services, curriculum, and educational technology. *A student who has an eligibility determination from a North Carolina Individualized Education Program (IEP) dated within the last three years. A current Eligibility Determination form (DEC3 or ECATS) is the form to submit with an application.

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First In Families Of The Southern Piedmont  (www.fifsp.com)

  • We serve as the housing agency for a local FIF chapter. First In Families (serving Union, Cabarrus, Stanly, Rowan, and Davidson counties) is a family support initiative operated by a family/consumer management team, providing supports to people with intellectual/developmental disabilities and their family member(s). We have the funding and ability to provide small grants (as our funds and policies allow) to qualifying individuals to distribute funds for emergency expenses, special equipment or non-covered medical needs. Please call Cindy Carroll at 704-261-1550 x 204 for more information.

 

Bee Mighty  (www.beemighty.org)

  • Serving the greater Charlotte area. Bee Mighty provides funding for medical therapy and equipment to Neonatal Intensive Care Unit (NICU) graduates. Bee Mighty was established so that families can focus on each other and concentrate on the development of their child without the added stress of financial ruin. Income is a consideration, as are expenses, length of NICU stay, diagnosis, private insurance coverage, etc. All are weighed on a case by case basis.

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Bethany’s Butterflies  (www.bethanysbutterflies.org)

  • To further Bethany’s legacy by providing families, medical providers, and healthcare institutions the resources required to improve the lives of children with complex neurological, developmental, and behavioral health challenges.

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NATIONAL GRANTS

 

United Healthcare Children’s Foundation  (www.uhccf.org)

  • Their mission is to improve children’s lives and help families gain access to the care they need through medical grants. Child must be 16 years of age or younger and  have a Social Security Number. There are specific income requirements.

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ACT-TODAY  (www.act-today.org/apply-for-grant)

  • As one of the only nonprofits that provides product and treatment services directly to families, Autism Care Today provides funding assistance to families throughout the United States on a quarterly basis.

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Giving Angels Foundation  (www.givingangelsfoundation.org/apply-for-help)

  • At the Giving Angels Foundation, our mission is to enhance the daily functioning of a child with a physical disability from a lower income family by awarding grants for life-changing equipment, medical supplies, essential family bills, specialized camps, and therapeutic toys. They classify special needs as children under the age of 21 with any type of physical disability (such as, but not limited to, spina bifida, paralysis, missing limbs) or illness (such as, but not limited to, cerebral palsy, multiple sclerosis, cancer).

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The My Gym Foundation (www.mygymfoundation.org/apply-for-a-gift)

  • The My Gym Foundation accepts applications from or on behalf of children with physical, cognitive, or developmental disabilities and those coping with chronic illness or financial struggles.

 

Requests, limited to gifts of $500 or less, may include but are not limited to rehabilitative therapy, My Gym classes, assistive devices, medical equipment, and sensory items.

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Visit our HELPFUL LINKS page for more information and support.

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