A home therapy evaluation can cost more or less than the family expects, and most of the total is set before the therapist walks through the door. Work through these questions in order, and write down every answer.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Before you book
Start with her physician. Ask whether a home therapy evaluation makes sense for the trip from bed to toilet, and ask the office to send the referral in writing. Questions about her strength, balance or medicines belong with the physician, not with the therapist's scheduler.
Then ask her health plan two things: whether the provider is in network, and whether a referral or prior approval must be on file before the visit. An out-of-network provider or a missing referral can change the bill more than anything else on this list, so settle both before the first appointment.
What moves the total
The number of visits is the next lever. Ask whether the evaluation is a single visit, whether follow-up visits are billed separately, and who decides when another visit is needed. Ask whether the written plan that comes after the evaluation is included or billed as its own line.
Ask how each visit is coded, whether as an evaluation or as treatment, because the two are counted differently. Ask the provider to walk you through each line before the first visit, not after the statement arrives.
This desk does not list prices. The numbers come from her plan and the provider, and they can change from one plan year to the next, so get the figures in writing for her case.
What to write down
Write down the physician's name and office, the referral number, the provider's name, whether the provider is in network, the number of visits included, and the name of the person who approved each step. Keep the written plan in the same folder as the referral.
If the answers are unclear, the local help page lists who in west St. Louis County takes these calls. The Sources page explains where the facts on this desk come from.