Participating Insurance List
- Aetna BetterHealth (Medicaid & Healthy Kids)
- CCP (Community Care Plan)
- CCP Healthy Kids
- CMS Title 19 & 21
- Sunshine Health Plan
- Simply (Medicaid & Healthy Kids)
- United Medicaid
- Ambetter by Sunshine Health
- Molina Marketplace
- Neighborhood Health
- United Healthcare (all plans)
- Part C
The Process for Using Medicaid and Commercial Insurance for Treatment
Kids SPOT accepts most major commercial insurances that approve speech, physical, occupational and applied behavior analysis (ABA) therapy in the South Florida area. We also accept Medicaid. After completing the necessary paperwork to approve your child for pediatric therapy services, we keep our clients informed on any insurance issues and keep all paperwork up to date.
If you have Medicaid or Centers for Medicare and Medicaid Services (CMS), you’ll need to obtain a prescription from your pediatrician for evaluation. When received, one of our CMS- or Medicaid-enrolled and state-licensed therapists performs testing along with an assessment to develop a Plan of Care with your child’s pediatrician. This process typically takes seven to 10 days.
Once your child’s pediatrician and one of our therapists sign the Plan of Care, an authorization request is submitted. Overall, the timeline for authorization and evaluation takes a minimum of three to four weeks.
What to Know About Using Your New Medicaid or CHIP Coverage
If you’re enrolled in the Children’s Health Insurance Program (CHIP) or Medicaid, here are some things to know about care and coverage:
When to Contact Your State Medicaid or CHIP Agency
Issues to take to your state CHIP or Medicaid agency include:
- You want to know if a product or service is covered, or you didn’t receive an enrollment card.
- You have a life change that may affect your eligibility for CHIP or Medicaid. This includes getting married or divorced, having your dependent reach an age where they no longer qualify, or getting a job that increases your income.
Using Your Coverage
For most questions, contact your state CHIP or Medicaid agency. If you’re enrolled in a health plan through CHIP or Medicaid, contact the member services phone number on the back of your enrollment card or your eligibility letter. This information should also be on the websites of your Medicaid or CHIP agency.
Authorized Early Steps Program Provider
Kids SPOT is an authorized pediatric therapy Early Steps program provider. Early Steps is a government program for children from birth to 3 years old. Contact your provider or visit Early Steps online to see if your child qualifies. Early Steps authorized providers will look for delays in various areas, such as:
- Physical: These factors include the child’s vision, health and hearing.
- Gross and fine motor skills: Your child’s gross and fine motor skills focus on walking, coordination, grasp and movement.
- Cognitive: The cognitive behaviors evaluators assess include learning, thinking and problem-solving skills.
- Social and emotional: Social and emotional behaviors are how your child interacts and plays with others.
- Communication: Your child’s communication may consist of anything from babbling to conversing.
- Adaptive development: Adaptive development comprises self-help and self-care skills, like getting dressed, using a toilet and eating.
Your child may also be eligible for Early Steps if they are diagnosed with any of the following:
- Neurological disorder
- Sensory impairments
- Genetic or metabolic disorder
- Autism spectrum disorder (ASD)
- Weigh less than 1,200 grams at birth
- Reactive attachment disorder (RAD)
At Kids SPOT, we will examine your child’s abilities in these areas to see if they qualify for the Early Steps program and develop a plan for addressing your child’s needs.
Once we establish plans and goals, our care team provides services as close to your child’s daily activities as possible. It’s essential to note that anyone can refer a child to the Early Steps program.
With Early Steps, your child can get the care they need while the program takes care of the bill. If you think your child would benefit from services and the Early Steps program, move on to the referral process today.
Learn More About Our Comprehensive Therapy Treatment Center
If you’d like to discuss your child’s needs or the therapy services they are receiving at any time, feel free to give us a call. You can also reach out to a Kids SPOT representative online to learn more about our comprehensive pediatric therapy services and what we can do for your child.
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