Policies

Intake Forms

Before your first session, please complete all intake forms in your packet. These help us understand your family, your child’s history, and how we can best support your journey together. Intake forms are emailed out and are also available here.

Cancellations and Missed Appointments

Individual Therapy Sessions

We strive to implement this policy in a reasonable fashion and take into consideration the somewhat unpredictable nature of working with children.

We understand that unexpected things happen. If you cancel at least 24 hours ahead and we are able to reschedule during the same week, the no-show fee will be waived. If the cancellation is late and cannot be rescheduled, a no-show fee may apply. To cancel an appointment, please visit our appointment cancellation web page.

If your child takes a break from therapy, we will do our best to hold your spot, but we cannot guarantee it.

Policy Regarding Insurance Reimbursement

Occupational Therapy and Speech Therapy are covered services under a flexible spending account.

Tumble N’ Dots is a private pay clinic and is not part of any insurance network.

We do provide superbills for potential reimbursement that you can submit to your health insurance carrier or FSA account as an out-of-network provider. Please review our Insurance Reimbursement Guide for Private Pay guide. 

The child’s family is responsible for all services rendered. If you wish to pursue possible reimbursement from your insurance company for an out-of-network provider, please provide us with the following to be included with your invoice:

• Letter of referral or prescription for services from the referring physician
• DSM-5 or ICD-10 diagnosis and code number (designated by the physician)

This information will enable us to provide an invoice that is in keeping with your health insurance company’s invoice policies.

To facilitate processing of reimbursement claims we provide our patients with a receipt for services (a superbill) that includes all information needed to submit a claim to your insurance company. It is not guaranteed that services provided will be covered by your specific insurance plan. For information about reimbursement rates, contact your insurance provider about your specific out-of-network benefits. Here are some helpful questions to ask your health insurance representative to clarify your out-of-network benefits:

• Does my coverage include mental health services?
• Does my coverage include seeing an out-of-network provider?
• What is my deductible and must it be met before services are covered?
• What is the amount of coverage per therapy session?
• Do I need a referral from my primary care physician to access my out-of-network benefits?

We will be happy to schedule a call with your pediatrician to discuss our findings during the evaluation process and consult on our recommendations.

Please remember that payments are due at the time of receipt regardless of delays in reimbursement by insurance providers.