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TheraTree Pediatric Therapy
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Parent Resources 

Welcome to our Parent Resources page, your go-to hub for essential information and tools to support your child's therapy journey. Here, you'll find forms, guides, and helpful links to manage appointments, update information, and stay informed about your child's progress. Explore our resources to ensure your child receives the best possible care.

Judson hit his goal today during our telehealth session! He has been working hard to gain bilateral upper extremity strength. He had a goal of completing 15 push-ups (from his toes!) with 0 rest breaks. He has been working hard in occupational therapy sessions by doing planks, yoga, and push-ups. He has also done a great job practicing on his own at home. In recent weeks, Judson has shown great improvements with his form and overall endurance. Today, all of his hard work finally paid off-  he reached his goal!

Telehealth Portal

Parent Portal

Access our Parent Portal for convenient, secure online management of your child's therapy services. Through our parent portal you can view:

  • Upcoming Appointments
  • Clincial Documentation:
    • Evaluation Reports
    • Progress Summaries
    • Treatment Notes 
    • Home Education Programs
  • Invoices & Make Account Payments
Multiple children can be linked to one portal.
Multiple parents can access their portal through their individual email log in.

Having trouble accessing your parent portal?
Email: contact@theratreepeds.com and include:

  • Your Name
  • Your Child's Name
  • Your preferred email to associate with portal.

Annual Patient Updates

To ensure we have the most current information about your child, please complete our Annual Patient Update Forms at the beggining of each new year. These forms help us keep your child's records up-to-date, including contact details, medical history, and any changes in therapy needs. Your cooperation ensures we provide the best possible care and avoids surprise bills.

Media Consent

We respect your family's privacy and preferences and understand those preferences may change when it's time to celebrate your child's success. Our Media Consent Form allows you to specify your consent for the use of photos, videos, and other media of your child during therapy sessions and clinic events. Your consent helps us share the positive impact of our services while safeguarding your child's privacy.

Release of Information

To provide the best care for your child, you may want us to share information with other healthcare providers, medical equpitment suppliers, or educational institutions. A Release of Information Form is required per HIPAA regulations for our staff to share your child's records with anyone you may have not listed on your original intake forms. However, our parent portal gives you direct access to all your child's records. You may download any document your self at any time to distribute to need your needs without completing a seperate form. 

Change of Insurance 

To ensure seamless billing and coverage, our Updated Insurance Form is required whenever there are changes to your insurance information. Keeping this information current helps avoid any interruptions in your child's therapy services or surprise bills. In addition to submitting this form at the time of insurance change, parents must call/text us at 270-688-8449 or visit the front desk to confirm your child's records have been updated with your new insurance infomation. 

Card Payment Authorization

For your convenience, we offer the option to keep a credit card on file for easy billing and payment processing. This incluse HSA or other payment cards with a standard credit card format. Complete the Card Payment Authorization Form when updating your cards. In addition to submitting this form at the time of card payment change, parents must call/text us at 270-688-8449 or visit the front desk to confirm your child's records have been updated with your new new card. 

Success Stories

We love celebrating the achievements of our patients! Please complete our Success Story Testimony Consent Form to allow us to share your child's therapy journey and successes. Your consent helps inspire other families and highlights the positive impact of our services, while respecting your child's privacy.

We want to ensure that your child's therapy experience is as smooth and stress-free as possible. Understanding your insurance coverage and financial responsibilities is an important part of this process. This guide will walk you through common insurance terms and financial responsibilities you need to know to avoid unexpected bills and feel confident in your child's care.


Insurance Verification and Coverage

Before starting therapy, verify your own insurance benefits to understand what services are covered.

  • In-Network Provider: An in-network provider has a contract with your insurance company to provide services at a negotiated rate.

  • Out-of-Network Provider: An out-of-network provider does not have a contract with your insurance company, which often means higher costs for services.

    • In-Network vs. Out-of-Network: We are in-network with most major insurance providers. If your insurance is out-of-network, you may have higher out-of-pocket costs.

    • Example: If we are out-of-network, you might pay 40% of the session cost instead of 20%.

  • Covered Services: These are the medical or therapy services that your insurance plan agrees to pay for. Coverage varies by plan and might include services like physical therapy, occupational therapy, speech therapy, or ABA therapy. 

    • Not all therapies are covered. Check which services (e.g., occupational, physical, speech, mental, ABA therapy) your plan covers.

    • Example: Your insurance may cover speech therapy but not ABA therapy. You would need to pay out-of-pocket for ABA therapy.

  • Limitations and Exclusions: 

    • Visit Limits: There may be a limit on how many sessions are covered each year.

      • Example: Your plan might cover 20 physical therapy sessions per year. After that, you’d need to pay out-of-pocket.

    • Exclusion: A condition or instance that is not covered by your insurance plan.

      • Example: Some out-of-state commercial plans only cover ABA therapy for patients with an Autism Diagnosis and therefore all other diagnoses are excluded. 

    • Service Caps: Certain services may have caps on the amount of coverage.

      • Example: Insurance might only cover up to $2,000 of ABA therapy annually. Anything beyond that would be your responsibility.

  • Requirements: Some plans need authorization from your insurance or a physician’s order from your doctor before we can start therapy.

    • Authorization: Authorization is a pre-approval process where your insurance company agrees that a specific service or treatment is medically necessary.

    • Physician’s Order: A physician’s order is a written order from your primary care doctor or specialist for you to see a therapist or receive a specific service.

    • Example: Without prior authorization for occupational therapy, your insurance may deny the claim, making you responsible for the full cost.

 

Financial Responsibilities

  • Coordination of Benefits: If your child has coverage from more than one insurance plan, benefits will need to be coordinated between the two plans.

    • Primary Payor: The insurer that pays a healthcare claim first up to the limits of its coverage. This is usually a commercial insurance plan from an employer or self-sponsored. If no commercial coverage, this may be a government-sponsored plan (Military or Medicaid). 

    • Secondary Payor: After the primary issues their payments, the claim goes to the secondary to pay the remaining balance up to the limits of its coverage. Depending on coverage, there may still be a balance. Government-sponsored plans (Military or Medicaid) will always be secondary payers to commercial plans. 

    • Example: If one plan covers 80% and the other covers 20%, you might not have any out-of-pocket costs.

  • Deductible: The amount you pay before your insurance starts covering services.

    • Example: If your deductible is $1,000, you must pay this amount out-of-pocket before insurance covers any therapy sessions.

  • Co-payment: A fixed amount you pay for a covered service, usually at the time of the visit. Co-pays vary depending on your insurance plan and the type of service.

    • Example: You might have a $30 co-pay per session.

  • Co-insurance: The percentage of the cost of a service that you are responsible for after meeting your deductible. 

    • Example: If your co-insurance is 20%, you pay 20% of the service cost, and insurance pays 80%.

  • Out-of-Pocket Maximums: After reaching this maximum, your insurance covers 100% of costs.

    • Example: If your out-of-pocket maximum is $5,000, once you’ve paid this amount, insurance covers the rest of the therapy costs for the year.

  • Some insurance plans have a combination of these.

    • Example: You may need to meet a deductible first, then have a co-pay for visits after your deductible is met. 

 

Billing and Payment Policies

  • Billing Process: We complete a payment estimate based on your insurance plan to be paid at the time of services. We then submit the claim to your insurance. Once processed, if there is any remaining balance, you'll receive a bill. 

    • Example: If insurance covers 80% of a $100 session, you’ll receive a bill for the remaining $20.

  • Explanation of Benefits (EOB): An EOB is a statement from your insurance company that details how a claim was processed, what they paid, and what you might owe. It’s not a bill, but a summary of how your benefits were applied.

  • Denial: A denial occurs when your insurance company refuses to pay for a service or treatment. This can happen for several reasons, such as lack of authorization or services being deemed not medically necessary.

    • Appeal Process: We can help you appeal the decision. This may involve providing more information to your insurance company.

    • Example: If insurance denies coverage for a specific therapy, we’ll work with you to appeal the decision by providing additional documentation.

  • Payment Plans: If needed, we can set up a payment plan to help you manage costs over time.

  • Late Payment Fees: If a payment is late, there may be additional fees. See your intake paperwork for a comprehensive list of fees. 

  • Out-of-Pocket Costs for Uninsured Services: Some services may not be covered, in this care you are responsible for paying. 

  • Private Pay Rates: We offer rates for services not covered by insurance.

    • Example: If your insurance doesn’t cover feeding therapy, you could pay our private pay rate directly.

 

Additional Tips to Avoid Unexpected Bills:

  • Ask for Cost Estimates: Before starting a new therapy or adding sessions, ask us for an estimate of your out-of-pocket costs.

    • Example: If your child needs an additional therapy session each week, we’ll estimate the cost based on your insurance coverage.

  • Review Your Explanation of Benefits (EOB): Your EOB is a summary from your insurance company showing what they covered and what you owe.

    • Example: After a session, your EOB might show that insurance covered $80 of a $100 session, meaning you owe $20.

  • Regular Financial Check-Ins: We’re here to help. Schedule a time to review your billing and coverage with us if you have any concerns.

    • Example: If your insurance benefits are running low, we’ll discuss options with you to continue care.

  • Updating Insurance Information: If your insurance changes, let us know immediately to avoid coverage issues.

    • Example: If you switch jobs and get a new insurance plan, coverage might be different, and we’ll need to re-verify your benefits.

  • Cancellation & Fees: We charge for late cancellations or no-shows.

    • Impact on Insurance Coverage: Frequent cancellations could affect your insurance coverage for future sessions. Insurance might deny continued therapy if sessions are frequently missed or canceled.

  • Stay Informed: Watch out for any changes to your insurance and review our financial policies before starting services. We want you to feel fully informed and confident in your child’s care.

CareCredit: Apply here

We accept the #CareCredit credit card to help bridge the gap between insurance and the cost of care. If you haven't met your deductible, or have other out-of-pocket expenses, CareCredit is a great option. Apply here or learn more today. 


Autism Care Today: https://www.act-today.org/

  • Grants are up to $5000.00

  • S.O.S. program for families with an immediate need for treatment/support and if not found, the applicant's physical safety is in jeopardy.

  • Grant payments are made directly to service providers

Anchor of Hope Foundation: http://www.anchorofhopefoundation.com/

  • The maximum grant for special needs children for various uses is $250 per child. Click on “Scholarships,” and then “Online Application” to reach the Anchor of Hope scholarship application and instructions.

Autism Cares: http://www.autismcaresfoundation.org/

  • The Autism Cares webpage contains a direct link to the registration process for a Financial Support Award. 
  • These awards are granted on a monthly basis to families who have experienced a qualifying event, such as the loss of employment. 
  • The maximum award per family is $1,000.

Autism Now State Support Grants and Cash Subsidies: http://www.autismnow.org/funding-and-public-policy/family-support-grants-and-cash-subsidies/state

  • The Autism Now webpage provides links to specific state family support grants or cash subsidies. 
  • Each resource has different qualifying amounts and eligibility criteria.

Autism Support Network: http://www.autismsupportnetwork.com/resources/autism-grants-unitedstates

  • The Autism Support Network webpage provides listings as well as direct links to dozens of financial resources and other online support.


Autism Speaks: https://www.autismspeaks.org/ 


Benefits.gov: https://www.benefits.gov/

  • This site provides access to a “Benefit Finder,” which offers multiple search methods to quickly find state and federal benefits.


Different Needz Foundation: http://www.differentneedzfoundation.org

  • Offers grants to people with developmental disabilities for therapy, equipment, and services.
  • The child must have a developmental disability diagnosis.
  • You may only submit an application in January. Grants are awarded in March.
  • You do not need to submit your income tax return.
  • The clinician and family decide on the appropriate session length.


First Hand Foundation: https://www.firsthandfoundation.org/

  • The foundation offers grants of up to $1,000 for ABA therapy for those meeting financial guidelines.


Friends of Man: https://www.friendsofman.org/index.php

  • Must be referred by a healthcare professional, social worker, case manager, teacher, clergy, or counsellor.
  • Assistance is only for prostheses, wheelchairs, medical equipment, mobility equipment.
  • Cannot be for previous services or existing balances.
  • Checks are issued directly to vendor


Giving Angels Foundation: https://givingangelsfoundation.org/

  • For children under 21
  •  Only for physical disabilities, such as Spina Bifida, paralysis, missing limbs or illness (such as, cerebral palsy, multiple sclerosis, cancer)
  • Maximum $1000 grant (one-time) per family.
  • Application is completed online by parent/caregiver only.

Home and Community Based Waiver: 

  • GRADD or RVBH can do case management for HCB recipients.
  • To Apply: Call the ARC department at 800.928.9094


Kiddie Pool Equipment Funding: https://www.adaptivemall.com/kiddie-pool

  • Family joins the program free and a custom webpage is created for child.
  • You market webpage and individuals can make donations
  • Donations are only for products and equipment sold by adaptive mall.

KY Integrated Health Insurance Premium Payment (KI-HIPP) Program: https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx

  • May be eligible if you have at least one Medicaid member on an existing employer health
  • Apply through benefind website: https://benefind.ky.gov/


Kya’s Krusade: http://www.kyaskrusade.org/info/programs-and-services/

  • Provides grants for adaptive equipment, hippotherapy, and PT/OT if not covered by insurance.
  • Open to children under 18 w/ confirmed Dx of a lifelong physical disability affecting motor skills/mobility and OT/PT is part of treatment program


Medicaid: https://benefind.ky.gov/

  • During COVID, if you do not have insurnace coverage, you can apply for 2 months of temporary coverage (must apply for Medicaid to continue) 
  • Apply online or reach out to a DCBS Assister for support. Applications can also be printed and mailed/faxed. An interview may be required


Michelle P. Waiver: https://chfs.ky.gov/agencies/dms/dca/iddcsb/Pages/mpw.aspx

  • For recipients of Medicaid or those who qualify
  • Provides assistance to individuals with intellectual or developmental disabilities.
  • May qualify if individual would be admitted to an intermediate care facility or nursing facility if they did not have waiver services

Modest Needs Foundation: http://www.modestneeds.org/for-applicants/

  • This link takes you to the required registration page to learn about several Modest Needs grant opportunities and eligibility requirements.


Orange Effect Foundation: https://theorangeeffect.org/grant-application/

  • For children and young adults with speech disorders to effectively communicate through technology and speech therapy.

Small Steps in Speech: http://www.smallstepsinspeech.org/

  • Open to children between 3 and 22 years of age and a combined family income under $100,000.

  • Intended for children with speech and language disorders

  • Must be applied for by the parent/guardian

  • Deadlines for grant submission are: 2/1, 6/1, and 11/1

  • Can only be used for future services

  • Grants are awarded one time for a family/individual
  • Services can only be provided by ASHA certified therapists (CCC-SLP)


Special Needs Resource Project: http://www.snrproject.com/Resource/Links/Kentucky

● Links/contact info for many resources and funding sources in the state


Suzy Foundation: https://suzyfoundation.org/

  • Provides therapy or technology assistance for different aspects of special needs children.
  • Child must be 17 years old or younger.
  • Letter or prescriptions from doctor confirming the need for the requested assistive device or therapy
  • Letter of denial from parent/guardian’s insurance company

Talk About Curing Autism: Family Scholarship Program: http://www.tacanow.org/family-resources/autism-grants/

  • Dozens of grant and scholarship opportunities are available for families to help with the cost of ABA therapy.


UnitedHealthcare Children’s Foundation: https://www.uhccf.org/

  • Parent/Caregiver must apply for the grant online.
  • Child must be 16 years of age or younger at the time of application.
  • Child must have a Social Security Number issued by the Social Security Administration. TIN numbers are not accepted.

  • Family must not exceed maximum eligible family income as documented on IRS Tax Form 1040.

    • $55,000 or less for a family of 2

    • $85,000 or less for a family of 3

    • $115,000 or less for a family of 4

    • $145,000 or less for a family of 5 or more

  • Primary coverage for the child must be by a commercial health plan, either through an employer or individually purchased. Secondary insurance through Medicaid or CHIP is permissible.

  • Child is under the care of a licensed medical professional and family is applying for treatments/equipment/services prescribed by a Medical Doctor (M.D.), Doctor of Osteopathic Medicine (D.O.) or Doctor of Audiology (Au.D.) for hearing conditions.
  • Awarded funds are accessed online and expenses are submitted to funds.


PRIVACY PRACTICES
​Therapeutic medical treatment and quality of care is one of our highest priorities. We are committed to the privacy rights of our patients and their families. We are required to provide you with this notice of our legal duties and privacy practices required to maintain the privacy of protected health information. We are required to abide by the terms of this notice currently in effect.  We reserve the right to change the terms of our notice and to make the new notice provisions in effect for all protected health information that we maintain. If we do update our notice, we will post a revised notice on our website. You may also request a copy of any revised notice by calling the office and requesting that a revised copy be sent to you in the mail or by asking for one at your time of you next appointment. 

Health Insurance Portability and Accountability Act (HIPAA): HIPAA is a federal law published by the US Department of Health and Human Services (45 CFR Part 160 and Subparts A and E of Part 164) in 1996 that sets national standards for protecting sensitive health information. It requires health care providers, including TheraTree, LLC, to safeguard patient Protected Health Information (PHI). TheraTree will notify affected individuals as required by law if a breach occurs that may have compromised the privacy or security of protected health information. ​HIPAA gives parents and guardians rights over their child’s health information, including the right to access records, request corrections, and understand how information is used or shared. TheraTree, LLC follows HIPAA regulations to keep patient health information private and secure.

Personally Identifiable Information (PII): Any information that can be used to identify your child or your family, either on its own or when combined with other information. Examples include name, address, phone number, date of birth, email address, Social Security number, or photographs and recordings that show identity.

Protected Health Information (PHI): A subcategory of PII that relates specifically to health care. PII becomes PHI when an individual is identified and connected to an their health information. PHI includes any information that identifies your child and relates to their past, present, or future physical or mental health, the care they receive, or payment for health care services. Examples include medical records, therapy notes, diagnoses, test results, treatment plans, and health insurance information. Both PII and PHI are protected by federal and state privacy laws, and TheraTree, LLC safeguards this information in compliance with HIPAA and applicable regulations.

HOW YOUR HEALTH INFORMATION MAY BE USED
PHI will be used and disclosed as part of rendering care for treatment, payment and, healthcare operations. Access to health information is limited to clinicians involved in care, authorized administrative personnel for billing and compliance, and payer or government auditors when required by law. Federal and state privacy laws permit the use or disclose your PHI without obtaining consent or without giving you a chance to object or agree with the use or disclosure in the following circumstances:

Provide Therapeutic Services: We will use your health information within our office to provide, coordinate, or manage your care​. This may include administrative and clinical office procedures. Because we believe students are the future for providing quality services to our patients, student clinicians, assistants, and interns on our team will have access to your health information, observe, and/or lead treatment. Although volunteers in our volunteer program do not have direct access to health records, they are present in our facility. All students and volunteers have completed HIPAA training and signed HIPAA agreements. We may share your health information with referring physicians/pediatricians/therapists or other health care personnel providing your treatment. TheraTree may disclose protected health information to business associates that perform services on our behalf when permitted by HIPAA. Business associates are required by applicable law and contract to appropriately protect the information they receive.​

Obtain Payment: We may include your health information with an invoice used to collect payment for treatment you receive in our office. We may do this with insurance forms filed for you in the mail or sent electronically. We will be sure to only work with companies with a similar commitment to the security of your health information.

Conduct Health Care Operations: It is possible that health information will be disclosed during audits by insurance companies or government appointed agencies as part of their quality assurance and compliance reviews. Your health information may be reviewed during the routine processed of certification, licensing, or credentialing activities.

Patient Communication: We may contact you to follow up on your care and inform you of treatment options or services that may be of interest to you or your family. These communications may include postcards, letters, telephone calls, voice mail, bulletins or email.

Abuse or Neglect: We will notify government authorities if we believe a patient is the victim of abuse, neglect, or domestic violence. We will make this disclosure only when we are compelled by our ethical judgment, when we believe we are specifically required or authorized by law or with the patient’s agreement.

Public Health and National Security: We may be required to disclose to Federal officials or military authorities health information necessary to complete an investigation related to public health or national security. Health information could be important when the government believes that the public safety could benefit when the information could lead to the control or the prevention of an epidemic or the understanding of a new medical device.

For Law Enforcement: As permitted or required by State or Federal Law, we may disclose your health information to a law enforcement official for certain law enforcement purposes, included (under certain limited circumstances) if you are a victim of a crime or in order to report a crime.

Family, Friends, and Caregivers: We may share your health information with those you tell us will be assisting you with your treatment or payment. We will be sure to ask your permission first. In the case of emergency, we will use our best judgment when sharing your health information.

Medical Research: Advancing medical knowledge often involved learning from the careful study of the medical histories of prior patients. Formal review and study of health histories as a part of research study will happen only under the ethical guidance, requirements and approval of an Institutional Review Board.

Uses and Disclosures of Therapy Notes: Therapy notes are recorded by a health professional documenting of currently level of functions. progress, and medical need for treatment taken during the session. We may disclosure notes taken for the following limited purposes.

For Treatment: The therapy provider that created the therapy note may use the notes for your treatment or to provide you with health care services/ For example, a physician may review her note prior to your therapy session. 

For Training: We may use and disclose therapy notes for our own training programs in which student , trainees, or practitioners learn under supervision to practice to improve their skills. 

Legal Action: We may use and disclose therapy notes to defend ourselves in a legal action or other proceeding. For example, we may provide therapy notes to our lawyers who are defending us in a legal case brought by you. 

Coroners or Medical Examiners: We may disclose therapy notes to a coroner or medial examiner. 

Required by Law: To Avert a Serious Threat to Health or Safety: We may disclose therapy notes when required to do so by law. We may use and disclose therapy notes if we believe that the use or disclosure is necessary to prevent or lesson a serious and imminent threat to the health or safety of a person of the public. 

Authorization to Use or Disclose Health Information: Other than what is stated about or where Federal, State, or Local law requires us, we will not disclose your health information without your written authorization. You may revoke that authorization in writing at any time.

TECHNOLOGY 
TheraTree, LLC uses audio, video, digital, and artificial intelligence (AI) technologies as part of daily clinical, administrative, and operational activities. This disclosure is intended to inform clients and families of these practices and the safeguards in place to protect Protected Health Information (PHI).

Electronic Systems and Communication: A variety of secure electronic systems are used to support client care and operations, including but not limited to: Electronic Medical Record (EMR) systems, secure patient portals, encrypted email communications, secure text messaging platforms, scheduling and appointment reminder systems, telehealth and virtual care platforms, cloud-based document storage and encrypted backup systems, data analytics tools, training and platforms, digital signature platforms for consents and forms, and online payment and billing platforms. All PHI is stored in TheraTree’s HIPAA-compliant EMR system. Paper materials are digitized for secure storage, with originals destroyed once electronic storage is verified. Records are retained for a minimum of seven (7) years after the last date of service, or longer as required by law or payer policy, after which they are securely destroyed through HIPAA-compliant methods.

Audio and Video Monitoring: Audio and video cameras are located in indoor common areas and outdoor spaces and used for safety, security, training, and quality assurance. Monitoring does not occur inside restrooms or select private therapy rooms. 

Recordings and Transcriptions: Remote or in person services and consultations may use HIPAA-compliant videoconferencing platforms and/or other secure devices to facilitate therapy and consultation services. Recordings may be used for transcripts, documentation, supervision, training, quality assurance or operational decision-making.  

Artificial Intelligence (AI) Tools: AI technologies are used to support clinical and administrative operations. Examples include transcription services, meeting analysis, clinical support tools, and data organization systems. These tools are implemented to improve care quality, efficiency, and safety, and are used in compliance with privacy and security requirements.

Digital Assessments and Monitoring: Tablet or computer-based testing applications, digital therapy tools, and standardized assessments administered electronically may be used for remote patient monitoring (RPM) and outcomes tracking. Remote therapeutic monitoring (RTM) devices may be incorporated such as smartphone apps or wearable devices to gather activity and/or physiological data as appropriate. RTM services may be billed to the insurance company.  

Data Protection and Privacy: All technologies listed in this disclosure and data collected will be maintained in accordance with HIPAA, state and federal privacy laws, and TheraTree, LLC’s internal compliance policies. Data may become part of the patients permanent medical record and will be securely stored, retained only as long as necessary, and disposed of in accordance with applicable law and policy. Protected Health Information (PHI) is safeguarded and access is limited to authorized personnel. Technology and collected data may be reviewed at varying intervals depending upon the patients treatment plan, medical necessity, and clinician availability. Technology is not continuously monitored and should not be used to report emergencies, urgent medical concerns, or situations requiring immediate attention. Call 911 or seek appropriate emergency services as needed. Data is not used for marketing or promotional purposes without separate written consent.  

PATIENT RIGHTS AND RESPONSIBILITIES
Patient receiving therapy services and their legal guardians have the following rights related to health information within the limits of the law.

Access to Care: Receive considerate, respectful, compassionate care regardless of your age, gender, race, national origin, religion, gender preference, or disability. Receive care in a safe environment free from all forms of abuse, neglect, or harassment. Have your property treated with dignity and respect. Receive services that are clinically appropriate and medically necessary when medical necessity is required for the applicable service or payer.​ Receive services from qualified personnel who practice within the applicable scope of their license, certification, credential, training, supervision requirements, and professional standards.​ Change health care providers if dissatisfied with your care.

Informed Care: Be informed of treatment plans and participate in the development and implementation of plan of care. Receive a clear explanation of evaluation results; to be informed of potential or lack of potential for improvement. Be fully informed of the care and treatment that will be provided by us, the cost of care, and how payment will be handled. Ask questions about evaluations, diagnoses, recommendations, treatment approaches, expected benefits, potential risks, alternatives, progress, and discharge recommendations.​ Be provided with services in a timely and competent manner, which includes referral to other appropriate professionals when necessary. Be informed of discharge in a timely manner and be involved in discharge planning. ​Be told the name of health care provider(s) and the professional qualifications of the person providing services. Request or refuse treatment, and receive information regarding the consequences of refusing treatment.

Restrictions: Request restrictions on certain uses and disclosures of health information. TheraTree is generally not required to agree to every requested restriction unless applicable law requires otherwise. ​We will make every effort to honor reasonable restriction preferences from clients.

Confidential Communications: Expect full consideration of patient privacy and confidentiality in care discussions, evaluations, and treatments. Expect that all communications and records about care are confidential, unless disclosure is allowed by law. Request communication in a certain way inlcuding privately with your other family members present or through mailed communications that are sealed. We will make every effort to honor reasonable requests for confidential communications.

Inspect and Copy Your Health Information: Read, review, and copy your health information, including evaluation reports, treatment records, progress notes, and billing records, as permitted by law. Certain health information may be subject to additional federal or Kentucky confidentiality requirements ​ , including mental health records, substance use disorder records, ​ test data (such as responses, scores, and examiner notes), test materials (such as manuals, test questions, or scoring keys), and other specially protected information​. Under Kentucky law and the American Psychological Association (APA) Code of Ethics, test materials are protected to preserve the validity and integrity of the standardized assessment(s) and cannot be released directly to clients, parents, or other unauthorized persons. Test data may only be released to another credentialed professional who has appropriate training and experience in the specialized testing and who is authorized to receive the data. When TheraTree creates, receives, or maintains records protected by 42 CFR Part 2, TheraTree will use and disclose those records in accordance with applicable Part 2 and HIPAA requirements. Part 2 records may receive additional protections beyond ordinary HIPAA requirements. Specific health information may be withheld if its release would pose a risk of harm or lead to misuse or misinterpretation of test results. If you would like a copy of your health information, please let us know by emailing contact@theratreepeds.com. You will be charged a reasonable fee described in the financial responsibility agreement and in alignment with state regulations for duplication costs.

Amend your Health Information: Ask to update or modify records if you believe your health insurance records are incorrect or incomplete. We will be happy to accommodate you as long as our office maintains this information. In order to standardize the process, requests must be made in writing along with a description of the reason for the change. Requests may be denied if the health information record in question was not created by our office, is not part of our records, or if the records containing health information are determined to be complete and accurate.

Documentation of Health Information: Ask for a description of how and where health information was used by us for any reason other than for treatment, payment or health care operations. Please let us know in writing the time period for which you are interested. Thank you for limiting your request to no more than six years at a time. We will charge a reasonable fee for these request define in our finacial responsibility agreement.

Request a Paper Copy of this Notice: Obtain a copy of this Notice of Privacy Practices directly from us at any time. We are required by law to maintain the privacy of your health information and to provide you and your representative this Notice of Privacy Practice. We are required to practice the policies and procedure described in this notice but do reserve the right to change the terms of this Notice. If we change our privacy practices, all patients will receive a copy of the revised Notice.

Complaints: Express complaints to us, or the Secretary of Health and Human Services if you believe your privacy rights have been compromised. We encourage you to express any concerns you may have regarding the privacy of your information. Please let us know of your concerns or complaints in writing and address them to our Patient Advocate so that we may undertake the proper procedures to remedy the situation as quickly as possible:
TheraTree, LLC Attn: Patient Advocate ​
Address: 2605 New Hartford Rd. Owensboro, KY 42303
Phone: 270-688-8449  Email: contact@theratreepeds.com ​

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. TheraTree will not retaliate against you for exercising your privacy rights or filing a complaint. ​Information regarding filing a HIPAA privacy complaint is available through the U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201

Patients and their legal guardians have the responsibility to:

  • Provide complete and accurate information reasonably necessary for TheraTree to evaluate, coordinate, document, bill, and provide services.​
  • Immediately communicate known safety risks, medical concerns, behavioral risks, allergies, precautions, or other information that could affect the safe provision of services.​
  • Promptly communicate relevant changes in the patient's health, medications, diagnoses, symptoms, behavior, functioning, insurance coverage, contact information, custody or guardianship information, or other circumstances that may affect care. ​
  • Attending scheduled appointments consistently and following TheraTree's Attendance and Scheduling Policy, including applicable cancellation, rescheduling, and notification requirements. ​
  • Arrive prepared for services with medications, equipment, communication devices, food, supplies, forms, records, or other items reasonably necessary for the scheduled service when applicable.​
  • Behave respectfully toward other patients, families, staff, and visitors and follow reasonable safety instructions and facility rules. ​
  • Respect the privacy and confidentiality of other patients and families encountered in TheraTree facilities or services.​
  • Remain under the care of your physician while receiving therapy services.
  • Participate in the evaluation and treatment process.
  • Follow mutually established plans of care, home recommendations, safety instructions, and other clinical recommendations to the extent they have agreed to participate in those recommendations.​
  • Ask questions  when you do not understand an instruction, recommendation, treatment activity, plan of care, or other information related to services.​ ​
  • Fulfill applicable financial obligations in accordance with the Financial Responsibility Agreement, including providing accurate insurance information and notifying TheraTree promptly of changes in coverage.​
  • Accept the responsibility for any refusal of treatment.

NONDISCRIMINATION AND ACCESSIBILITY SERVICES​
TheraTree, LLC complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, including limited English proficiency and primary language, sex, age, or disability in its health programs and activities. TheraTree, LLC does not exclude individuals from participation in, deny the benefits of, or otherwise subject individuals to discrimination in the provision of health care services on the basis of a protected characteristic.

TheraTree, LLC provides free language assistance services and auxiliary aids and services when necessary to ensure meaningful access to our health programs and services and effective communication with individuals with disabilities. Free assistance may include qualified interpreters, including sign language interpreters, oral interpretation in other languages, translated information, and information provided in accessible formats. You will not be charged for language assistance, auxiliary aids, or services that are required to provide meaningful access or effective communication. ​Language assistance and accessibility services are available free of charge. This notice is available in alternate formats and in additional languages upon request. ​If you need language assistance, an interpreter, an auxiliary aid or service, an accessible format, or another communication accommodation, please tell a TheraTree staff member or contact:
TheraTree, LLC Attn: Section 1557 Coordinator​
Address: 2605 New Hartford Rd. Owensboro, KY 42303
Phone: 270-688-8449  Email: contact@theratreepeds.com 

Complaints​: If you believe TheraTree, LLC has failed to provide required language assistance, accessibility services, reasonable modifications, or has otherwise discriminated on the basis of race, color, national origin, sex, age, or disability, you may file a grievance with TheraTree's Section 1557 Coordinator. Information about TheraTree's Section 1557 grievance procedure and assistance with filing a grievance are available from the Section 1557 Coordinator. TheraTree, LLC will not intimidate, threaten, coerce, retaliate against, or otherwise discriminate against an individual for filing a grievance, opposing discrimination, requesting an accommodation or assistance service, or participating in an investigation.

Civil Rights Complaints​: You may also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. Filing an internal grievance with TheraTree, LLC does not prevent an individual from filing a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.​
Online: HHS Office for Civil Rights Complaint Portal ocrportal.hhs.gov
Mail: Centralized Case Management Operations U.S. Department of Health and Human Services 
200 Independence Avenue, S.W. Room 509F, HHH Building Washington, D.C. 20201
Phone: 1-800-368-1019  TDD: 1-800-537-7697  Email: 
OCRComplaint@hhs.gov

​

GOOD FAITH ESTIMATE
If you do not have health insurance, or if you have health insurance but do not intend to use it to pay for your services, you have the right to receive a Good Faith Estimate explaining the expected charges for your health care. A Good Faith Estimate is not a bill. It is an estimate of the charges TheraTree, LLC reasonably expects for the items and services identified based on the information available when the estimate is prepared.
You have the right to request a Good Faith Estimate before scheduling services. If you request a Good Faith Estimate before scheduling services, TheraTree, LLC can provide it within 3 business days after the request. If you schedule services at least 3 business days in advance, TheraTree, LLC can provide a written Good Faith Estimate within the timeframe required by federal law. If you schedule services at least 10 business days in advance, TheraTree, LLC can provide a written Good Faith Estimate within 3 business days after scheduling.
The Good Faith Estimate will identify the items and services reasonably expected to be provided and the expected charges for those services. Requesting a Good Faith Estimate or initiating an eligible dispute will not adversely affect the quality of health care services you receive. If you receive a bill from TheraTree, LLC that is at least $400 more than the amount identified in the applicable Good Faith Estimate, you may have the right to dispute the bill through the federal Patient-Provider Dispute Resolution process.
To request a Good Faith Estimate or ask questions about expected charges, contact: TheraTree, LLC Finance Department: finance@theratreepeds.com
For additional information about your rights under the No Surprises Act, visit www.cms.gov/nosurprises or call the No Surprises Help Desk at 1-800-985-3059.

GRIEVANCES 
Clients, parents, legal guardians, and authorized representatives have the right to communicate concerns, recommendations, opinions, or grievances regarding the services received. You have the right to file a grievance without interference, coercion, discrimination, retaliation, or reprisal. Filing a grievance will not adversely affect your access to services or the quality of services provided. If you need assistance understanding or using the grievance process, please ask a TheraTree staff member for assistance.​

How to File a Grievance: A written grievance may be submitted to TheraTree, LLC regarding a concern about services, treatment, client rights, staff conduct, communication, policies, or another matter related to services received. Clients have 30 calendar days from the event to file a grievance. Please include enough information for the concern to be reviewed, including the client's name, the nature of the concern, relevant dates or circumstances, and the resolution being requested when applicable. TheraTree will review and respond to written grievances within 30 calendar days of receiving the grievance. Written grievances may be submitted to:
TheraTree, LLC Attn: Ombudsman
Address: 2605 New Hartford Rd. Owensboro, KY 42303
Phone: 270-688-8449  Email: contact@theratreepeds.com

Appeals: If you disagree with TheraTree's written response or resolution, you may submit a written appeal according to the process and timeframes established in the Client Grievance Policy. Clients have 30 calendar days from receiving the grievance decision to file an appeal. TheraTree provides a written appeal decision within 30 calendar days of receiving the appeal. Written appeals may be submitted to:
TheraTree, LLC Attn: Ombudsman
Address: 2605 New Hartford Rd. Owensboro, KY 42303
Phone: 270-688-8449  Email: contact@theratreepeds.com ​

Kentucky Cabinet for Health and Family Services: Clients may also contact the Kentucky Cabinet for Health and Family Services regarding concerns about services. Current Cabinet contact information may be verified through the Kentucky Cabinet for Health and Family Services. ​

Cabinet Ombudsman: Kentucky Cabinet for Health and Family Services Office of the Ombudsman and Administrative Review Phone: 1-800-372-2973  TTY: 1-800-627-4702

Signs of Improvement!

"The staff have worked really well with her and she enjoys going to her sessions. She hasn't been going long yet but there are signs of improvement and they have given us, as her parents, goals and activities we can continue with her at home."

Milestone Moment

Winston has been working on communication skills with his therapist this week. Winston would mimic words, but never phrases and does not make statements on his own, yet! Winston's therapist has been prompting him to repeat phrases said to him and he has improved his willingness to communicate the phrases everyday. Although, today Winston verbally mimicked the phrases he has been practicing with his therapist for the first time! Way to pass such a HUGE milestone, bud!!