FAQ

It might seem like a lot, but that’s why we’ve broken down the process here step-by-step.

1. If you have EPSDT AND private insurance, call your insurance carrier to find out if your insurance policy will pay for IN-HOME therapy with an out-of-network provider.  Please write down the date, what they said, who you talked to, and sign and date the note (e.g., per Stephanie at Humana, our policy will not cover in-home physical therapy, sign, and date, listing your name and client/child’s name).

If you have EPSDT and do NOT have private insurance, we will ask you to provide this to us in writing.  We will send you consent forms to fill out that includes this document.  If your private insurance will NOT pay for therapy, but you have EPSDT, we DO have the capability to proceed with service through EPSDT once we get an opening.

If your private insurance pays for therapy, we will proceed with the service once we get an opening.  If you have EPSDT, we will bill that after private insurance has been exhausted.  If you do not have EPSDT, you may be responsible for charges that private insurance does not cover.  

If you have private insurance ONLY—call your insurance carrier to find out if your insurance policy will pay for IN-HOME therapy with an out-of-network provider.  We also offer self-pay options that might be reimbursable by your private insurance.  

2. Contact us to be placed on the waiting list.  Please let us know who your case manager is! We will need information from them.  

3. AFTER we contact you or your case manager with an opening: we will send you consent forms for therapy we will need an order from your doctor for an ST, OT, or PT evaluation

4. Once we get an opening, the consent forms, the doctor’s order, and the information we need from the case manager, we will process and send for approval from Medicaid.

5. After we receive a PA (prior authorization) from Medicaid (you will receive a copy, too – often before we do), a therapist will contact you to schedule a date, time, and place to complete the evaluation.  Please feel free to contact us (and send us the PA!) if you receive a PA in the mail before we contact you!

6. After completing the evaluation, we will need to get ongoing therapy orders from your doctor.  

7. After we receive the ongoing orders, we will process and send for ongoing therapy approval from Medicaid.  Once we receive the PA (prior authorization) from Medicaid for ongoing therapy, the therapist will contact you to schedule the date & time of the future appointments.

Please let your therapist or us know if you have any questions during this process.

 Yes! Our website and all of our systems are compliant.  We also partner with AccountableHQ to ensure HIPAA compliance across our practice. 

We do have the ability to bill for EPSDT services through some of our providers.  We are also able to bill private insurance companies, as an out-of-network provider.  We are required to bill private insurances first (if you have it).  If you do not have private insurance, we can proceed through EPSDT.

Yes, we do, depending on location and therapist availability.  It is not guaranteed, but we try our best to accommodate the needs of our clients.

PIC provides services across central and eastern Kentucky, including the following cities:​