Starting a Private Pediatric Practice

I'm thinking about starting a private pediatric practice and would appreciate any suggestions on where to get info. about starting one up. I especially need to learn about how to bill insurance companies.

I am trying to do the same thing as well, but it looks as though no one has replied to your message. I am currently doing research and as soon as I find out any information I will let you know ! :)

I just got out of private practice. It is a stressful event to track down insurance reimbursements that you are owed. You need to obtain a medicaid number. I dont know how Florida medicaid is, but arkansas medicaid is very picky after the fact. They will pay for therapy then change their minds and yank the reimbursement back. You really have to have your ducks in a row. I enjoyed the freedom and the income, however, I wont be pursuing private practice in the future.

I am in florida as well but in the Orlando area. Also in the process of starting a practice. Since just one person has replied with some suggestions...how about we try to share ideas...? I am two weeks away. I am in the process of obtaining medicaid number and advertising. There is also another program for 1-3 yrs old (at least in Florida) it is called early steps. You may also have it in Maryland. The website is www.cms-kids.com/default.htm.

hello

my wife and i are setting up an OT private practice also... would appreciate any info as well that is acquired and will share the info obtained... about time OT's got it together and went out on their own!... pt's do it all the time!!!

regards

Hi,

I created an online billing tool that is probably exactly what you are looking for. It lets you send claims electronically to a large list of insurance companies. It really makes the billing process VERY easy. There are several subscription plans that are perfect for therapists who are just getting started ($8.95 per month to manage up to 5 clients, you can manage unlimited clients for $19.95 per month).

There is a 30 day free trial with no restrictions. Your credit card is not needed for the free trial. I highly recommend that you try it. It has helped so many thereapists.

The web address is eiassistant.com. Come check it out, you have nothing to lose. You can read user testimonials and contact current users to hear about their experience.

www.eiassistant.com

Hey,

I'm interested in going into OT and that is how I came across the forum.

I worked for 10 years at a Third party administration company (insurance company) in NY. I did the credentialing of providers applications to gain acceptance with the plan and bill for services and I also processed medical claims there, so I know a thing or two about the field.

I'm not exactly sure what kind of information you are looking for but there are a few things you must know.

First many things depend on your state and who you will be billing for the services as far as private insurance or medicaid etc....
You must be very careful as someone already stated the insurance many times has to be hunted down to pay so you must be familiar with what is covered, what is not and get pre-authorizations to make sure before any procedures THAT IS THE MOST important precaution so you may get reimubursed. The insurance companies will find the smallest detail to not pay a claim other times it may be due to erorr or incompetence of the workers.
As far as becoming participating with a company well you just simply request an application and you either become contracted as a facility (which will cover all OT's within the practice) and get reimbursed under a general facility name or the proprietor's name depending on the tax id you use. The tax id or EIN (employer identification number) you must obtain from the state. It is used for purposes of taxes just like any vendor or store would use it. Sometimes it is not needed and you can use your social security number (The information is on the back of the W9 form which comes with an application from the companies). The other option is filling out applications for all OT's in the practice. You should contact the individual companies that have clients and plans who are permitted OT visits and get the info and applications directly from them.
95% of applicants are accepted just submit all documents requested on application.

Only those with over the limit malpractice payouts or providers that have been on sanctions lists are usually rejected.

Hope that helps somewhat because i wasn't exactly sure if your questions were regarding how to set up accounts with the companies or how does the actual submitting claims work.

OT08 in Orlando, Florida said: I am in florida as well but in the Orlando area. Also in the process of starting a practice. Since just one person has replied with some suggestions...how about we try to share ideas...? I am two weeks away. I am in the process of obtaining medicaid number and advertising. There is also another program for 1-3 yrs old (at least in Florida) it is called early steps. You may also have it in Maryland. The website is www.cms-kids.com/default.htm.

Hi. I live in NY. I am in the process on moving to Orlando and I was wondering if you could educate me about the OT salaries in Orlando. I prefer to get this info from OTs who are there in the field. Thanks and I wish you luck on opening your own practice

Hi This is in response to the person interested in OT from Elmhurst Queens. I have been led to believe that many of the insurance companies are not open to accepting applications to be on their provider lists. They frequently state the network is closed. If you can offer any other information it would be greatly appreciated. If you need some assistance or info about OT in NY let me know.

Marie in Westminster, Maryland said: I'm thinking about starting a private pediatric practice and would appreciate any suggestions on where to get info. about starting one up. I especially need to learn about how to bill insurance companies.

I consult to therapists across the country who want to start private practice and also have many products available to serve as a guide. PLease check out my website www.nytherapyguide.com. Best of luck in your endeavor.