Billing & Insurance

This is the maximum amount you have to pay per year for covered health care services.

This is the fixed percentage that you, the insured, must pay toward the insurance claim after you meet your deductible. This is also known as “member responsibility.” Insurance will pay a percentage of the total “allowed amount” for the claim, and you are responsible for the “co-insurance,” until the out-of-pocket max is met.

This is a fixed out-of-pocket amount that you, the insured, must pay toward the insurance claim after the deductible is satisfied. This is also known as “member responsibility.” Insurance will pay the total “allowed amount” for the claim, minus the co-payment amount that you are responsible for, until the out-of-pocket max is met.

Until you meet your deductible, insurance does not kick in to cover any of the “allowed amount” costs for the insurance claim. The amount that is allowed is applied towards your deductible, but you, the insured, are responsible for paying the bill until you have “met your deductible.”

For example, if you have a $1,000 deductible, you will be responsible for paying the first $1,000 of allowed charges. After you have met your deductible, your co-insurance or co-payment will kick in. At this point, insurance pays their portion of the allowed amount of the claim, and you pay the co-insurance or co-payment. If you satisfy your out-of-pocket maximum, insurance will then cover 100% of the allowed charges for covered services per your benefit plan.

Please keep in mind, insurance companies often have exclusions and limitations for covered services written within the details of your benefit plan. While we make it a priority to help families understand the financial liability of pursuing therapy services, we highly recommend families complete due diligence with understanding the details of their specific insurance plan, and what your financial liability for services will be.

If your plan puts a yearly cap on the number of covered therapy visits, once you have reached your visit limit maximum for the year, your insurance company will no longer cover physical therapy, occupational therapy, or speech therapy visits for the remainder of the year. Some insurances have different limitations to the frequency or duration of covering services, as well as limiting coverage for therapy services by excluding certain diagnostic codes.

Our billing team is here to support you in seeking clarity on what insurance will cover. However, we highly recommend you reach out to your insurance company directly to understand how they process your claims.

Please give any new insurance plan information to our billing team at [email protected] or the front desk during your next session. We will need a copy of your new insurance card once you receive it.

If we do not get this information in a timely manner, families will incur an administrative fee to reprocess claims to the new insurance.

We generate our statements on the 15th of each month. You will receive this via text message, email, or mail. This will depend on how you signed up to receive them via our patient portal.

You can find the balance on your account by logging into your Patient Portal online. This will always have the most up-to-date balance based on the visits that have been processed through your insurance company.

Please visit our Resources page to learn more about financial assistance in the Kansas City area. There are several resources available that may be able to assist you on your journey!

We believe that children deserve the best, and we want to continue treatment without unnecessary breaks. This is why we need a form of payment on file for each child to ensure their outstanding balance is resolved in a timely manner.

After therapy services are provided, an insurance claim is sent to the insurance company within 1-10 business days, on average, from the time of service. It can take insurance companies several weeks and at times, months, to process insurance claims. Our billing team is diligently working on monitoring the timely and accurate processing of insurance claims that we submit to your insurance company on your behalf. Once the insurance claim has been processed accurately, there oftentimes will be a remaining balance that is due from you, as the member. Instead of collecting payment for services at the time of service, we allow the insurance claim to process accurately, and then having your insurance card on file allows us to resolve the outstanding balance for your patient-responsibility in a timely manner.

Having your credit card on file is a relatively new, but rapidly adopted practice across healthcare providers and complimentary industries. Our intention with keeping your credit card on file is in alignment with our agreement with insurance companies to submit claims on your behalf, and wait on their processing before passing your financial responsibility fees onto you, per your insurance claim processing and agreement.

During intake, you have the option of selecting the frequency you’d prefer for us to charge the card on file, applying member responsibilities fees from insurance claims that have been processed and completed, or applying private pay rates accumulated from services that have been provided. If you have any questions on this policy, please reach out to our billing team at [email protected].

Yes, we do accept HSA/FSA cards. Once you have completed your payment through your patient portal using your HSA, FSA, debit, or credit card, please email the billing team at [email protected] to request your itemized receipt.

Playabilities partners with a third-party provider called Advance Care. This partnership allows clients to use a medical-specific credit card to access critical therapy services with a 0% interest rate for over a year, depending upon credit scores. Families can also keep their Advance Care Card on file with us to maintain a current account, simplifying ongoing payments and ensuring uninterrupted access to care.

It is important that our families are aware of their therapy benefits so that they can plan not only financially for the year, but also for their child’s therapy needs due to any therapy cap limitation on their insurance plan. We prioritize partnering with families to understand how these insurance benefit limits can impact the care for their children. However, we do ask that families monitor their annual therapy visits if they have a designated number of visits allowed per year, especially if the child is receiving therapy services outside of Playabilities.

Our billing team works hard to monitor the number of therapy visits completed while your child is under our care at Playabilities, and we try our best to notify families that are nearing their visit limits. In these situations, our clinical and billing team will counsel your family on options for how to proceed with services for your child, given the financial circumstances you are navigating.

Absolutely! Click this link to be redirected to our online payment system.