Thrive Outside LLC’s Policies and Practical Considerations

Cancellation policy

Since we know life happens, you are allowed one rescheduled visit for sickness, schedule conflict or travel per season. For this ONE session, please use the make up dates on the Thrive

calendar to reschedule the missed visit.

Per season, any canceled or missed sessions after the 1st missed/canceled session is not eligible for reschedule, replacement service, or refund. (Except for the Summer June July August season, 2 INDIVIDUAL SESSIONS can be made up if able.) Please consult the Thrive calendar to plan accordingly. Please give 24-hours notice for a canceled session whenever

possible.

If you are enrolled in a package where your child is coming 2x/week, then you are allowed two rescheduled visits for sickness, schedule conflict or travel per season. Per season, any canceled or missed sessions after the 2nd missed/canceled session is not eligible for reschedule, replacement service or refund.

Replacing an in person session

If you would like to replace one of your 10 seasonally in-person sessions with another type of visit (school visit, IEP meeting, etc), you must schedule this proactively with your therapist with sufficient notice to accommodate your request. Replacing an in person session with another type of visit cannot be done retroactively to replace a 2nd (or subsequent) missed session, except during the summer season of June-July-August, where you can replace 2 if needed during the make up times.

COVID-19 quarantine and air quality policy

Thrive strongly believes in the benefits for in person therapy sessions and will continue to strive to make those happen whenever possible. However, Thrive also recognizes that attendance is critical and one of the reasons for moving to package pricing is to provide different avenues for your child to make progress even when there are necessary cancellations due to air quality or quarantine.

For in-person sessions canceled due to COVID-19 quarantine or unsafe air quality, a replacement service will be provided from the following options:

- 50 minute teletherapy session

- 50 minute phone consultation

- Progress report

- Home program

- In-person make up session (if possible)

We will work together to determine which option is best for your child on the day that your session is canceled.

What counts as unsafe air quality?

● AQI over 100 (using Purple Air with US EPA conversion and only outdoor sensors checked), 90 minutes before your scheduled session at the location of your session

Therapist initiated cancellation

If your therapist cancels an OT session due to illness or unavailability, all efforts will be made to schedule an in-person make up session in the season when the cancellation occurs. In the event that a visit cannot be rescheduled by the end of the season, a $180 refund will be issued for the canceled session.

Switching weekly session time

For a schedule change (day and/or time), you must give Thrive one month’s notice before you would like the change to occur. There are no guarantees that you will be able to switch, especially if you need an after school spot, but Thrive will do everything possible to accommodate the request.

Payment for Your Occupational Therapy Services

There are two ways to pay for your season package:

Either

1. Prepay for the entire season by check made payable to Thrive Outside LLC

Or

2. Pay monthly via automatic withdrawal with a credit/debit card.

Regardless of how you choose to pay, all clients must have a credit card on file with us and be enrolled in autopay. Your card will be charged on the 1st of the month for the monthly fee, according to which package level you have selected. Any additional a la carte services will be charged on the day of that service.

It is your responsibility to update the card on file to make sure it is current and valid. In the case that a charge cannot be made due to an expired card, you will be contacted by Thrive Outside to input a new card on file. If you do not update your card in 72 hours, you will be charged an additional $25 administrative fee.

If you would like to pay in full for the season for a 3% discount, you may pay by check. If you are paying in full by check, you must let Thrive Outside know 2 weeks before the start of the season, and mail the check to arrive before the 1st of the first month of the season. The check will be deposited on the 1st of the month. If the check is not

received by the 1st of the month, your credit card on file will be charged for the normal monthly fee based on your package level. Please make checks payable to Thrive Outside LLC. For returned checks, there is a $25 fee plus any additional bank fees.

Full amount due if pre-paying by check:

● Pro Package: $3302.85

● Standard Package: $2488.05

● Basic Package: $2080.65

Insurance Reimbursement Receipts (Superbills)

Thrive OuTside is cash-based and does not bill insurance. Your insurance plan must have out-of-network benefits in order for you to be reimbursed for services provided by Thrive

OuTside, as we are not part of any insurance network. Further, many insurance plans will only reimburse for occupational therapy services if a physician has prescribed them as

medically necessary PRIOR to treatment. It is very important that you check with your insurance provider before starting services to clarify what services are covered, how they are covered and how they are reimbursed.

If you are seeking reimbursement from your health insurance company, you must claim benefits independently. Payment in full is due to Thrive OuTside regardless of insurance reimbursement. Charges are non-negotiable as agreed upon in the service agreement.

At the end of each season, if requested, Thrive OuTside can provide a paid-in-full invoice (called a “superbill”) with CPT codes that insurance companies use to identify procedures. CPT codes typically used for therapy include 97530, 97112, 97110, 97535, 96170, 97166.

Superbills will include all 1:1 therapy sessions that your child has attended, but please note many of the high value offerings that are included in each package are not reimbursed by insurance.

It is unfortunate that for many insurance companies, highly valuable services like communication between sessions, home programming, and phone consultations are not reimbursed. These additions to “typical” service delivery are amazing and help therapy to be more effective for everyone involved. There is research that shows the undeniable benefits of communication and collaboration between therapists and clients for maximum gains, and that is why Thrive does things differently than the typical model. We know these additional high value offerings increase the efficacy of therapy, so we have changed the typical model for one that is better for clients.

The fact remains, insurance reimbursement is a confusing, unfair place and we acknowledge that. Therefore, in order to help families, I include an increased per session rate on the superbill to reflect a majority of the financial investment you have made. A superbill at the end of the season will document the 10 sessions in a season and capture the majority of the package price (with 180$ per hour) in the total.

No Rollovers

The contents of each package are to be used in the season that they are paid for. Any unused phone consultations will NOT be rolled over into the next season, and any rescheduled sessions

must be rescheduled in the current season and will not be rescheduled to the next.

Discontinuing services

For a pause (longer than a month) or discontinuation of services, you must give Thrive OuTside 2 weeks notice in writing. If the end of therapy does not coincide with the end of a season, you will receive a prorated refund based on your end date (2 weeks after you have given Thrive OuTside written notice). The amount reimbursed will be based on the time

remaining in the season, not on what services have been provided.

Switching package level

Every season, you can determine what level of service is best for your family. If you are changing your level of enrollment, you must give 2 weeks notice in writing before the end of the

season so Thrive OuTside has time to make the appropriate changes.

Evaluations

Evaluations are a critical part of the therapeutic process. All new clients need an OT evaluation from within the past year. If you do not have an OT evaluation, you must complete an evaluation before beginning individual therapy with Thrive OuTside. After your evaluation is complete, or if you have your first consultation session with an evaluation, you are ready to start! Due to our program organization, you will always begin therapy at the beginning of a month.

If you are beginning therapy part way through a season:

Starting month 2 of 3 the season – 2 phone conversations- STANDARD (2 phone consultations BASIC)+ the available in person sessions, as determined by the Thrive calendar.

Starting month 3 of 3 the season – 1 phone conversations – STANDARD (1 phone consultations BASIC)+ the available in person sessions, as determined by the Thrive calendar.