Premera/Lifewise, Regence BlueShield and L&I/Workers Compensation Insurance
I am an in-network provider for Premera/Lifewise, Regency BlueShield, and BridgeSpan Health. If you have coverage for occupational therapy (usually included in the outpatient therapy and/or rehabilitation benefit), I can bill your insurance company for my services. Clients without therapy benefits or who are insured by a carrier other than these may be able to request reimbursement for invoices paid through a flex spending or health savings account or as part of their out of network benefit.
I am able to bill L&I (or a self-insured company) for Lifestyle OT services if several conditions are met (you have an accepted claim, your attending physician refers you specifically for OT services, and the goal of treatment is specifically related to work).
L&I/Workers Compensation Insurance (and some medical insurance plans)
I am a provider for Washington State Department of Labor and Industries (L&I) and also work with self-insured (private) workers compensation companies.
Most medical plans specifically exclude ergonomic assessments as a covered benefit. Generally, this is because work-related injuries (and any related treatment) are covered under workers compensation insurance. But if your personal medical insurance plan covers ergonomic assessments, I am happy to bill your insurance for my services.
For those without coverage for ergonomics, I regularly work with clients whose injuries impact their ability to work but are not work-related (due to personal medical issues, injuries as the result of a car accident, etc.).
Employers often have a policy that allows for ergonomic assessments for employees who have injuries/symptoms that are not work-related (if they are impacting an employee’s ability to work). Many will allow for an assessment as a disability accommodation with a request from an employee’s treating medical provider. I am happy to discuss the benefits and costs related to an ergonomic assessment with an employer.
For those who are self-employed or have a home office, another option is paying privately for an assessment and then requesting reimbursement from your medical insurance provider through a flex-spending account or health savings account.
These services are generally not covered by medical insurance since health coaches are not required to have a professional license and are not qualified to treat those with medical conditions (unless they have a separate health care-related license). However, if your treatment goals qualify me to work with you as an OT, we can discuss how to bill for these services through your medical insurance plan.
If you are interested in my health coaching services and want the added benefit of my professional experience as a health care provider, I am happy to work with you on a private pay basis. I understand that each client has different financial resources to spend on their health and do my best to design a plan that will work with your budget. For some, group sessions may be more cost-effective. For others, individual sessions may be the most efficient use of their time and resources. For many, a combination is most appropriate.
*Please note that every insurance plan is different, and even within the same carrier, each policy will have different benefits. It is best to contact your insurance carrier or administrator directly to determine whether my professional services as an OT are covered under your specific plan.