We understand that healthcare billing can be challenging, and we try to make that process as stress free as possible.  We accept the following health insurance plans and will gladly verify your benefits prior to treatment.  While we do try to obtain the most accurate information, it is estimated, not a guarantee.

We are in network with the following insurance carriers:

  • Aetna (except Duke Select, Duke Basic)
  • Blue Cross Blue Shield (except Blue Value, Blue Home)
  • Cigna
  • Medcost
  • Medicaid
  • Medicaid managed care plans (Amerihealth Caritas, Carolina Complete Health, Healthy Blue, United Healthcare Community, Wellcare)
  • United Healthcare
  • UMR/Multiplan
  • Early intervention providers for Wake County

Insurance FAQs

How do I know my insurance plan is accepted?

If you are interested in getting services for your child, you can call our office at 919-844-6611 or send an inquiry HERE to have us confirm we accept your insurance plan.

What if I don’t have insurance or you don’t accept my insurance?

If you currently don’t have insurance or we are out of network with your insurance carrier, we offer reasonable self-pay amounts for our services.  See below for pricing.

  • ST/PT/OT/FT Evaluation and report: $200.00
  • Treatment (any service): $40.00 per 15 minutes.  For example $80.00 for 30 minutes, $120 for 45 minutes.
How do you determine insurance coverage?

We will verify your benefits prior to your child’s appointment. Please note when verifying insurance benefits, that it is only a quote, not a guarantee of coverage or payment. We encourage you to call your insurance company to obtain specific benefits your plan provides.

What are visit limits?

Some plans specify a limit on the number of physical/occupational/speech therapy visits allowed per plan year. Sometimes these visits are combined with other services such as chiropractic care or occupational therapy. Other times, the visit limit applies to each service only. It is each patient’s responsibility to keep up with the number of visits they have used. Once you have exhausted your visit limit, your insurance will often not pay for additional visits. If your therapist determines that more visits are necessary, we offer private fee rates for each discipline. We are happy to assist you in planning ahead in these situations, so that we can come up with an effective plan for your child’s optimal recovery.

What if my insurance denies coverage?

We cannot guarantee what your insurance carrier will and will not pay. As always, we look to our patients to understand their benefit packages, which are issued through their employer groups. If you have any questions concerning your insurance benefits, each insurance company has a member service department available for questions. We will send your claims for services rendered to your insurance carrier for you, and will even appeal unreasonable claim denials. But there are times when we will need to request and receive your assistance in the processing of your claims. And if your insurance carrier denies any claims, we do ultimately hold you financially responsible for any balance.

Will you file my insurance for me?

Yes, we will file insurance for any in-network plans. In most cases, insurance will cover a portion of treatment costs, as long as your benefits cover OT, PT, and speech-language therapy AND services are considered medically necessary. We understand navigating insurance can be confusing, so Abilitations will contact your insurance company and verify your coverage based on your policy as a courtesy to you! In addition, if you do have benefits, we will also file claims directly to insurance – on your behalf – to take the worrying and confusion off your hands.