If you are applying for Long Term Care (LTC)/DDD (Division of Developmental Disabilities), here is some useful information on how this will affect your Physical, Occupational, Speech or Feeding Therapies here at Team 4 Kids.
As a parent of a child with a Developmental Delay who has LTC/DDD and has been coming to Team 4 Kids for therapy for years, I know first hand how confusing and sometimes overwhelming this process can be!
There are essentially 8 steps that will be taken before your therapies can begin or resume:
- Application
- Evaluation/Assessment.
- Determination. {If eligible,you will move on to step 4}
- Become Effective with LTC AHCCCS Healthcare Plan
- Schedule ISP Meeting with Support Coordinator
- Meeting Date Becomes DDD Effective Date.
- Request Prescriptions From PCP.
- Authorizations Received! {Let The Therapy Begin!}
One of the common misconceptions of LTC/DDD is that your therapies will be covered through your AHCCCS healthcare plan. Once you are approved for DDD services, your authorizations will then switch to DDD rather than your AHCCCS healthcare plan. This can be a lengthy process, therefore it is integral that you let any of our Administrative Teammates know about your eligibility ASAP. We can start working on your family’s behalf and get the ball rolling on receiving the appropriate authorizations. There is a small window of time between becoming eligible for LTC/DDD and when your authorizations will become effective which can leave your therapies without coverage.
Once you have received the great news that you have been accepted, this will become your effective date. If you previously had an AHCCCS plan, this will be when your plan will convert to Long Term Care. However, authorizations from DDD will only become effective after your first meeting with your Support Coordinator. This meeting is called an Individual Service Plan (ISP) meeting. At this meeting you will coordinate services that will be covered through DDD, including therapies. The date of your ISP meeting will then become your effective date for authorizations. Depending on scheduling issues, this could be a good amount of time leaving a gap of coverage. After your ISP meeting, your Support Coordinator will require prescriptions from your child’s pediatrician specifying what therapies your child will be receiving as well as frequency. Your authorizations will not be given until these prescriptions are received, which can also cause a gap in authorization. If your family has a commercial primary insurance, these steps will still need to be taken and authorizations are required with DDD as secondary insurance.
This is all overwhelming to families new to the process. We are here to help! If you have any questions, you are welcome to call the office and we will be glad to assist in any way we can!
Robin Petraglia
Patient Care Coordinator
