Frequently Asked Questions

Each private insurance policy is different and comes with its own limitations and coverage benefits.

Prior to beginning therapy services, our billing team will verify your insurance benefits based on your policy and provide you with a Letter of Financial Responsibility. We know dealing with unexpected expenses is challenging, and we want to ensure you’re well-informed before beginning with our practice.

If your insurance plan doesn’t offer coverage for therapy services, or offers only limited coverage, we make every effort to work with you to ensure you can obtain the services you need.

Carolina Therapeutics is in-network with a variety of insurance plans, including:

• Aetna
• Blue Cross Blue Shield
• Cigna
• MedCost
• Medicare
• United Healthcare
• North Carolina Medicaid
  • Cardinal Innovations
  • Partners Behavioral Health Management
• South Carolina Medicaid
  • Absolute Total Care
  • Blue Choice
  • First Choice by Select Health
  • Molina
  • Tefra

We provide patients with a Letter of Financial Responsibility that outlines the specifics of their individual insurance plan. For more information on insurance and billing for therapy services, reach out to our billing specialist directly at billing@carolinatherapeutics.com or 704-654-8599 x 2.

South Carolina Medicaid’s benefits coverage for medical services is well-known, but coverage for ABA Therapy Services is extremely limited at this time.

The insurance reimbursement rates for those requiring ABA Therapy – according to the SC Department of Health and Human Services’ Autism Spectrum Disorder State Plan – are substantially beneath the minimum necessary to provide the high-quality ABA services that we demand of our clinicians. This includes limited coverage for assessments, parent training, and program management. In order to maintain our quality standards, we are unable to provide ABA Therapy services when SC Medicaid is the only available insurance source.

Yes. It is our policy to only offer therapy services to those who have demonstrated medical necessity via a referral from a qualified physician or other appropriate medical practitioner, and we routinely assist our clients in obtaining these necessary referrals.

Although some insurance plans do not require a referral from a doctor or appropriate medical practitioner, our administrative team works to obtain a prescription for therapy services from your loved one’s doctors to ensure that therapy is documented as medically necessary, which helps to ensure that therapy services are authorized and covered by your insurance plan.

Although we are happy to collaborate with other practices regarding your loved one’s care, insurance benefits often do not allow for the coverage of services through multiple practices.

Feeding Therapy and Speech Therapy by a Speech-Language Pathologist are separate services, but insurance plans often do not pay for services provided by two separate practices since the services are provided by one practitioner.

However, we are happy to look into your insurance plan specifics and discuss additional services on a private-pay basis should you wish to receive therapy from two separate practices.

Our waitlist times vary depending on client demand and clinician availability. Because many of our clinicians offer highly-skilled therapy services, we may have longer waitlists than some other practices. This is especially true for Feeding Therapy Services and ABA Therapy Services.

However, our waitlists are not linear, meaning that although we like to ensure that those who have been waiting longest receive services as quickly as possible, we also ensure that our therapists are appropriate for your family and its specific needs. Here are some of our considerations:

• What is your availability for therapy?
• Where will therapy be provided?
• Is the right therapist for your family available based upon your needs?
• What are your insurance plan’s therapy requirements? For example, do you have the appropriate diagnosis for services?

We understand that waiting for therapy services to begin is challenging, and we do our best to keep you updated and informed on the process of initiating services. While we aim to process all client referrals as quickly as possible, we believe that finding the right fit between client and therapist is crucial to obtaining the best possible therapeutic outcome.

If you are on our waitlist, please remember that our referral coordinators are actively making every effort to pair you or your loved one with the best possible therapy provider at the earliest possible time.

CentralReach is the electronic medical records management tool that our practice utilizes in order to maintain patient records, manage clinician schedules, and provide patient portal access to all of our therapy clients.

Pertinent personal information, such as social security numbers and driver’s license numbers, are necessary in order to verify insurance coverage for clients. All personal information provided to Carolina Therapeutics, PLLC, remains strictly confidential, and is maintained in an encrypted, highly-secure format only accessible by authorized administrative personnel.

By registering with CentralReach, you can complete all of our intake paperwork online. This is HIPAA-compliant and accessible online by computer, tablet, or mobile device.

Required information is indicated by an asterisk (*). Although it may seem like a lot, this information helps us in ensuring that we match you or your loved one with the best possible clinical provider.

If you have any difficulty completing the necessary paperwork online, contact our administrative team. You can also stop by one of our offices to fill out the paperwork on one of our company iPads.

Our clinicians see patients in homes, daycares, throughout the community, and at our various clinical office locations.

We currently see clients for therapy services in the Greater Charlotte region, including Charlotte, NC, Fort Mill, SC, and Rock Hill, SC, as well as in Greenville, NC and Greenville, SC. We also provide therapy services at specialized centers, like Thrive Day School and Melmark Carolinas.

Our clinical office locations include:
Carolina Therapeutics, PLLC
1698 Hwy. 160 W., Ste. 240
Fort Mill, SC 29708

Carolina Therapeutics, PLLC
308 C Greenville Blvd.
Greenville, NC 27858

Carolina Therapeutics, PLLC
6705 White Horse Road
Greenville, SC 29611

Our office hours are Monday through Friday, 9 a.m. to 5 p.m. However, many of our clinicians work with families on their schedules and may have availability outside of these hours.

Our clinicians work hard to ensure that patients can be seen during times of need, and we understand that this may often mean working around a variety of schedules. Although we do our best to meet the needs of our clients, weekends are not offered for those receiving ABA Therapy Services at this time. Occasionally, our medical providers will work with families on the weekends based upon special circumstances, but this is not a regular occurrence.

Any therapeutic community outings with our clinicians must be approved by a supervisor, program manager, or rendering provider at least 24 hours in advance.

Carolina Therapeutics offers a variety of therapy services, including speech therapy, feeding/swallowing therapy, occupational therapy, physical therapy, and ABA therapy services. We also offer lactation consulting and specialty evaluations.

Availability of services may be limited depending on your location and the availability of clinicians in your area:

Charlotte, NC (in-home and throughout the community): speech therapy, feeding/swallowing therapy, occupational therapy, physical therapy, and ABA therapy services.

Fort Mill, SC (in-home, throughout the community, and our clinical office): speech therapy, feeding/swallowing therapy, occupational therapy, and ABA therapy services.

Greenville, NC (in-home, throughout the community, and our office): speech therapy, feeding therapy, and lactation consulting.

Greenville, SC (in-home, throughout the community, and our clinical office) – ABA therapy, speech therapy, occupational therapy, and physical therapy services.

For additional information about services available in your area and clinician availability in your area, please feel free to call us at 704-654-8599.

Our clinicians are trained to work with clients of all ages. Our medical providers who offer speech therapy, feeding/swallowing therapy, occupational therapy, and physical therapy services routinely address the needs of patients across the lifespan.

ABA Therapy services are only offered to pediatric patients (18 months through 18 years of age) with a confirmed Autism Spectrum Disorder diagnosis.

At Carolina Therapeutics, we individually assess each patient who has demonstrated significant self-harm or aggressive behaviors and, based upon the level of severity demonstrated, will determine if we are able to provide therapy services within the scope of our practice.

When a child has a history of engaging in such behaviors, we have an obligation to consider the safety of our clinicians, the child, and our other patients with whom the child may have contact. These considerations impact our ability to take on a specific patient.

Note that all of our ABA Therapy clinicians, and many of our medical providers, are trained in Crisis Prevention Intervention (CPI) to appropriately address the challenges created by patients with self-harm behaviors.

Play Therapy, also called Developmental Therapy, is often offered to families with children ages birth to three as part of an Early Intervention Program. Children learn best through playing, and children play better when therapy is fun!

At Carolina Therapeutics, all of our clinicians implement skilled therapeutic intervention strategies with an emphasis on play, using toys functionally while actively engaging with others. However, traditional “play therapy” is not directly offered by our practice at this time.

Although Applied Behavior Analysis (ABA) frequently falls under “behavioral health benefits,” we do not offer mental health counseling or psychological services at this time. If you would like a referral for mental health counseling or family counseling, please reach out to your primary care provider for an appropriate referral in your area.

No, Carolina Therapeutics does not currently offer tutoring services. If your child does not qualify for skilled intervention through Speech Therapy, Occupational Therapy, Physical Therapy or ABA Therapy, but you feel as though additional support is required, we may recommend tutoring.

Due to the substantial need for high-quality therapy services for those demonstrating medical necessity, we do not see patients who do not qualify for therapy services, even on a private-pay basis.

Our evaluating clinicians use diagnostic methods that are based upon state-of-the-art research. We take into consideration variables such as the individual’s strengths and weaknesses, impacts on the individual’s quality of life, family dynamics, scheduling availability, individual history, and prognosis, to name a few. We always make recommendations based on medical necessity and apply for therapy coverage to the highest level possible.

Even though we may make a recommendation for a particular quantity of a therapy service, we are limited to certain constraints, such as insurance coverage, policy limitations, skilled provider availability (based on the service type), and client schedules.

Following an evaluation by an appropriate Carolina Therapeutics evaluating clinician, a plan of care is created for you or your loved one. Collaboration between therapy practitioners may also occur, particularly if you or your loved one receives multiple therapy services.

Individualized goals are always included within our plan of care in order to support each client’s specific needs. We develop goals by analyzing formal assessments, developmental milestones, performance on activities of daily living, and prior therapeutic history, among other things.

Each plan of care contains goals specifically related to a Home Exercise Plan, as the leading research indicates that family involvement is key to developing a successful therapeutic intervention plan.

After the plan of care is developed, we also discuss desired goals with the client and family so that all members of the family are involved in helping to achieve the highest possible therapeutic benefit.

We love all of our therapists and we make every effort to accommodate requests for specific clinicians to provide therapy services. For families who are looking for specific therapeutic services or intervention strategies, we will try our best to place you with a qualified clinician with the specific expertise you require at the earliest possible time.

However, if you would like to wait for a specific clinical provider, you can remain on our waitlist until your preferred provider is available, though you may experience a prolonged waiting period for the initiation of therapy services.

Many of our clinicians maintain a full-time caseload with a wide variety of patients, and meeting one of our clinicians prior to services beginning can prove very challenging as that clinician attempts to ensure that existing patient needs are being satisfied.

We encourage you to check out our clinician biographies prior to therapy services beginning. If you have specific questions about our clinicians prior to beginning services, reach out.

We require that a person who is at least 18 years of age be present for all therapy sessions conducted at home or within the community. We must also obtain a HIPAA release signed by a legal guardian so that we may discuss patient progress and events observed during therapy sessions with interested parties.

This policy is necessary for the safety and wellbeing of our clients and clinicians. If an appropriately-aged caregiver cannot be present for a therapy appointment, we will need to cancel the appointment.

No. Although our clinicians may attend therapy sessions conducted within the community, they are required to drive separately. They cannot drive your child to or from an appointment or outing, and they are not allowed to ride in your vehicle.

This policy is necessary for the safety and wellbeing of our clients and clinicians.

We love that your family loves our clinician – we do too! However, all clinicians must follow specific Codes of Ethics pursuant to their particular therapeutic discipline. Many of these ethical requirements specifically state that clinicians are unable to provide babysitting services, and doing so could be a violation of a clinician’s code of ethics that could harm their ability to participate as a professional therapeutic provider in the future.

If you are looking for babysitting services or respite care, reach out to your provider for recommendations on local agencies and funding sources that might be able to help.

The therapy world is full of acronyms, shorthand and abbreviations. Here’s a glossary to help you share a common vocabulary with your providers:

• ABA – Applied Behavior Analysis – Treatment approach based on behavior theories and principles of learning for those with Autism Spectrum Disorders.

• AOTA – American Occupational Therapy Association – Professional association representing the interests and concerns of occupational therapists and students of occupational therapy.

• APTA – American Physical Therapy Association – Professional organization representing Physical Therapists, Physical Therapy Assistants and students of physical therapy.

• ASHA – American Speech-Language-Hearing Association – Professional, scientific and credentialing association for audiologists, speech-language pathologists, support personnel and students.

• BACB – Behavior Analyst Certification Board – Professional organization that certifies and registers ABA Therapy practitioners.

• BCBA-D – Board Certified Behavior Analyst-Doctorate – PhD-level certification in behavior analysis.

• BCBA – Board Certified Behavior Analyst – Graduate-level certification in behavior analysis.

• BCaBA – Board Certified Assistant Behavior Analyst – Undergraduate-level certification in behavior analysis; must be supervised by a BCBA or BCBA-D.

• CAS – Certified Autism Specialist – Certification program for educators and licensed professionals who provide services to individuals on the Autism Spectrum.

• COTA – Certified Occupational Therapy Assistant – Associate-level certification; requires clinical experience and supervision from a licensed Occupational Therapist.

• Dx – Diagnosis – Label determined by doctor or treating provider. Many different diagnoses may impact one’s ability to participate in daily activities.

• EI – Early Intervention – Therapy for children ages birth to 3. EI services often provided in collaboration with service coordinators and an EI Agency – Children’s Developmental Services Agency in NC, and BabyNet in SC.

• MD – Doctor of Medicine – Degree received by a medical provider.

• OT – Occupational Therapy – Therapy for those needing assistance to complete daily living activities throughout lifespan. For children, OT may look like play; for adults it may address job and life skills.

• OTR/L – Occupational Therapist Registered/Licensed – Rehabilitation specialist with a Master’s degree who helps clients participate in daily living activities.

• PT – Physical Therapist – Highly-educated, licensed health care professionals who help patients reduce pain and improve/restore mobility.

• PT – Physical Therapy – Treatment of a disease, injury or deformity by physical methods, e.g. massage, heat treatment and exercise, rather than by drugs or surgery.

• PTA – Physical Therapist Assistant – Paraprofessionals who provide physical therapy; work under direction and supervision of physical therapists.

• RBT – Registered Behavior Technician – Paraprofessional practicing under supervision of a BCaBA, BCBA, or BCBA-D; directly implements behavior-analytic services.

• Rx – Prescription – Written authorization for therapy services required by a patient’s doctor or psychologist.

• ST – Speech Therapy – Intervention focused on improving a child’s speech and abilities to understand and express language, including nonverbal language.

• SLP – Speech-Language Pathologist – Graduate-level certification in speech, language, voice, fluency and swallowing therapy.

• Tx – Treatment – Abbreviation used by therapists and medical providers.