Client Registration and New Client Contact Form Information

We are pleased that you have chosen Pediatric Development Center of Atlanta to meet your child’s developmental needs. We look forward to working with your family. Before beginning Occupational Therapy, Speech or Feeding Therapy services there are a few easy steps to complete.

Be advised we are not accepting New Patients with any Form of Georgia Medicaid at this time. We are In Network with Anthem BCBS, Aetna and United Healthcare.  We will bill for Out of Network Benefits for other Insurance Carriers such as Cigna and Humana. We do have Tricare authorized Therapists on Staff.

GETTING STARTED – New Client Contact Form Click on Click Here in Step # 1 

  1. Click here to request an appointment for an evaluation and/or treatment services. Our office staff will contact by phone in 1-2 business days to discuss the following: basic client information, insurance/reimbursement information, prescription/referral, and registration forms and questionnaires, and to schedule the appointment.
  2. Once you have a Scheduled Appointment, please download and review the Notice of Privacy Practices listed below, then click on the Online Forms. When completed click the Submit Button at the end of each Form. VERY IMPORTANT – PLEASE COMPLETE THE FORMS AND SUBMIT AT LEAST 3 BUSINESS DAYS PRIOR TO YOUR SCHEDULED APPOINTMENT DATE. THANK YOU!
  3. Please plan accordingly for an on time arrival for your Appointment.

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Secure – Client Registration Forms

Button-Download-iconNotice of Privacy Practices – Download and Review 

**Online Client Registration Form – Required**

**Online Consent Form – Required**

**Online Parent Questionnaire (Medical History) – Required**

**Online Primary Insurance – Required**

**Online Secondary Insurance – Required if you have Secondary Insurance**

**Online Appointment Scheduling Request Form – Required If You Are Requesting Treatment Services After an Evaluation**

**Online Secure Email Authorization – Optional But Recommended**

**Online Authorization For the Release of Healthcare Information – Optional**

**Online VOICE MAIL Authorization For the Release of Healthcare Information – Optional But Recommended**

**Please use Secure File Upload on the Home Page to send us a copy of the Front and Back of your Medical Insurance Card(s), and a Copy of the Front of your Driver’s License**

Frequently Asked Questions

How do I enroll my child in therapy services?
To enroll your child in therapy services please follow the steps for “Getting Started” at the top of the page.  If you have any questions do not hesitate to contact our office for further assistance.

How do I know if my child needs a doctor referral for therapy?
Some insurance carriers require a doctor’s referral or prescription for occupational therapy and for evaluations in order for services to be covered. You will need to contact your insurance provider to determine if a referral is required. If a referral or prescription is needed, we can contact your child’s physician to obtain these documents.

What if I want my child to have an evaluation, but the pediatrician doesn’t feel it is necessary?
Not all pediatricians feel that an evaluation is necessary for certain delays or concerns that parents might have about their child’s development or behavior and sometimes doctors like to wait to refer a child for an evaluation.  If this is the case and you feel that you would still like to have your child screened or evaluated now you may do so, but without a doctor’s prescription you may be required by your insurance company to cover the cost of the evaluation.  In some cases if a developmental issue is identified that requires therapy services and a doctor provides a prescription for such an insurance company might reimburse for some or all of the cost of the evaluation.  This is dependent on the insurance plan and our office would be more than happy to assist you in communicating with your insurance company on this matter.

What happens if my insurance doesn’t cover all of the therapy visits?
Some children with significant delays or impairments often require more frequent therapy services than their insurance plan will cover.  If you have a secondary insurance plan, like Medicaid or the Katie Beckett Waiver, it may roll over and cover additional services. If you do not have secondary insurance and your child requires therapy services beyond what your primary insurance will cover, our billing coordinator will be happy to work out a payment plan that is appropriate for your family to cover the additional therapy services.
Some insurance companies don’t cover all evaluations.  If this is the case we can often work within your insurance company’s parameters to find an evaluation that is still appropriate and covered by insurance.  If you would like us to perform a specific evaluation that is not covered or a suitable alternative evaluation cannot be found, you will be required to cover the cost of the evaluation.  Our billing coordinator would be happy to work with you to set up a payment plan for the cost of the evaluation.