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Patients with CHOC Health Alliance Insurance

For our patients who have CHOC Health Alliance Insurance – they require us to have our patient’s physician sign our reports stating they agree with our plan of care. Please be on the lookout for reports from this insurance type and send back to us timely to ensure a quick authorization turnaround.

Should I refer for Occupational Therapy or Physical Therapy?

Typically our Occupational Therapist will treat any upper extremity diagnosis including hands/wrists/arms/elbows/shoulders. Our Physical Therapists can also treat these body parts however they typically evaluate and work on all other body parts here at maXum Therapy. If you have a patient with any upper extremity ailments, please refer them for Occupational Therapy and all others for Physical Therapy.

Should I refer to maXum's Pediatrics Clinic or Adults Clinic?

Typically we see patients 12 years and older at our Adults Clinic. If they are under 12 but are a typically developing child and have strictly some type of orthopedic ailment, please also refer them to our Adults Clinic as long as they can follow typical instructions for strengthening and exercises. If the patient has any type of neurological condition or are not typically developing, please refer them to our Pediatrics Clinic if they are under 18 – our Pediatrics Clinic specializes in developmental delays and neurological conditions with children and adolescents.

How does aquatic therapy work?

We treat offsite at the YMCA in Fullerton. Our therapists may or may not enter the water so we typically treat Adult patients only for safety purposes. If a child or adolescent is referred to participate we will evaluate them here in our clinic to see if they would safely benefit from our Aquatic Therapy services. Aquatic Therapy is typically in a group setting of 5-10 patients at a time working on exercises in a weightless environment.

I have a question about referring a patient and which CPT Billing codes I should request from the insurance

We require our evaluation CPT codes to be accurate before evaluating a patient. If a referral is sent to us with incorrect codes, it can delay the patient being seen for their evaluation if a modification of an authorization is needed so it is important to request correctly the first time. Our codes vary based on type of insurance (Medi-Cal, Medicare, PPO, HMO, Workers’ Comp, etc). If you have questions regarding referrals and evaluation codes or authorizations please contact 714-646-8319 opt 1 and ask to speak with our authorizations department.