Preparing for your first visit

We can’t wait to meet you! Please click on the links below to complete the required information. Feel free to call us at 316-440-3316 if you have any questions.

All Patients:

1. Client Information and Payment/Insurance Information*

2. Sprout Policies*

3. Initial Pediatric Health Questionnaire*

Child in FOSTER CARE:

Foster PARENT/CAREGIVER to complete forms 1-3 listed above*

1. Client Information and Payment/Insurance Information*

2. Sprout Policies*

3. Pediatric Health Questionnaire*

Foster Care AGENCY or Case Manager to Complete:

1. Foster Care Agency Information

Sprout Notice of Privacy Practices - Click HERE to read our Privacy Practices in detail

Forms will be hyperlinked

FORMS

Insurance

We accept insurance as a courtesy to our clients and will make every effort to bill your insurance provider according to the terms of your plan. However, please note:

Insurance verification is not a guarantee of coverage. Even if a representative confirms coverage, services may still be denied.

It is strongly recommended that you review your policy and contact your insurance company directly to understand your benefits.

To help guide your conversation with your insurance provider, consider asking the following questions:

Are Occupational Therapy (OT) services covered under my plan?
Are there any diagnoses or age-related exclusions (e.g., developmental delay)?
Are there any OT-specific exclusions in my policy?

Be sure to document the date, time, and confirmation number of your call for future reference.

Methods of Payment

In Network Insurance Plans:

We are in network with most commercial insurance companies

In Network Medicaid:

Healthy Blue Kansas

Sunflower State

Kancare UHC Community Care

Out of Network Insurance Plans:

United Commercial Policies

Private Pay

Cash, Checks, and Credit Cards Accepted

Questions about cost of services can be directed to Julie Frazier:

(ph) 316-249-5888, (Fax) 316-202-5186, or email Julie Frazier .