Will the cost of Dolphin Assisted Therapy Program, or part thereof, be compensated by the health insurance company?
Reimbursement/Compensation of Care
Some costs of the care provided in our center may qualify for reimbursement/compensation from your health insurance, (e.g. physiotherapy). In order to check whether you are also eligible for reimbursement and to ensure that the reimbursement is actually granted, you can follow the following step-by-step plan.
You can also find additional information and tips when applying for the reimbursement/compensation in our 'Q & A' section.
Step 1 - Which health insurance plan do you have?
It is important for you to check which type of health insurance you have so that you know what the terms and conditions of your coverage are and what kind of reimbursement you can expect.
Step 2 – Prior permission
A health insurance provider generally requires that prior permission be obtained before treatment. Failure to receive permission implies that you are not entitled to reimbursement. The CDTC’s Dolphin Therapy program would be considered non-urgent care as it is requested and provided in advance. By applying for prior permission, you will also receive an overview of the costs that your health insurance company may or may not reimburse.
Whether or not you require prior permission may differ for each health insurance provider. It is wise to check which conditions are stated under your policy. Refer to the website of your health insurance company or your policy’s specific conditions.
In preparation for requesting permission from your insurance provider, you can in any case request a quotation from us with an overview of the treatments that are carried out and the associated costs. You can submit this with your request to your health insurance provider. You can request this quotation through our CDTC Office: firstname.lastname@example.org
In addition, it is wise to ask your attending doctors/physician(s) to send a referral to you or to write a letter confirming that they recommend and support the treatment.
Once you have obtained the quotation and referral letter, you can then request permission from your health insurance provider. Most health insurance companies use standard forms for this request. Please contact your health insurance company for further information on obtaining the correct forms.
If permission has been granted by your health insurance provider, it is wise to keep the paperwork safe. In addition, we would like to receive a copy of the letter of consent, so that we can accurately provide the information that the insurance company requires when submitting the invoice after the program has been completed.
After the therapy program has been completed you will receive an invoice from us. You can send this invoice to your insurance company in order to receive the pre-determined reimbursement.
Q & A
It is important that you provide the health insurer with accurate information that would be important in their objective assessment of the case (preferably with 1 contact person). Some suggestions of information that you might submit:
- a thorough description of the medical and physical situation
- an explanation from the doctors why you or your child will benefit from the treatment;
- a description of the treatment that is being carried out (see example here) [hyperlink to attached factsheet PDF].
OPTION: You can also invite the health insurance company to contact us to ask further questions. We are always prepared to answer these questions and provide further explanation.
Always ask your health insurance company for a detailed justification of a possible refusal to pay a reimbursement/compensation in the event that you ask for a reassessment. Please feel free to share this information with us.
If no permission has been granted beforehand, it is possible that your health insurance company will refuse to give a reimbursement/compensation. It is important that you ask for permission as soon as possible and coordinate with your representative at the health insurance company.
Your doctor can explain the following information: - a description of the medical situation - a description of the treatments that have been done previously - an explanation of why you/your child will benefit from the treatment.
Over the years several foundations have been established to provide financial support to patients and their families who wish to participate in the Dolphin Assisted Therapy Program in Curaçao.