In Clinic & At Home Pricing
Brain Harmony is an in-network provider for TriCare East only. If you are a TriCare East member, we accept Prime and Standard plans. Prime requires authorizations before services are provided. The only out-of-pocket costs for our services are the co-pays and deductibles defined by your insurance plan.
For all other insurance plans, Brain Harmony is an out-of-network provider. Brain Harmony collects payment when services are rendered; however, we will submit claims electronically on your behalf in hopes that your plan will provide you reimbursement. You should not expect to get reimbursement from your insurance company until you have met your out-of-network deductible.
Out for In?
Brain Harmony's clinics are located in the Pan Handle of Florida, an area of the country without enough health care providers to meet the needs of the community. Because the area is considered medically under-served, you may be able to obtain an exemption from your insurance company to include Brain Harmony as an in-network provider for your family. In this scenario, Brain Harmony will accept payment from your insurance company and your responsibility will be for the co-pays and deductibles as if Brain Harmony is an in-network provider under your plan.
To understand if this is an option for you, please call the member line on the back of your insurance card. Inform them that your family member will be seeking pediatric occupational therapy specializing in using iLs' suite of products and you are unable to find a provider in your area. If your insurance plan does not have a pediatric OT in your area specializing in using iLs' Suite of Products, ask your insurance company how to include Brain Harmony as an in-network provider for your child.
Nationwide Home Program
Brain Harmony's home program is typically not covered under most medical insurance plans; however, some families have obtained reimbursement using the Durable Medical Equipment (DME) coverage of their insurance plan. Many plans do not require authorizations for Durable Medical Equipment less than $500 a month. To learn your options under this scenario, please contact the member line on he back of your insurance card and ask if your plan includes DME coverage and ask how to submit reimbursement for a DME bill that you incurred out-of-pocket.
For those families who intend to submit a DME claim to your insurance company for the monthly use of the iLs Focus system or the one-time use of The Safe and Sound Protocol, you may need the following information about Brain Harmony:
For both clinic or home-based services, Brain Harmony accepts the following methods of payment:
all major credit cards
checking account drafts
health care spending accounts
Gardiner Scholarship - Brain Harmony is a direct bill provider.