Policies

Program Philosophy

Developmental and holistic theories are critical in treating children with autism and other disabilities. It is important to utilize a knowledge base of a variety of theories and models to provide a customized treatment for every child, which include but not limited to SCERTS Model (Social Communication, Emotional Regulation, Transactional Supports), Therapeutic Crisis Intervention, Physical Crisis Intervention, Picture Exchange Communication System, behavioral intervention, and total communication.

Every child is unique and requires an approach that addresses his or her learning style and needs.

Autism Education

Peak Potential Therapy is based on both research and years of experience in treating children with disabilities, such as autism. We do not believe that any particular program will meet the needs of all children. Rather, when our therapists observe and interact with a child, he/she will show what he/she needs in order to learn. Our organization supports early, intensive, and consistent therapy for children, especially those on the autism spectrum because research clearly supports improved outcomes with early and intensive services. Parents are encouraged and supported to be active participants throughout the therapeutic process.

Peak Potential Therapy also provides training during therapy to parents, in order that they learn how to use effective therapeutic supports anywhere they are. Through this method the child is supported by the parents and the therapist in the same therapeutic manner, so the child can learn to communicate and emotionally regulate him/herself independently. These skills are regarded as foundations for the development of academic and social skills.

NOTICE OF PRIVACY – Practice & Confidentiality

THIS NOTICE DESCRIBES HOW PROTECTED MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Peak Potential Therapy LLC’s client/family’s confidential information will be upheld to the fullest extent possible. Peak Potential Therapy LLC will follow HIPAA rules. For more information on HIPAA rules and your rights, visit the US Department of Health and Human Services website, www.hhs.gov/ocr/hipaa/, or call Health and Human Services toll-free, 866-627-7748.

Authorization for Treatment/Consent to Health Care Services: I am requesting and agreeing to permit health care and or educational services to be provided to my minor child at Peak Potential Therapy (PPT). I voluntarily consent to all medical treatment and healthcare-related services that the caregivers at PPT consider to be necessary for the client named below. These services may include diagnostic and or therapeutic services. I am aware that the practice of healthcare-related services is not an exact science; no guarantees have been made to me about the results of treatments or examinations. I recognize and understand that PPT hires independent contractors, including but not limited to therapists, pathologists, and consultants, and they are not employees or agents of PPT. PPT is not responsible for the acts or omissions of the contractors who are not directly controlled by PPT.

I understand that PPT may provide certain services by remote telehealth technology. Such telehealth services involve a health provider who is at a site remote from my location at the time of the services, and, as such, telehealth often involves the transmission of video, audio, images, and other types of data. The remote health provider will determine whether the condition being diagnosed or treated is appropriate for telehealth, and I understand that I may have to travel to see a health provider in-person for certain diagnoses and treatment matters.

Authorization to Release Information: I permit PPT, its affiliated health care providers, and or their authorized personnel to access and or release all or any part of the client information, including by not limited to, the appropriate health care insurer(s), third-party payor(s), students receiving education or training in health care, and or PPT’s agent(s), attorney(s), and or consultant(s) for purposes including treatment of the patient, billing (or collecting payment) for services and health care services including improving patient care, training, marketing, or educating students, performance improvement initiatives, discharge planning, risk management, personal health record or other system-wide program(s) designed to foster interaction with patients via electronic means, and or as required by law. I understand and consent to disclosure of confidential medical and or educational information to a State or Federal Health Oversight Agency; an appropriate Public Health Authority; for purposes required by State and or Federal law; in cooperation with a Law Enforcement Investigation; in cooperation with a domestic or child abuse investigation; and for any other permissible purpose as outlined in Notice of Privacy Practices. PPT is permitted or required, under specific circumstances, to use or disclose protected health information without the client’s written authorization.

Record Retention Policy: PPT retains client medical and education records in accordance with applicable law and pursuant to its record retention policies.

Computer Data: I understand that the client’s medical and or education records will be accessible to authorized PPT personnel through computers and that PPT will comply with certain safeguards established by federal state and local law as well as PPT Policy.

Certification: I certify that to the best of my knowledge and belief, the information provided is complete and correct. I understand that this consent is subject to revocation by me at any time in writing, except if the person or entity authorized to make a disclosure has already acted in reliance on this form. Otherwise, subject to applicable law, this consent will expire at the same time PPT’s record retention period for this document expires.

Additional Permitted Uses and Disclosures of Confidential Medical Information: I consent to receive, on the cellular phone and or other telephone number(s) that are provided to PPT or updated at a later time, text messages and or telephone calls or other communications using live, artificial or prerecorded voices, automatic telephone dialing systems, or any other computer-aided technologies from PPT or other third parties who may act on their behalf. Such text messages and or telephone calls may be related to any purpose, including those related to my account and or the care rendered. I understand this consent to communications is not required to receive services from PPT or any of the other authorized callers and that data usage and other charges may apply. I may revoke this consent to these communications in writing at any time.

Peak Potential Therapy LLC is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to protected health information.

Peak Potential Therapy LLC is required to abide by the terms of the Notice currently in effect.

Peak Potential Therapy reserves the right to change the terms of this Notice. The new Notice provisions will be effective for all protected health information that it maintains.

Peak Potential Therapy LLC will provide individuals or patients with a revised Notice by emailing a notice.

Individuals may complain to Peak Potential Therapy LLC and to the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated. A brief description of how the individual may file a complaint follows:

COMPLAINTS: Peak Potential Therapy LLC clients and/or their guardian have the right to voice their complaints. Complaints should be made in writing to Holly Reimann at Peak Potential Therapy LLC, 8984 Darrow Road, Suite 2-289, Twinsburg, OH 44087 (telephone: 267-259-6461). Upon receipt of a complaint, an action plan to resolve the problem will be implemented. Peak Potential Therapy LLC will in no way retaliate because of a complaint.

Peak Potential Therapy LLC contact person for matters relating to complaints is:
Holly Reimann, MA CCC-SLP
7689 Sagamore Hills Blvd.
Northfield, OH 44067
(330) 405-8776
HReimann@peakpotentialtherapy.com

This Notice is first in effect on July 20, 2008.

Health & Safety

Peak Potential Therapy LLC follows health and safety guidelines to ensure the safety of the clients and herself. Precautions that the therapist uses include wearing gloves while handling bodily fluids and disinfecting toys/materials that have come in contact with bodily fluids. All bodily fluids are treated as if infections.

COVID19 Precautions & Protocols

We have been closely following the coronavirus (COVID-19) updates and want to assure you that we are following the guidelines from trusted resources and are taking comprehensive measures to ensure that our clinic stays safe for your child. Thank you for your patience and understanding during this time.

The health and well-being of our clients & staff is our top priority. For more detailed COVID-19 precautions and protocols, please click here.

Emergency Treatment Authorization:

The parent/guardian/caregiver of the enrolled client hereby authorizes the diagnosis and treatment of a qualified and licensed medical professional, of my child, should a medical emergency occur, which the attending medical professional believes requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement or impairment, or undue pain, suffering or discomfort if delayed. In the event of a medical emergency, every attempt will be made by the attending physician to contact the parent/guardian/caregiver in the most expeditious way possible. The authorization is granted only after a reasonable effort has been made to reach to the parent/guardian/caregiver. Permission is also granted to Peak Potential Therapy LLC and its affiliates to provide emergency treatment prior to the child’s admission to the medical facility. This release is authorized for the duration of the client being in Peak Potential Therapy LLC’s care. This release is authorized and executed of the parent/guardian/caregiver’s free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in the parent/guardian/caregiver’s absence.

Liability Hold Harmless Agreement Waiver:

The parent/guardian/caregiver of the enrolled client hereby understands that Peak Potential Therapy LLC takes reasonable precautions to ensure that Peak Potential Therapy LLC’s camp programs, therapy sessions, and activities are conducted by qualified personnel in a safe and responsible manner. The parent/guardian/caregiver hereby acknowledges and agrees that there is the possibility of physical injury or loss associated with my child’s participation in the program and hereby release, hold harmless, indemnify, and discharge Peak Potential Therapy LLC, its affiliated organizations, employees, and associated personnel including the owners of the program and program facility against any and all claims, liabilities, costs, and/or damages deriving from my child’s participation in the program, whether arising from an act or omission, negligent or otherwise, to the fullest extent permitted by law. The parent/guardian/caregiver understands that any fees charged for the program do not include accident or personal insurance. The parent/guardian/caregiver recognizes these risks and agrees to accept these risks by allowing their child to attend Peak Potential Therapy LLC’s camps and therapies, and participate in these programs. Permission is granted for the enrolled client to participate, and the parent/guardian/caregiver understands and acknowledges that this voluntarily and knowingly accepts responsibility for their child’s participation in all Peak Potential Therapy LLC’s camp and therapy activities.

Services

The staff primarily works with children with various disabilities. It is understood that children with disabilities need specialty treatment in the realms of social communication, emotional regulation, behavior modification, and or specific objectives from their Individualized Education Plan.

Fee Schedule – effective 7/1/2023

2023/2024 Therapy Services Fee Schedule
Center-Based Rates
In-Home / Community / Travel Rates
Private Pay Discount
Hourly
up to 3-hrs
up to 10 miles
10-20 miles
20-30 miles
30-40 miles
40-50 miles
50-60 miles
25%
20%
Travel Fee ****
$25
$40
$55
$65
$80
$95
Speech-Language Therapy
    Speech-Language Therapy
$140
$165
$180
$195
$205
$220
$235
$105
    SLT Assessment Package (up to 3 hrs; hourly therapy rate applies thereafter)
$420
$445
$460
$475
$485
$500
$515
$315
Occupational Therapy *
    Occupational Therapy
$140
$165
$180
$195
$205
$220
$235
$105
    OT Assessment Package (up to 3 hrs; hourly therapy rate applies thereafter)
$420
$445
$460
$475
$485
$500
$515
$315
Intervention & Reading Specialist *
    Therapy with Consultant
$115
$140
$155
$170
$180
$195
$210
$86.25
    IS Assessment Package (up to 3 hrs; hourly therapy rate applies thereafter)
$300
$325
$340
$355
$365
$380
$395
$225
Applied Behavior Analyst / Behavior Consultant *
    Therapy with a Behavior Consultant
$140
$165
$180
$195
$205
$220
$235
$105
    ABA Assessment Package (up to 3 hrs; hourly therapy rate applies thereafter)
$420
$445
$460
$475
$485
$500
$515
$315
Behavior Tutor / Registered Behavior Technician **
    ABA Tutor – Level 1 ***
$40
$65
$80
$95
$105
$120
$135
$32
    ABA Tutor – Level 2 ***
$45
$70
$85
$100
$110
$125
$140
$36
    ABA Tutor – Level 3 ***
$50
$75
$95
$105
$115
$130
$145
$40
Social Skills / Group ABA Therapy **
    Group facilitated by Lv.1 staff ***
$30
$55
$70
$85
$95
$110
$125
$24
    Group facilitated by Lv.2 staff ***
$40
$65
$80
$95
$110
$120
$135
$32
    Group facilitated by a licensed professional (OT, SLP, BCBA)
$70
$95
$110
$125
$135
$150
$165
$56
Academic Tutor / Aide / Instructional Assistant **
    Tutor – Level 1 ***
$40
$70
$85
$100
$110
$125
$140
$36
    Tutor – Level 2 ***
$45
$75
$90
$105
$115
$130
$145
$40
Additional Services
    Additional Progress Reports (weekly, monthly, etc.)
$105
per report
    Integration of assistive technology (iPad, laptop, etc)
$10
per session
    Visual Supports Creation
$50
    Parental Training & Consulting
$140
    Education Planning (3-hour minimum; plus travel)
$180
Min. $540
    Education Advocacy (3-hour minimum; plus travel)
$180
Min. $540
    Training & Seminars (3-hour minimum; plus travel)
$250
Min. $750
    Expert Witness (3-hour minimum; plus travel)
$250
Min. $750
Special Needs Camps
    SMILE Summer Camp (OT, SLP, BCBA, IS)
$850
per 5-day week
    Camp Wonder (OT, SLP, BCBA, IS)
$750
per 5-day week
    Camp Suntastic (OT, SLP, BCBA, IS)
$199
per 1-day week
    Camp SnowCubs (OT, SLP, BCBA, IS)
$800
per 5-day week
    Spring Break Camp (OT, SLP, BCBA, IS)
$800
per 5-day week
    Camp ABC (OT, SLP, BCBA, IS)
$400
per 3-day week
    Before & After Care Respite
$22
per hour
    Camp Aide
$25
per hour

* For clients paying out of pocket: 25% DISCOUNT off listed rates
** For clients paying out of pocket: 20% DISCOUNT off listed rates
*** Level-1: Bachelor’s Degree or lower; Level-2: Bachelor’s Degree and/or practical experience and/or RBT Certificate; Level-3: Master’s Degree or BCaBA (Board Certified Assistant Behavior Analyst)
**** For distances further than 40 miles, please contact us.
***** If insurance or other third-party payor is covering the cost of the service and the family wants service to happen outside of the center and the payor doesn’t cover the higher billable rate with the travel fee, then the family will be invoiced the travel service fee.

If you have questions regarding the above fee schedule, contact the staff at Peak Potential Therapy.

Telehealth

Telehealth is a method of service delivery that is provided by Peak Potential Therapy with technology, which includes, but is not limited to video and audio, phone, text, and or email, and may not involve direct, face-to-face communication. Secure video with audio is done over Zoom.com, in order to help maintain HIPAA compliance. There are benefits and limitations to this service. Clients will need access to the appropriate technology to participate in the Telehealth service provided. Exchange of information will not be direct/face-to-face; any “paperwork” or information may be exchanged through electronic means.  The client and those permitted by law may have access to client records or communications. The client communications, data, documentation, etc. will be stored in Central Reach as standard practice in conjunction with the Policies and Notice of Privacy-Practice & Confidentiality.  If a need for direct, in-person service arises, it is the client’s responsibility to call Peak Potential Therapy to request an in-person appointment. I understand an immediate opening may not be available. I may decline Telehealth services at any time without jeopardizing my access to future care, services, and benefits. Telehealth services rely on technology, which allows for greater convenience in service delivery. There are risks in transmitting information over the internet that include, but are not limited to, breaches of confidentiality, theft of personal information, and disruption of service due to technical difficulties.  I understand that there may be limitations to image quality or other electronic problems that are beyond the control of the healthcare providers. In emergencies, in the event of disruption of service, for routine services, or administrative purposes, then it may be necessary to communicate by other means than was originally planned. In emergency situations, call 911 or proceed to the nearest emergency room for help. For video service disruption, you will receive a phone call from the provider. Please ensure that we have your preferred phone number on file and or an alternative means of reaching you if necessary. For any administrative, scheduling, or questions, you may contact the owner, Natalie “Holly” Reimann, hreimann@peakpotentialtherapy.com, or via her cell 267-259-6461. The laws and professional standards that apply to in-person medical and therapy services also apply to Telehealth Services.

Telehealth service rates follow the “Center-Based Rates”. Refer to each service’s fee schedule for the corresponding fees.

As a client of Peak Potential Therapy,  I understand I have the option to and may receive services through Telehealth methods.

New Client Intake

An individual becomes a client of Peak Potential Therapy LLC once a complete intake has been done and services have been started. An initial consultation is suggested to help the client transition to and start building rapport with the therapist. The first hour of Consult, Observation, and or Meeting time will be free of charge. The initial Consult may be at any location and or maybe over the phone depending on the family’s needs. All following Consult time will be billed at the corresponding rate, as noted in the Fee Schedule. If the consult takes place outside of the therapy center, the new client will pay the difference between the in-center rate for the in-home rate for the corresponding distance and professionals’ time.

Billing Policy

Peak Potential Therapy LLC is committed to providing the best treatment for our clients and we charge in accordance with what is usual and customary for our area. We are pleased to provide you with this information to help you understand our client billing practices.  It is important that clients are aware of their financial responsibility.  The client’s guarantor is financially responsible for the services provided. A guarantor is a person held responsible by our practice for medical expenses incurred on a client’s behalf. This may be the client’s parent(s), legal guardian(s), or agent(s), or maybe the client if aged 18 or older or if emancipated. If any third party, scholarship, or grant does not pay the total for services rendered then the client’s guarantor is responsible for paying the balance owed.

Payment is required at the time service is rendered, unless service has been prepaid or the family and Peak Potential Therapy LLC have a predetermined set arrangement in regard to billing and payment to a third party (i.e.: PASSS, Autism Scholarship, etc.). Services billed to PASSS are provided in sessions. Peak Potential Therapy cannot bill for all services provided to the client or family to the Ohio Department of Education (ODE) for the Autism Scholarship Program (ASP) or Jon Peterson Special Needs Scholarship program (JPSN), and families utilizing these services are responsible for obtaining other funding sources or paying out of pocket for services not covered. The services that cannot be billed to ODE for ASP or JPSN include assessments advocacy, expert witness, and respite care. When billing to ODE for the ASP, materials, equipment, and administrative costs cannot and will not be billed. Families utilizing funding through the ODE for the ASP or the JPSN will comply with the regulations of the corresponding scholarship program. Specifically, the checks made payable to the guarantor and Peak Potential Therapy will be signed. Families choosing to utilize the ASP or JPSN, will have an estimate generated prior to starting services and redone annually that will be the monthly service plan contract to be billed to ODE of which will be signed by a parent or guarantor. This estimate will list the services and respective rates that will be provided by Peak Potential Therapy and billed to ASP or JPSN. This can be adjusted at any time the family chooses with a 30-day written notice. Then the new estimate will be created by Peak Potential Therapy, and a parent will sign it before services can be continued.

Our office will work with families in every way possible to locate funding sources for therapy.  However, families need to be aware that we CANNOT TAKE ANY RESPONSIBILITY for the DECISIONS made by CLIENT’S INSURANCE COMPANY. Clients are ultimately responsible for payment of therapy services rendered should all other sources default.

For any further insurance-related questions, please contact us at 330-405-8776.

Health Insurance

In-Network Insurances

We accept all insurances, but are in-network providers only for the following companies (benefits are usually different for out-of-network coverage or may not even exist):

  • AETNA
  • ANTHEM / BLUE CROSS BLUE SHIELD
  • CIGNA
  • HUMANA / TRI-CARE
  • MEDICAL MUTUAL
  • SUMMACARE
  • UNITED HEALTHCARE

Health insurance is a contract between a patient and an insurance company.  Healthcare providers, such as Peak Potential Therapy, are not part of that contract and merely file claims directly to the client’s insurance company on the patient’s behalf.  Peak Potential Therapy LLC provides this service for its clients with the understanding that the ultimate financial responsibility for payment-in-full lies with the client, not the insurance company.

Health insurance coverage may not relieve patients of financial responsibility for the entire cost of services rendered by Peak Potential Therapy LLC.  Our financial contract is with you, not your insurance company.  Peak Potential Therapy LLC makes reasonable, good-faith efforts to bill your primary and secondary insurance, follow up when payment is not received, and at times, file appeals of denial or rejection on your behalf. Ultimately, unpaid balances become the client’s financial responsibility.

Claims are bill clients’ insurance with current fees and accept their allowable amounts as payment only if health insurance is in-network (see the list above). We do require payment for services rendered at the time of service. This means that any copays or co-insurance will be collected at the time of the visit.  Any annual deductible that has not been met yet will be collected at the time of service

Client Responsibility – Provide accurate insurance information to Peak Potential Therapy LLC so that claims can be submitted on your behalf.  Clients are responsible for promptly communicating any changes in health coverage or health insurance to ensure that the information we have on file is accurate and up to date at all times.  This includes: name, address, phone number, employer, and information about dependents.

Ohio Autism & Jon Peterson Scholarship

Peak Potential Therapy, LLC is proud to be an Ohio Department of Education approved scholarship provider for both the Autism Scholarship and the Jon Peterson Special Needs Scholarship.

The Jon Peterson Special Needs Scholarship Program provides families with students who have an existing IEP from their home district the opportunity to utilize funds for alternative educational options. To find out more information, apply, and link to Peak Potential Therapy’s provider listing – click here.

The Autism Scholarship Program is eligible for students, ages 3 and 21 years old, identified with Autism or Pervasive Developmental Disorder, and qualify for an IEP.  This scholarship gives Ohio families the opportunity to utilize privately funded sources and special education programs other than the programs offered in their local school district’s ability to fulfill educational requirements and the contracted services on the student’s IEP (speech, occupational, behavior therapy, etc.).  To learn more, apply, and link to Peak Potential Therapy’s provider listing – click here.

Funding begins July 1 and ends on June 31, but applications are accepted and approved year-round at a prorated amount.

Grant Funding Sources

We understand that for many families, finding financial assistance and grant funding for therapy services can be a struggle. To help make it easier to access these resources, we’ve compiled an extensive list of grant sources. These sources can provide financial assistance with a variety of therapy services provided by Peak Potential Therapy.

Financial Assistance – CareCredit

If you need financial assistance, we can provide you with information on an outside lending agency, Care Credit. Upon acceptance by this credit company, you can receive a no-interest, no-fee loan for up to 12 months. For information go to their website at www.carecredit.com

Delinquent Accounts

If payment in full is not received within 30 days of the date of service, we will send you a notice, email, and then by mail, that your account has become delinquent. If payment is not received within 10 days of the delinquency notice, your account will be referred to a collection agency unless you have arranged an installment payment plan. In order to arrange a payment plan, you must come to the office and sign a promissory note within 10 days of the date on the delinquency notice that you receive from us. A 20% interest rate will be charged monthly to delinquent accounts ($5 minimum). If your account is referred to a collection agency, it cannot be retrieved and your credit rating may be damaged.

Cancellation / No Show (Effective 1/25/2019)

For clients who are scheduled for less than 10 hours per week of one-on-one services, the following will apply:

Peak Potential Therapy LLC understands there may be times when you may miss an appointment due to emergencies or unforeseen obligations to work or family. Appointments must be canceled with at least a 24-hour notice, and will not result in any charges. Families may cancel a session for any reason. Failure to cancel the appointment in advance, the family will be invoiced 50% of the cost for that appointment and will make payment at the following session. The family MUST call to cancel an appointment, office (330) 748-0389 or directly to the staff’s cell. If the client who is canceling is part of a group, the group members will be contacted and a decision will be made with all families to determine if the entire session will be canceled or will continue as scheduled. Peak Potential Therapy understands that emergencies and unforeseeable things happen, which is why each client receives 1 FREE cancellation that is provided within the 24-hour notice period per quarter (January-March; April-June; July-September; October-December).

If the therapist arrives at the client’s home OR waits for the client at the therapy center for the scheduled session and the client is a no-call / no-show, the full cost of the session will be invoiced to the client and payment will be due at the next scheduled session.

For clients who are scheduled for more than 10 hours per week of one-on-one services, the following will apply:

As a reminder, Peak Potential Therapy is a private medical practice (just like your physician’s office). We are mandated to follow the HIPAA (Health Insurance Portability and Accountability Act) regulations.

There will be a $50 “Scheduling Fee” invoiced to the family that will not be covered by insurance nor a third party payor for any appointment missed for any reason and not canceled with at least 24-hour notice. Any appointment canceled with less than 24-hour notice is considered an “emergency cancellation.” Payment is to be made at the beginning of the next appointment (cash, check, or charge are accepted) or services will be refused. There is no charge if you provide notice of at least 24 hours in advance. Exceptions will be made for hospitalizations or other severe events. If the company closes due to a blizzard, tornado, etc., you will not be charged the Scheduling Fee.

We are empathetic to each family’s situation, in that everyone has a child with special needs. We understand that there may be a quick onset of illness as well. Therefore, each client is given one free emergency cancellation per month.

Please understand that when a client’s appointment is missed a domino effect occurs. First, continuity of care is interrupted. Each client needs to receive the hours of prescribed therapy. Consequently, the staff are out of pre-scheduled work and pay for those hours. Staff who end up with minimal hours cannot pay their bills and will look for another position at a different company that offers reliable work. Also, a child who is waiting to begin receiving services is going without care. Furthermore, the direct BCBA (Board Certified Behavior Analyst) supervision time requirements mandated by your insurance provider and the BACB (Behavior Analyst Certification Board) for RBTs (Registered Behavior Technicians) are thrown off schedule. When you do not bring your child in for services, it affects others too.

Thank you for your understanding and for respecting the staff and the services provided.

If you want a hard copy of this, please request it when you come in for your next scheduled appointment. An updated Policy Agreement will need to be signed in our EMR system, Central Reach.

Photograph / Video Release

All photographs taken by Peak Potential Therapy LLC staff or agents must obtain a signed release form from any person or guardian of children under the age of 18 years old who is visibly recognizable in the photograph. Crowd scenes where no single person is the dominant feature are exempt.

These rules govern photographs intended for use in any Peak Potential Therapy LLC publication of a marketing or a public relations nature, such as newsletters, brochures, viewbooks, promotional items, or other such material. Releases also must be obtained for photographs used on the Web. These rules are not in effect when photographs are taken of news events, but photographs taken for news purposes require a release for reuse in marketing materials.

This release form has been approved by the Peak Potential Therapy LLC’s Office of General Counsel.

Client Progress Reports

Progress will be reported quarterly to the client’s family in an individualized Progress Report and or to meet the requirements of the Ohio Department of Education. There is no additional fee for the Quarterly Progress Report. More frequent reporting may be requested for an additional charge. The CentralReach portal is the means by which data, reports, etc. will be keeping the client’s information. Both daily progress notes and quarterly progress reports are collected in CentralReach. The client’s account can be accessed at any time and or reports downloaded at your discretion.

Discipline of Clients

It is understood that children with disabilities need specialty treatment in the realms of social communication, emotional regulation, behavior modification, and or specific objectives from their Individualized Education Plan. If a child has a behavior plan, that is part of his/her IEP or that has been developed and used by the client’s behavior therapist, psychologist, or other professional, Peak Potential Therapy will comply in following the behavior plan that is in place. If the therapist disagrees with or wishes to change any aspect of the current behavior plan, the therapist will notify the family first and request a team meeting before changes are made. If a client does not have a behavior plan in place but engages in disruptive, aggressive, or injurious behaviors to him/herself or others, then the least restrictive assistance will be given to ensure the client’s and others’ safety.

Client Satisfaction

Clients will be contacted at least on an annual basis and offered to complete an anonymous survey. The survey will inquire about the satisfaction of services and overall company procedures. The owner will review every survey submitted and make changes as needed. Customers are able to contact the owner at any time to relay their satisfaction or concerns to Natalie “Holly” Reimann, (330) 405-8776, or in writing to 8984 Darrow Road, Suite 2-289, Twinsburg, OH 44087.

Internal Monitoring

Staff are evaluated at least on an annual basis by their immediate supervisor or the owner. Furthermore, if any staff have complaints or comments, they can contact the owner to resolve the issue. Natalie “Holly” Reimann, (330) 405-8776, or in writing to 8984 Darrow Road, Suite 2-289, Twinsburg, OH 44087.

Staff Training & Professional Development

Staff will be provided with training at least on a bi-monthly basis by Peak Potential Therapy. Training for staff includes topics relevant to autism as well as other disabilities. Individual training will be provided individually on an as-needed basis by the staff’s immediate supervisor or the owner. All staff will comply with their professional national and state organizations to maintain certifications and licensures.

Termination of Services

Peak Potential Therapy LLC or family can decide termination of services at any time or for any reason. Family satisfaction is critical to our organization. If a client/family has any questions, concerns, comments, or ideas, he/she is free to disclose the information as soon as possible. The therapist will discharge the client from speech-language services when the client has reached all of his/her goals and has stabilized progress for three months.

If a client chooses to stop services and has made a prepayment, but has not used all 10 sessions, the sessions used will be calculated at the hourly rate, then deducted from the prepayment amount. For any credit on a client’s account that is not used when a client stops services, the remaining balance will be issued in the form of a PPT Gift Certificate (no cash, check, or credit card refunds.) Gift certificates are transferable but have no cash value.

Gift Certificate – Terms & Conditions

These Gift Certificate Terms and Conditions (hereinafter “Terms and Conditions”) govern the purchase, use, and redemption of gift certificates purchased from Peak Potential Therapy LLC, d/b/a Peak Potential Therapy (“Peak Potential Therapy”). For questions, comments, or suggestions, please contact Peak Potential Therapy by writing to:

Peak Potential Therapy
8984 Darrow Road, Suite 2-289
Twinsburg, OH 44087
(330) 405-8776
contact@peakpotentialtherapy.com

Purchasing, Sending and Receiving Gift Certificates

  • Gift certificates are void where prohibited or restricted by law.
  • Gift certificates cannot be used to purchase gift certificates.
  • Except as provided herein, gift certificates have no cash value.
  • Gift certificates are not valid until payment has been received and successfully processed by Peak Potential Therapy.
  • Peak Potential Therapy reserves the right to refuse service or reverse any gift certificate purchase for any reason and return the funds to the purchaser.

Redeeming Gift Certificates

  • Gift certificates are only redeemable at Peak Potential Therapy for the amount or service specified on the gift certificate. Peak Potential Therapy reserves the right to convert service-based gift certificates to their monetary value, equivalent to what was paid for the gift certificate, at its option and sole discretion.
  • Gift certificates cannot be used or redeemed for services or products provided by Peak Potential Therapy affiliates, or with any third party accessible from Peak Potential Therapy.
  • Except as required by law, gift certificates are not redeemable for cash and cannot be returned for a cash refund.
  • Any unused balance of the gift certificate will remain until redeemed.
  • If a purchase exceeds the amount listed on the gift certificate, the redeemer is responsible for paying the difference at the time of purchase.
  • For security purposes, a recipient may be required to show a valid ID before he or she can redeem the gift certificate.
  • Use and redemption of our gift certificates are also governed by our Privacy Policy.
  • Peak Potential Therapy, its agents and vendors, may provide gift certificate purchasers with information about the redemption status of gift certificates.

Cancellation and Expiration of Gift Certificates

  • Peak Potential Therapy reserves the right to immediately invalidate gift certificates, without notice, should it receive a credit card chargeback, returned check or other forms of repudiated payment made towards the gift certificate.
  • Peak Potential Therapy is not responsible for lost or stolen gift certificates. Reasonable and prudent steps are taken to verify the legitimacy of a redeemer and upon full redemption; the gift certificate will be identified as not valid for payment of any kind.
  • Peak Potential Therapy reserves the right to dishonor the gift certificate, if it reasonably believes it was not validly purchased, has already been redeemed, or the redeemer stole or is otherwise not the intended beneficiary of the purchaser.
  • Gift certificates expire 12 months after the date of purchase, except where prohibited by law.
  • Peak Potential Therapy may, at its sole option and discretion (unless required by law) replace a lost gift certificate, provided the original gift certificate is valid, has not been redeemed and the replacement is issued to the verifiable beneficiary of such gift certificate. Such replacement will be the beneficiary’s sole remedy for such lost or misplaced gift certificates.

Miscellaneous Terms and Conditions

  • Gift certificates are in U.S. dollars.
  • Peak Potential Therapy reserves the right to change these Terms and Conditions from time to time in its sole discretion.
  • PEAK POTENTIAL THERAPY, ITS AGENTS AND AFFILIATES, MAKE NO WARRANTIES, EXPRESS OR IMPLIED, WITH RESPECT TO GIFT CERTIFICATES, INCLUDING WITHOUT LIMITATION, ANY EXPRESS OR IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. IN THE EVENT A GIFT CERTIFICATE NUMBER OR BAR CODE IS NON-FUNCTIONAL, YOUR SOLE REMEDY, AND PEAK POTENTIAL THERAPY’S SOLE LIABILITY SHALL BE THE REPLACEMENT OF SUCH GIFT CERTIFICATE.
  • Gift certificates, and these Terms and Conditions, are subject to and governed by the laws of Ohio, without reference to its principles of conflicts of law.
  • If any provision of these Terms and Conditions should, for any reason, be held invalid, prohibited by law or unenforceable in any respect, such term will not apply. However, the remainder of these Terms and Conditions shall be enforced to the full extent permitted by law. A court of competent jurisdiction is hereby empowered to modify the invalid, prohibited or unenforceable provision to make it valid and enforceable.
  • Risk of loss will pass to the purchaser of the gift certificate upon the electronic transmission of such gift certificate to the recipient or purchaser.

Website Information Disclaimer

The Peak Potential Therapy LLC website is designed for educational purposes only. The contents of this website are not medical, legal, technical, or therapeutic advice and must not be construed as such. The information contained herein is not intended to substitute for informed professional diagnosis, advice, or therapy. Visitors should not use this information to diagnose or treat Autism Spectrum Disorder or Related Disorders without also consulting a qualified medical, psychological, or educational professional. Listing of opinions, treatments, professionals, and organizations on this website does not imply endorsement by Peak Potential Therapy LLC.

Rates for all services provided by Peak Potential Therapy are listed online as well as in the “Fee Schedule” that is enclosed with your Intake paperwork.

Non-Discrimination

Peak Potential therapy does not discriminate on the basis of race, ethnicity, color, national origin, sex/gender, disability, veteran status, political beliefs, religion, sexual orientation, or age in the administration of any of its services, admissions policies, or other agency-administered programs.

If any policies or procedures change, Peak Potential Therapy LLC will notify the family and obtain a new, signed “Policies & Procedure Statement of Agreement.”

Thank you for choosing to receive services from Peak Potential Therapy LLC. We look forward to working with your family.

 

Addendum to Policy Handbook – for Jon Peterson Scholarship  Program – FY2022

Admission

The family of the client will complete the following to get started with services:

  1. Client Registration (completed online through HIPAA compliant site)
  2. The client (AKA: student) needs to have a current IEP and ETR. Based on the ODE Policies for JPSN, and all policies from ODE need to be followed.
  3. Sign the Policy Agreement
  4. Sign the Photo Release
  5. Sign the Estimate
  6. Complete the ABA Intake Form (only needed if starting ABA/Behavior services)
  7. Complete the Client Registration Form 

Cancellation/ No Show

The client is responsible for notifying Peak Potential Therapy in advance if he/she is not able to attend, will be late, or needs to be picked up early.  

If a client is chronically late or cancels with more than 50% of sessions being affected in a month, then the family will have a consult session to find ways to help remediate the issue(s) and improve or prevent the recurrence of performance issues. All extenuating circumstances will be taken into consideration to find a resolution for consistent services.  If a resolution cannot be made then the family can choose to stop services or Peak Potential Therapy will discharge the client. 

Transfer

When a client has services from another JPSN Provider and is changing to Peak Potential Therapy all the policies for “Admission” apply. Furthermore, the “Authorization for Disclosure” maybe signed by the client, if the client wishes that Peak Potential Therapy collaborate with or communicate with the prior provider. 

When a  client leaves Peak Potential Therapy, the family is expected to put in writing their decision and date when the last date of service will be. In addition, the “Authorization for Disclosure” maybe signed by the client, if the client wishes that Peak Potential Therapy collaborate with or communicate with the next provider. 

Termination of Services

When a client chooses to stop services, the client will make a written statement stating their action and date when the last date of services will be. If a client cancels more than 50% of sessions being affected in a month, then the family will have a consult session to find ways to help remediate the issue(s) and improve or prevent the recurrence of performance issues. All extenuating circumstances will be taken into consideration to find a resolution for consistent services.  If a resolution cannot be made then the family can choose to stop services or Peak Potential Therapy will terminate the client’s services. If a client is receiving ABA/Behavior services, the behavior treatment plan will be reviewed and modified. If behaviors continue at an unsafe severity level that is beyond what services the staff are capable of managing, then a consult session will be held with the client to identify potential solutions and outside resources that can potentially help the client; then the client will be discharged.

 

Updated: 7/1/2023