A 24-year- old woman has been referred to the outpatient clinic for occupational therapy treatment for
carpal tunnel syndrome. The woman’s health insurance has very limited coverage of occupational
therapy services and refuses to pay for additional treatment after 4 sessions. The OT feels that the
woman could benefit from additional treatment. What should the OT do?
A. Call the woman’s insurance company and plead for more sessions.
B. Inform the woman of the coverage limitations and the costs for paying out of pocket.
C. Provide the additional therapy at no extra charge.
D. Discharge the woman from OT due to inability to pay.
Answer: B. Inform the woman of the coverage limitations and the costs for paying out of pocket. If a
patient’s insurance coverage runs out before a course of therapy has ended, the OT should inform the
patient of their options regarding continued treatment. The patient can then decide whether to
discontinue treatment or pay for treatment out of pocket.