Become a Kool Kid
Step 1
Contact us with your referral.
Kool Kidz accepts referrals from:
- Physicians
- Early intervention coordinators
- Other therapists/educators
- From the family itself
Phone: (770) 643-0868
Email: contactus@koolkidzpt.com
Payments Accepted
We accept the following forms of payment:
- Private Insurance (out of network provider)
- Blue Cross Blue Shield (in network provider)
- Private Pay
- Medicaid
- Peachcare for Kids
- Amerigroup CMO
- Peach State
- CareSource
Step 2
Submit your info.
We need some support information prior to your first appointment. Listed below is a checklist of the items we need. Download, print, and fill out the forms by clicking on the links below.
Chart Review Form
The Chart Review Form (Espanol) provides a physical checklist of all the required forms
Prescription
From your child’s primary care physician.
Current physical therapy evaluation
Less than 12 months old. We can perform the evaluation, but if another therapist has done a recent evaluation, we’ll accept it.
History
Consent
Guarantee/Authorization
Cancellation Policy
Kool Kidz Cancellation Policy Form
Insurance information
A copy the front and back of your primary and/or any secondary insurance cards.
Medicaid information
A copy of the current month’s eligibility form (Traditional Medicaid, Georgia Better Health Care, Deeming Waiver, or Peachcare for Kids).
Preauthorization
Kool Kidz is able to bill your insurance. If your insurance company requires preauthorization, please go through this process prior to beginning physical therapy.
Current IFSP (Individualized Family Service Plan)
Required if your child is age 0 to 3 and participating in the Georgia Babies Can’t Wait Program.
Current Physician Plan of Care
Required if using medicaid as funding source and not covered under an IFSP. Kool Kidz can assist in the preparation of this document for your physician.