Billing Info & Questions

FAQs

• Will my insurance cover physical therapy?

  With most insurance companies physical therapy is a covered benefit. If you are not sure if physical therapy is a covered benefit please call our front office staff with your insurance information and they can help you further. Our staff is helpful and knowledgeable about physical therapy benefits and will call your insurance company to check your specific benefit information.

• Are you in network with my insurance plan?

  We are in network with most major insurance companies. You should call your insurance for specific information about who they have listed as contracted providers in your area. Many insurance companies provide out of network benefits as well. Check with member services and they can provide you with specific out of network information.

• Do I have to use my insurance?

  If we are a contracted or in network provider with your insurance plan you do have to use your insurance. It helps protect you and the therapists against fraud. If we are not an in network provider, then we do have self pay rates available. Call our front office for further information.

• If I need pre-authorization for my insurance to cover physical therapy what do I need to do?

  We are more than happy to explain the steps involved for authorizing care to start therapy. Every insurance company has different requirements but most pre-authorizations can be done at the clinic when you come in for your first visit. If your primary care physician is required to add the authorization we can contact them directly to get that taken care of for you.

• Do I need a prescription or referral for my insurance to cover physical therapy?

  Most insurance policies require a handwritten document with a physician’s signature for physical therapy to be covered. If your insurance company covers care based on medical necessity then we need to have a prescription proving medical necessity. If you choose not to get a prescription and your insurance company does deny the coverage, then you as the patient are liable for all costs incurred by accepting treatment.

• How do I get a prescription or referral to start care at your facility?

  Call your primary care physician (PCP) and request that they send a prescription to our facility. If you have not seen your PCP about your current complaint or injury then they will ask that you come in for a visit. If you have not seen your PCP for this problem they will need to see you before they can decide if physical therapy is the right fit for you. If they agree that physical therapy would benefit you they will write you a prescription that you can bring in with you to your first appointment.

• What will my out-of-pocket expense be after each treatment?

  As a courtesy, our office staff checks your benefit information with your insurance company. We review your benefits sheet at your first visit and go over any expenses that you will be responsible for. If copayments are required by your insurance, you will be required to pay this at each visit. Deductibles will be decided by your insurance company and they will send you an explanation of benefits (EOB) letting you know what your responsibility is for each visit up to the deductible amount. If you have any questions about the specific details we will make sure that you know what to expect.

• Why did I get a bill?

  After we submit the claim for your treatment, your insurance will process it according to your plan and send you an explanation of benefits (EOB) statement. This information is also sent to our billing office so they can process your account accordingly. For example, if you have a copayment and did not pay it at the time of your visit you may receive a statement from us for that amount. If you feel that you should not have received a bill, call our office staff and they will help you further. We may have you contact our billing company directly but will strive to answer all your questions on your first call to us.

• What can I do if my insurance will no longer cover therapy but I still want to continue treatment?

  If you feel physical therapy is helping you, you we want to do everything we can to make sure you can continue care with our facility. We may be able to bill you at a reduced rate or a self-pay rate if we have a denial from your insurance company. Please contact our office for further details.

• If I have a prescription in hand, when can I start therapy at your facility?

  We may have appointments available the same day you call. Contact our helpful front office staff and they will set you up with an appointment for your initial evaluation with one of our friendly therapists.