Insurance

What Does This Mean?

A fee-for-service clinic mean we are out-of-network with all insurance companies. You may request a receipt that has the codes on a super bill to send self-claims to your insurance company.

We are contracted with the company called Reimbursify. You download an app and you fill in the codes. The request will go directly to your insurance company to be processed so you will receive reimbursement for the treatment rendered, dependent on your percent of out-of-network benefits.

Please Read Below

If you have a high deductible or copay, it may be cheaper to NOT use your insurance for some services. With us not billing insurance, in some instances you may SAVE money.

Insurance companies dictate and strongly influence in-network treatment including number of visits and type of treatment. They may deny payment which means YOU have to pay for treatment, or the in-network clinic doesn’t get paid.

By going out of network, it allows us to give you optimal care without the insurance constraints.

Due to decreasing reimbursement rates by insurance companies, in-network clinics are forced to see more and more patients. Most patients are passed off to an aide to provide care. Many typically apply heat/cold packs and have someone watch you on an exercise machine. They require multiple visits per week just to cover their expenses.

We don’t just give you exercises that can be done at home or at a gym and then have it billed to an insurance company. We do, however, devote the full time of your appointment to our hands-on approach. This will facilitate speedier recovery with less appointments. This makes our treatments a HUGE BARGAIN.

SOMETIMES THE OUT-OF-POCKET EXPENSES ARE LESS THAN BILLING INSURANCE

How Can That Be?

As deductibles and physical therapy copays increase, many patients will end up paying more for services at an in-network clinic as opposed to an out-of-network such as ours. If you have not met your deductible, you will end up paying full price for each treatment which can typically run about $200/visit. If you have a $2,000 or higher deductible, you will be paying a high amount for each appointment. Our standard 30-minute, full-attention visit, is considerably less.

Therefore, before you decide where to go for physical therapy based solely on if they accept your insurance, make sure to check on how much you will be paying at an in-network clinic instead of an out-of-network clinic like ours. You may be able to save a LOT of money.

Questions to ask your insurance and a potential in-network clinic

1. Ask your insurance company about what percentage of the total PT bill you will be required to pay at an in-network clinic (especially if you have not met your deductible).

If you will be paying 100% of the bill until you have met your deductible, ask the PT in-network clinic the amount of the average bill sent to an insurance company. (The total amount of the bill —— NOT what the insurance company has agreed to pay the clinic)

In most cases, if you have not met your deductible you will have to pay the full cost of treatment billed to the insurance company.

Ask your insurance company if you have in-network deductible and an out-of-network deductible. The out-of-network does not apply to your in-network deductible if you have 2 different deductibles.

2. Ask the in-network clinic:

• If you have met your deductible, how much will your copays will be?

• How many times per week is the average patient is asked to come in for the treatment?

• Do they use aides to monitor exercises and hot packs?

• How long does the PT spend with you before sent out to the gym?

3. Consider the quality of care you will receive in an in-network clinic.

Medicare

We are not a participating Medicare provider. We can only accept Medicare beneficiaries as patients when the patient does NOT want to bill Medicare for any physical therapy services. The request to not involve Medicare in payment must be made before treatment and made by the patient’s own free will.

But, if you have Medicare and still want to see us, we have numerous options you may take advantage of. We require an agreement to be signed before treatment attesting to you or anyone else that Medicare will not be billed for any treatment.

After signing this agreement, we can assess what level of care you require, and payment is made at the time of treatment. See our fee schedule under RATES in our menu.

Reimbursify

Taking the Worry out of Filing Your Own Claim

We understand that handling your own claims to the insurance companies may sound complicated. That is why we provide you with an app that makes the process easy and effective.

Built upon decades of experience in the healthcare industry, Reimbursify’ s proprietary claim-filing process ensures efficient submissions that get reimbursements fast. The app will allow you to track both current and past claims. With one tap you can submit recurring identical claims.

Reimbursify works for any out-of-network office visit with any doctor, practitioner, or therapist. If your claim is rejected by your insurance company, Reimbursify’ s expert system comes to the rescue.

Their team of industry-savvy professionals have identified the most common reasons that claims get rejected and have imbedded the pathway to resolution right into the app list.