Getting to Know Your Health Insurance – FAQ’s

Frequently Asked Insurance Questions

 1.     What kind of health insurance does your clinic take?

We accept all PPO insurances, Medicare and we are “in network” with most all PPO insurance companies. Here are a few: Anthem Blue Cross, Blue Cross Blue Shield, Blue Shield, United Health Care, Aetna, Cigna, Health Net, Medicare and First Health. We also take auto accident claims, workers compensation, and Lien’s. If your insurance company is not listed, please feel free to give us a call and we would be happy to check and see if we are in network with them.  We will also be more than happy to contact your insurance company to verify all of your health insurance benefits so you are fully informed of what your insurance will cover.

2.     What is the difference between a co-pay and co-insurance?

A co-pay is your portion (flat dollar amount) due the day of your visit that is not covered by your health insurance. Co-insurance is the percentage of your visit cost that your insurance company does not cover. For example, if you are covered 80% with a 20% co- insurance, then you will be responsible for a 20% co- insurance until you have met your out of pocket maximum (not all policies have out of pocket maximums though). This payment will not be made until we receive an explanation of benefits (EOB) from your insurance company.  We then generate a statement for you at the end of the month. If you would like to get an estimate of about how much each visit will cost you, please do not hesitate to call and have our office manager check your insurance coverage.

3.     What is an EOB?

EOB is short for Explanation of Benefits. Your insurance company will always send you an EOB for each visit that is billed. It will explain the payment breakdown for the medical services provided.

4.     If I only have a few visits for physical therapy or I have already used my visits for the year, can I still come in for treatment?

Yes, you may still be able to attend physical therapy. If your insurance does not have a “hard max” visit limitation, we can petition your insurance company for more visits by having our physical therapist write a letter of medical necessity to your insurance company to receive additional visits.

5.     What if I do not have insurance?

We do have self pay options with different types of packages depending on how many physical therapy visits you will need to attend. The pricing is available upon request.

6.     What if I have a very high deductible but I need attend physical therapy for a prolonged period of time? Are there any finance options?

If you have a really high deductible, the amount you must pap out of your pocket before your health insurance covers anything, you might be wondering how you can cover some of your health insurance costs.  We offer a GE Capital 6 months no interest credit card that will help finance your physical therapy should you need help covering the immediate cost. We can do a complimentary verification for you to see if you will be approved.

Do you have more questions?  Give us a call… We will be happy to make this all make perfect sense!