Insurance & Billing
Expenses associated with medical services can be confusing. The goal of this page is to make things more clear for your understanding. For specific questions regarding a bill please email email@example.com
We accept all major insurances, including but not limited to
VA Community Care Program
Competitive Self Pay rates.
We have added some new payment features to assist in the process, and provided some resources regarding the Billing Process, please check them out below.
Premium: A monthly payment you make to have health insurance. Like a gym membership, you pay the premium each month even if you don’t use it, or you lose coverage. If you’re fortunate enough to have employer-provided insurance, the company picks up all or part of the premium.
Copay: Your copay is a predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.
Deductible: The deductible is how much you pay before your health insurance starts to cover a larger portion of your bills. In general, if you have a $1,000 deductible, you must pay $1,000 for your own care out-of-pocket before your insurer starts covering a higher portion of costs. The deductible resets yearly.
Coinsurance: Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, after your deductible has been met. For example, if you have a 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.
Out-of-pocket maximum: The most you could have to pay in one year, out of pocket, for your health care before your insurance covers 100% of the bill.
Verification and Submission
When you call to schedule your first appointment, we'll ask you for your insurance information. Then, as a courtesy to you, we will call your insurance company to verify your benefit coverage and we'll review this information with you before you begin your first visit.
In addition, we encourage you to call your insurance carrier to find out your physical therapy and/or occupational therapy benefits provided by your medical plan prior to your visit.
Finally, we will promptly file your claim with your insurance company on your behalf so you won't have to worry about having to fill out any other forms.
Billing for physical therapy services is similar to what happens at your doctor’s office. When you are seen for treatment, the following occurs:
The physical therapist bills your insurance company, Workers’ Comp, or charges you based on Common Procedure Terminology (CPT) codes.
Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
The payer processes this information and makes payments according to an agreed upon fee schedule.
An Explanation of Benefits (EOB) is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.
The patient is expected to make the payment on the balance if any.