Who bills my insurance?

We will bill your insurance company for your visits. We only ask that you cover your estimated coinsurance or deductible at the time of your visit. The amount that you will owe at that time of your visit depends on the health insurance plan you have.

 

How often do you bill my insurance?  

Claims for treatment are electronically forwarded to your insurance company no more than 2 days after treatment, provided we have complete and correct insurance billing information.

 

How long does it take for my claims to process?

In a perfect world, it should take about 15-20 days after your insurance company receives the claims. Often, delays in payment occur when information is incomplete, out of date, or inaccurate.  If you do not receive any correspondence from your insurance company within 3 weeks of the date of your evaluation, please contact your insurance company to clarify any potential issues.

 

What should I do with the correspondences I receive from my insurance company?  

Please open and read your mail from your insurance company.  Although we do what we can to help you get your claims paid in a timely manner, it is important that you remain proactive in the process. Insurance companies will delay benefit payments for claims if any requested information in the correspondence to you does not receive a prompt response.  

 

It is important to know that as a provider of physical therapy services, the only part of your treatment we control is the delivery of the actual treatment. We do not control the payment process or the amounts allowed or paid by your insurance company.  

 

We try to mitigate problems in the payment process by:

    • Contacting your insurance company prior to your treatment and verifying coverage and benefit information.
    • Providing benefits, coverage, and expected out of pocket cost information to you before your first appointment.
    • Limiting your out of pocket cost to $207.00 for your evaluation and $177.00 for each follow up visit.

 

When should I expect a bill for any remaining balances?

Our billing office will first bill your insurance company for all services after each visit. If your insurance plan does not cover a specific service or procedure or does not cover the entire cost, you will be responsible for the uncovered fees. We do our best to estimate these fees to match up at the time of service, but as hard as we try, we cannot always accurately predict how your insurance company carrier will handle a claim.

 

Why is the initial estimated cost different from the bill I just received?  

Most insurance companies do not pay 100% of the actual amounts billed to them for treatment. Typically, insurance companies “adjust” the charges submitted to them, to what they consider as “usual and customary”.  They then process the charges according to your plan benefits. Our office will collect the difference paid by yourself and your insurance if it is less than $207.00 for the evaluation and $177.00 for follow up visits. We are obligated by law to collect amounts paid to you by your insurance company in excess of these amounts to avoid medical fraud.