Physical Therapy Services Payment Options
DO YOU ACCEPT INSURANCE?
We are a a cash-based treatment model, which means the physical therapist enters a contract with the patient to provide physical therapy services in a manner that both parties have determined will help them reach treatment goals most efficiently. Cash-based billing eliminates confusion and allows for clarity in decision making on the part of the patient and their provider. Documentation for evaluations, treatment visits, and progress notes are performed just like any other physical therapy practice and comply with all legal requirements.
The patient pays at the time of service, allowing the therapist to focus attention on providing the best possible service while keeping administrative costs low. You may pay for services using actual cash, a check, or a credit or debit card.
Health Savings Account (HSA) and Flexible Spending Accounts
Another option for payment are Health Savings Account (HSA) and Flexible Spending Accounts (FSA) which are flexible spending arrangement offered by the IRS. Both are tax-advantaged accounts that allow you to save specifically for medical cost.
How do I use my HSA or FSA accounts for services?
You can pay for IRS-qualified medical expenses with funds from your HSA by using your debit card. You can also pay for part or all of your IRS-qualified medical expenses out-of-pocket and reimburse yourself later with HSA funds. You must submit a claim to the FSA (through your employer) with proof of the medical expense and a statement that it has not been covered by your insurance plan. You will then receive reimbursement for your costs.
AT PILATES PLUS PHYSICAL THERAPY THE THERAPIST IS AN OUT OF NETWORK PROVIDER - WHAT DOES THIS MEAN?
This simply means that the therapist has not entered into a contract with ANY individual insurance companies to receive reimbursement according to the contracted rates. At Pilates Plus Physical Therapy & Wellness our physical therapist feel there energy is best spent working with patients. It is important to note that in network provider status is not currently based on education, experience, skills, or treatment outcomes, but is often determined by the number of providers in a demographic area.
CAN MY INSURANCE BE BILLED FOR CASH-BASED PHYSICAL THERAPY SERVICES?
Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide payment for services received "out of network". Going out of network means that you can choose to see a physical therapist who is not a participating provider with your insurance company. Many patients choose to receive services out of network in order to see the physical therapist of their choice. In the case of cash-based services, it is the patient who is waiting for reimbursement rather than the provider.
In many cases, the out of pocket expenses for a course of physical therapy will actually be LESS for services provided at Pilates Plus Physical Therapy & Wellness due to the ability to charge less per visit. This allows Pilates Plus Physical Therapy & Wellness staff to focus all energy on patient care, and allows patients to make informed decisions regarding the costs of their health care choices.
WHAT STEPS ARE INVOLVED IN SUBMITTING A CLAIM TO MY INSURANCE COMPANY?
The process is quite simple: Pilates Plus Physical Therapy & Wellness will provide you with an invoice at the time of service that you may submit to your insurance company for reimbursement. The invoice has all of the necessary information (business name and address, tax ID, national provider identification, license numbers, etc.) as well as the patient’s ICD-10 (diagnosis) and CPT (billing) codes. You may choose to submit bills following each visit, one time per month, or at any other interval, typically up to one year following the date of your treatment appointment.