Many health insurance policies allow claims for Physical Therapy services from our clinic. (Unfortunately most won’t pay for Pilates Exercise.) It’s likely that your health insurer considers us a “Preferred Provider.” It’s important that you call your health insurance provider to confirm your coverage, or read your health insurance policy carefully, as coverage for Outpatient Physical Therapy services are typically described in a subsection, and general medical claim limits may not apply.
CALL YOUR INSURANCE COMPANY
To avoid expensive surprises, call the insurance customer service number on your insurance card and ask them the following questions:
* What is my Outpatient Physical Therapy coverage?
* What are my current available balances in dollars and/or hours?
* Do I need to be aware of any restrictions or limitations on my coverage?
* Do I need a prescription or referral? And if so, who needs to write it?
We are happy to bill your insurance company as a service to you. If we bill your insurance company, you will not receive an invoice from us until your insurance has accepted and paid their share of the claim. However, you should receive an Explanation of Benefits (EOB) from your insurance company, which itemizes the amounts they will pay and the amount for which you are responsible.
- First Choice
- KPS Health Plans
- Blue Cross Blue Shield
- Labor and Industries (L&I)
- Work Injuries
- Motor Vehicle Accidents (PIP)
- Discount for cash-pay patients
If you do not see your insurance carrier listed, feel free to contact our front desk to see if your plan is in network.
If we are a preferred provider with your health insurance, your insurance company will determine what they will pay for the procedure (the allowed amount) and based on that, what you will pay – once they receive our invoice. Our clinic cannot determine in advance what you will owe. Their determinations will be highly individualized due to the incredible number of available policies and options, and the fact that Therapies (Physical, Speech, Massage) are frequently grouped as one benefit.
Our statements list which visits have been billed to insurance and are pending payment. They also list which visits have already been paid by insurance and what your current balance is after those payments. Once we start sending you statements, there will be monthly re-billing fees assessed to accounts that are not promptly paid in full: $5 or 1% per month (12% per year), whichever is greater. In order to avoid a large bill at the end or re-billing fees, you may want to pay your approximate percentage at each visit.
We offer a 15% discount for accounts paid in full at the time services are rendered, IF…
If you do not have health insurance (payment at time of service is required), or
If we are not a preferred provider with your health insurance company, or
If we are a preferred provider, but your Outpatient Physical Therapy benefits are exhausted.
If we are a preferred provider with your insurance company, we cannot offer any discount to charges accrued as part of your deductible; as a preferred provider, we are required to charge their allowed fees, neither more nor less, until the benefit is exhausted.
For more information call Customer Care at (206) 405-3947 and ask about Outpatient Physical Therapy.