For more information or questions, please contact our Clinical Operations Director Kelly Sanders at (805) 788-0805, ext. 216 or email firstname.lastname@example.org.
Physical Therapy is a health care specialty involved with evaluating, diagnosing, and treating disorders of the musculoskeletal system. The ultimate goal of Physical Therapy is to restore maximal functional independence to each individual client. To achieve this goal, physical modalities such as exercise, heat, cold, massage, and mild electrical stimulation are utilized. Physical Therapy is provided by Physical Therapists, who are licensed health care professionals with a master’s or doctorate degree in Physical Therapy. Physical Therapists evaluate, diagnose, and manage the physical therapy treatment plan, customizing it to each individual’s needs.
Thank you for choosing Avid Physical Therapy for your physical therapy needs. We have put together some information to help you prepare for your first visit.
- Please wear or bring comfortable, loose fitting clothing that will allow the therapist to expose the affected regions of the body. Exercise wear such as sweats, t-shirts, and shorts are recommended.
- Please plan to be in our facility for 60-90 minutes for your first appointment. Your therapist can tell you how long each follow-up appointment will be, usually 60 minutes.
Please arrive 10 minutes before your scheduled appointment time if you will be completing the new client paperwork in the office. For your convenience, we also have this paperwork on line if you would like to complete it ahead of time. Additionally, please bring the following items to your first visit:
- Your health insurance card. We will need to make a photocopy of this card to ensure we collect all necessary information to bill your insurance company.
- If we will be seeing you for a worker’s compensation injury, please bring any information you have regarding your claim (claim number, adjustor’s name & contact information).
- Physician’s order / prescription
- Co-payment if applicable. Co-payments are due at the time of service and will be collected at that time. We will verify your benefits, including copayment amounts as a courtesy at the start of your care. Please note we accept cash, check, and Mastercard/Visa.
What to expect during your first appointment…
- During your first visit or evaluation, a licensed physical therapist will examine you and discuss your medical history, why you are seeking physical therapy care and any other concerns. Your therapist will complete a series of tests and measures; for example measuring flexibility and strength, as well as your ability to perform specific functional activities. Following the examination, your therapist will review their finding with you and with your input, outline a treatment plan and therapy goals designed to help you recover and get back to your regular activities as quickly as possible.
Do you accept my insurance?
Our facilities and providers are contracted with most major insurance companies such as Medicare, Blue Cross, Aetna, Cigna, and many workers’ compensation insurances. We are happy to bill your insurance as a courtesy to you and will assist you in determining whether your insurance benefits will cover our services.
Is Physical Therapy covered by my insurance?
Because all individual plans vary in restrictions and requirements, we encourage you to contact your insurance company to understand the extent of coverage you may have available for physical therapy. It is important to be aware of any limitations that your insurance plan entails such as:
- Any unmet deductible
- Co-pay or co-insurance amounts
- Pre-authorization requirements
- Visit limits (annual)
- Maximum dollar amount in coverage
- Primary Care Physician limitations
How can I find this information?
Call the contact number that is listed on your insurance card, or go to the payer’s website and register your account. Ask for specific Physical Therapy benefits and verify any of the above requirements.
How can your front office staff help me?
After you make an appointment with one of our clinics, we will be contacting your insurance company to verify your benefits and do our best to understand your specific coverage limitations. We’ll provide you with a copy of this summary of information at your first appointment. Keep in mind that these are the benefits quoted to us by your insurance company which are subject to changes beyond our control.
How do I find out how many treatments my insurance will pay for?
Physical Therapy benefits are usually considered part of Physical Medicine and Rehabilitation services. Your insurance may limit the number of visits per year, and/or a specific dollar amount allowed for these services. Massage Therapy, Chiropractic treatment, Occupational and Speech Therapy can also be included in this group. If this is the case, your Rehabilitation insurance dollars or number of visits allowed may be spread among all of these services.
What information do we need from you?
We strive to provide top notch customer service by communicating to you any insurance coverage issues that may arise. However, health insurance benefits can be complicated and confusing. To minimize this, we need your correct insurance information, address and phone numbers. We ask that you alert us with any concerns, problems and changes as they arise.
We appreciate your understanding that any patient co-pay, or estimated co-insurance, and deductible responsibility will be made at the time of service and remaining patient payments will be made promptly after receiving your statement.
When will I receive a bill?
As a courtesy, we will bill and assist in obtaining payment for the physical therapy services you receive. It typically takes between 45 and 90 days for you to receive a statement.*
- Upon receiving services, our central billing office bills your insurance and works directly with your insurance company for processing.
- Potential issues and benefits limitations are facilitated through this process.
- Insurance company acknowledges receipt of and processes your claim.
- You will typically receive an EOB (Explanation of Benefits) from your insurance company.
- Insurance company informs the billing office of the "allowable amount" for your services and processes your claim accordingly.
- Central billing office will issue your statement for the amount that your insurance company assigns as your responsibility.
- Depending on your length of care, your monthly statement may or may not include all dates of service. Each visit will be listed on the statement.
- You can pay your balance due by check, credit card, online, or by calling our billing office at 866-387-7778. You can also make a payment on your account by visiting the clinic you were treated in.
*Please note that circumstances beyond our control can often delay billing. If your insurance company denies benefits, inaccurately processes your claims, or delays the acknowledgement of your claims, we will strive to inform you any time we identify the problem.
I don’t have insurance coverage, but need physical therapy. What are my options?
We offer a cash rate program for those clients without insurance coverage, or for services rendered outside what your benefits will cover. Please contact your nearest clinic to inquire about our cash rates and any other options available.
If a third party is liable for your injury, please contact your nearest clinic for a review of your circumstances to determine how we may be able to assist you.
For Billing, Account, and Payment Related Questions: 866-387-7778
What do the insurance and billing terms mean?
Below are some of the more common insurance terms that you may encounter.
Co-Payment: This is the amount the insurance company requires the patient to pay on the day of service.
Allowed Charges: An "allowed charge" is the amount an insurance company pays for services received by their client that is provided by an in-network provider. The in-network contract we have with an insurance company requires us to accept the "allowed charge" for any services provided.
Co-insurance: Your contract may state that you are required to pay a percentage of the allowed charges. For example, you may have an 80% – 20% plan, which means that the insurance company will pay 80% and you will pay 20% of the allowed charges.
In-Network Benefits: These are the benefits your insurance company will pay if we have a contract with them. After the insurance company receives our bill for services rendered, they will determine the allowed charges they will pay for each service. We are bound by our in-network contract with the insurance company to accept their determination of allowed charges.
Out of Network Benefits: These are the benefits that your insurance company will pay if we are not a preferred provider, or directly contracted, with that company. The patient may be responsible for a higher portion of the total bill.
In order to save you time, we encourage you to fill out the forms below and fax them to the clinic before your first visit. You can also print them out and bring them with you to your first visit.
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Payments on account may now be made online. Click here to be directed to our secure online payments portal.
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