Insurance & Doctor Questions

» Insurance & Doctor Questions

Insurance & Doctor Questions

My Doctor Is Suggesting Surgery, Should I Try Physical Therapy First?

A doctor may refer a patient for physical therapy before opting for surgery. A conservative approach with physical therapy in most cases is a good idea prior to surgery. The physical therapy referral is also made when the patient has had a high number of treatments by other types of providers and continues to have complaints.

Do I Need A Prescription To Get Physical Therapy?

Some insurance plans require you to have a signed prescription from your doctor. If you are a Medicare patient, you are required to have a signed prescription from a physician.  If you and your physician have had recent contact regarding your current issues, we may be able to help obtain that prescription after the initial evaluation in PT.  We recommend you obtain this prior to the first visit when possible, though.  

Patients should be aware that although their insurance policy may indicate that a prescription is not necessary for PT, it most likely also states that only treatment that is deemed ( by the insurance company) to be medically necessary will actually be covered.  Also be advised that insurance companies can, years after treatment has been completed, go back into your case and retroactively decide that your treatments were not medically necessary.  Those patients who present for PT without prescriptions have the most difficulty proving the treatments were medically necessary.  Therefore, we require a prescription if the patient is coming to us under insurance. 

Is An Insurance Authorization Different From A Physican's Referral?

Yes. An insurance authorization is usually obtained through the referrals coordinator in your doctor’s office, who gets written permission for treatment in physical therapy from your insurance company. This is normally seen in Workmen’s Comp claims as well as some insurances such as Tricare.

Will My Insurance Pay For Physical Therapy?

Most insurance providers do cover physical therapy. You still may be responsible for co-pays, co-insurance, deductibles and supply charges. We always call and verify physical therapy benefits with your insurance company prior to your first visit. If it seems that there may be issues with your coverage, we will try to speak with you prior to your first visit.  Since you are ultimately responsible for you bill, we highly encourage you to call your insurance company as well.

Can I Pay Out Of Pocket?

Yes! We understand many patients do not have health insurance or have other reasons for not wanting to bill their visits through their health insurance. We offer self-pay packages or the option to pay as you go. Please contact the front office for pricing.

Will My Therapist Talk With My Doctor?

The physical therapist sends notes to your doctor including initial evaluations and progress notes, usually every 4-6 weeks. On occasion the therapist will call and discuss your treatment with your doctor if there are any specific concerns that cannot be conveyed through written communication.