Questions About Billing, Referrals, & Insurance
Can I Go to Any Physical Therapy Clinic?
In most cases, you have the right to choose any physical therapy clinic, such as Aspen Hill Physical Therapy. The best thing to do is give us a call and we will attempt to answer all of your questions.
Can I Go Directly to My Physical Therapist?
All fifty states have some form of direct access. In most cases, if you are not making significant improvement within 30 days, the therapist will refer you to or back to your Silver Spring, Maryland-based physician. Seeing a physical therapist first is safe and could save you hundreds or even thousands of dollars.
Who Pays for the Treatment?
In most cases, health insurance will cover your treatment.
How Does the Billing Process Work?
Billing for physical therapy services is similar to what happens at your doctor's office. When you are seen for treatment, the physical therapist bills your insurance company, Workers' Comp, or charges you based on Common Procedure Terminology codes. Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer. The payer processes this information and makes payments according to an agreed upon fee schedule.
An Explanation of Benefits is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient. The patient is expected to make the payment on the balance.
It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.