Insurance and Payment Options for Physical Therapy

Insurance Options for Physical Therapy

Constant changes to insurance plans and provider networks can make it difficult to understand your insurance coverage. We know what it feels like to try to navigate the system alone.

All patients, or prospective patients, of Excel Physical Therapy can receive free insurance checkups at any time. Our staff will help you understand the type and amount of coverage included in your health plan before starting treatment.

Do you have insurance questions?

Answers to insurance questions

Our staff works with insurance companies every day. It is okay if you don’t know the ins and outs of insurance; we do.

If you don’t understand the difference between co-pays and coinsurance or don’t know your deductible from your out-of-pocket max call our office. We can help you understand what these terms mean and how they pertain to your plan.

Do I need a referral for physical therapy?

The need for a referral is a common misconception about physical therapy. In Wisconsin you are allowed direct access to physical therapy without a referral. However, some insurance such as Medicare will require a referral. When in doubt, call your insurance company or Excel Physical Therapy.

Will my insurance cover physical therapy?

Although every plan is different, most insurance will cover physical therapy that is medically necessary and provided by a licensed physical therapist.

Particularly if you are covered through Medicare or a Health Maintenance Organization (HMO), you will want to make sure that the physical therapist you choose is covered “in network,” as this will impact the amount you owe versus what the insurance company will cover. We are happy to assist you to determine if we are preferred providers for your insurance plan.

Our free insurance checkup will allow you to have a clear picture of your coverage before beginning treatment.

How to make the most of your insurance coverage

At Excel Physical Therapy we are always available to help you understand your insurance coverage. Here are a few tips we often share with our patients:

  • Know your coverage – You can find your coverage information in your insurance plan book, by calling the number on the back of your card or asking your healthcare provider for help. If you prefer to have the coverage in writing, ask the insurer to email, fax or mail a copy of your coverage information. As you review medical bills from any hospital, doctor, chiropractor or therapist, make sure that your insurance company is paying them claim correctly.
  • Check your medical bills – If you don’t understand them, contact the billing department in the office where you received care. Billing departments are run by people like you and me, we all make mistakes. If this happens, your provider will often adjust your bill to correct the error or discrepancy.
  • Appeal denied or reduced payments – If you feel the coverage provided by your insurance is not in line with what is guaranteed in your plan, you can appeal the payment.

What if I don’t have insurance or have high deductibles?

While this is an important consideration, we are committed to helping you get the care you need.

We can create a treatment plan that works with your insurance or financial limitations. We will work together to develop a program that maximizes independent exercise and self-care, while providing the most essential hands on care. Effective physical therapy treatment can reduce the use of expensive imaging and testing, decrease use of medications, and reduce the need for costly procedures and surgery.  We ask that you discuss any financial limitations with your therapist at the first session so he/she can create an appropriate treatment plan.

Point of Service Payment and Punch Card Program

At Excel Physical Therapy, our goal is to get you fast access to the treatment you need so you can get back to loving life. This means eliminating the pain of insurance pre-approvals and expensive treatments. We offer two private pay options at Excel Physical Therapy – our point of service pay physical therapy plan and our pre-pay punch card program.

The point of service pay physical therapy and punch card programs provide opportunities for patients with high deductibles, high copays and coinsurance to receive affordable physical therapy. Pre-Pay Punch card program 

Our pre-pay punch card program is a perfect option for patients who are looking for regular access to affordable treatment. One punch card is $390 for four, 45 minute treatment sessions.  

Point of Service Pay physical therapy 

Our point of service system is a great option for those who are looking for quick access to affordable physical therapy but don’t need much treatment.  Point of service treatment is $ 97 for 30 min and $ 145.50 for 45 min.  

Pre-pay punch card terms and conditions: 

Pre-Pay punch cards will be punched before the treatment session. Punch cards are redeemable for in-office services and have no cash value. Remaining treatment sessions on cards should be retained for future treatment. More than 2 cancellations with less than 24-hour notice will result use of one additional session being punched on the card. The user of the card is responsible for retention of the card. Lost or stolen cards will not be replaced by Excel Physical Therapy. 

All documentation and assessment time is included in the total treatment time. This program cannot be combined with any insurance billing options. The user declines insurance coverage for services provided under the prepay/point of service program. Medicare recipients have additional limitations on the use of this program. 

Access affordable physical therapy today

Looking for fast, affordable physical therapy? Contact us today for more information on our private pay physical therapy options or to schedule your free consultation.

“I was extremely happy with the treatment and welcoming staff. The whole office atmosphere exudes happiness.”

– Christine S., Excel Physical Therapy Patient