Insurance for Physical Therapy

Insurance 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? Contact us today >>

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.

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.

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:

  1. 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.
  2. 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.
  3. 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.

 

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

– Christine S., Excel Physical Therapy Patient