Integrated Physical Therapy Services, Inc. is a provider for most insurances
available to Eastern Ohio and Western Pennsylvania. Please visit our
extensive, and growing, list to the left.
If you do not see your insurance provider listed here, that does not
necessarily mean that you cannot access our services. Please call our
office and we will be happy to contact your insurance for you to
determine coverage, including deductibles and co-pays.
Ultimately, it is your responsibility to know your insurance plan and coverage. However, we pride our business on exceptional customer service and will work with you to make sure that your portion of the physical / occupational / speech therapy expense fits your budget and expectations.
If you begin therapy and have not discussed coverage with office coordinator, please do so as soon as possible.
Also, if we are not a provider for your insurance, that does not necessarily mean that we will not get reimbursement from your insurance company. Again, it is important to have our office coordinator contact your insurance so that we can work out a payment plan or make special arrangements for you.
We encourage our patients to be educated and proactive regarding their healthcare. You may want to contact your insurance company for your own benefits information. If your information is different from ours, we can make another phone call for clarification.
Your bill will vary depending on the treatment you receive and the billing codes used.
Questions to ask your insurance company:
• Does my plan cover Outpatient Physical Therapy or Occupational Therapy or Speech Therapy (depending on which therapy you need)?
• What is my deductible?
• Has my deductible been met? If not, how much of the deductible has been met?
• What is the amount of copay I will need to pay?
• Are there any visit limits or restrictions?
• Are my visit limits based on calendar year, benefit year, or other time frame?
• Do I need to obtain prior authorization for physical therapy?
• Do I need a referral from my physician?
Co-pays and Coinsurance:
Co-pays vary depending on insurance plans. We will determine your co-pay during your first visit or as soon as we can contact your insurance company. Because co-pays are often a percentage of the allowable charge to your insurance company, it is not always possible to accurately predict the exact amount owed per treatment. However, we encourage that you make some payment towards each treatment to avoid a large bill at the end of your therapy. We offer very flexible payment plans to ease your financial burden while still being able to provide a quality therapeutic outcome for you. If your co-pays are high, as they often are these days, we can make arrangements to modify the frequency of therapy intervention to decrease your financial burden.
Deductibles:
This is the amount of out-of-pocket expense required by the insured before your insurance will begin paying towards your medical expenses. It usually combines all medical expenses, your including doctor visits. Each insurance policy varies on the amount of deductible that is required. Because it is difficult to get full accuracy on the amount remaining on your deductible, we will wait until we hear from your insurance company to charge you this amount.
Statements:
We will send out monthly statements. Unfortunately these can be confusing because of claims that are still pending collection from your insurance company. Do not be alarmed if the total amount of money due reflects a significant amount. As your insurance payments come in we can give you more accurate information on the amount actually owed by you. Please contact our accounts representative for any questions and concerns.
Cash-Pay:
For patients who choose not to use, or do not have insurance coverage for physical therapy, we offer our services for cash payment. Contact our office coordinator for details on cash payment rates.
MEDICARE:
We accept insurance for all Medicare recipients. Co-insurance charges or denials are the responsibility of the insured. But, we offer very flexible payment plans to ease your financial burden while still being able to provide a quality therapeutic outcome for you. If you have more than one insurance policy, you must inform us which is primary and complete a Medicare Secondary Payer Form. We will provide billing to both Medicare and your secondary or supplemental insurance, if you have one.
Medicare has strict regulations to qualify you for coverage. You must have a physician's referral, and return to see your physician every 90 days in order to continue physical therapy. In addition, your therapist will track your progress, as we must be able to document clear functional progress to justify continued services.
Your Responsibilities:
You, as a recipient of rehabilitation services, are ultimately responsible for payment of these services.
Regarding payment, our policies are as follows:
If your insurance company refuses to pay or has not paid after 90 days, your bill will be turned over to you for immediate payment.
You will have 15 days to pay the balance without a late fee unless you make arrangements with one of our office coordinators to engage in a flexible payment plan.
* Late fees:
1.5% monthly for late payments after 30 days from date of service
Specific insurance situations:
* Medicare
Co-insurance charges or denials are the responsibility of the insured. If you have more than one insurance policy, you must inform us which is primary and complete a Medicare Secondary Payer Form.
* Worker's Compensation
If your worker's compensation claim is denied, you are personally responsible for your bill. All worker's compensation patients must be approved by worker's compensation prior to initiating therapy.
* We DO accept TriCare
* We DO accept TriCare for Life
* Auto Insurance
Any charges not paid by medical pay provisions of auto insurance (yours or that of other parties in the accident) are YOUR responsibility and are due and payable in full upon receipt. We WILL NOT file a Motor Vehicle Accident (MVA) claim with a private health insurance plan.
Please look at the list below to find your coverage. This list is continually expanding. If you do not see your insurance listed, do not assume that we cannot see you. We will make appropriate contact with your provider to see if we are in or out of network. If we are not, we can make beneficial arrangements for you and will pursue in network status.
Medicaid
Medicare Railroad
Anthem BC/BS plans including:Blue traditionalBlue accessBlue preferred primaryMedicare Advantage HMOMedicare Advantage PPO
(Anthem Senior Advantage)
Aetna:Aetna golden medicareAetna elect choiceAetna quality point serviceAetna USAcessOpen acces aetna selectAetna choice POS IIOpen choice PPOAetna affordable health choicesAetna health fundAetna signature adminstratorsAetna HMOAetna SelectAetna managed choiceAetna golden choiceAetna open access HMOAetna choice POSAetna open access managed choiceTraditional choiceAetna affordable health choices-indemnityAetna health fund health savings account
Optum HealthCommercial PlansSelf Funded Employer GroupsMedicareWorkers CompAuto
Interplan Health Group
HealthSmart
OrthoNet
AARP Medicare Advantage
Bureau of Worker's Comp
UMWA Health & Retirement Funds
The above list is not necessarily all inclusive. If you do not see your insurance above, please contact our office coordinator. We will be able to make arrangements to provide the best care possible.
A Patient's Guide to Getting the Best Coverage
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