Embodying the Nature of Restorative Healing
PAYMENT INFORMATION
In order to provide the level of care we feel you deserve; we have made the choice to be an out-of-network, cash-based clinic. This keeps the insurance company from dictating your care and allows us to spend exclusively one-on-one time with you on every visit.
Read more about our treatment approach and breakthrough path toward healing below…
SERVICE | CASH PRICE |
Initial Evaluation & Care Plan Development – 60 minutes, devoted one-on-one time with your therapist acknowledging your physical concerns through review of your history and discussion, establishment of care through initial treatment and initial supportive exercises as well as recommendations will be provided. Also, within this dedicated time of getting to know your concerns, your hopes for resolution of such concerns along with the goals you dream of resuming in your life will be explored and such a pursuit will be initiated. | $130 |
Care Plan Treatment Session – 60 minutes, devoted one-on-one time discussing your experience in response to your care to date, evaluation of your remaining and present concerns, treatment progressions of your remaining recovery needs and review of your supportive exercises and advancements if indicated as well as supportive recommendations will be provided each treatment session. | $105 |
Incremental Reassessment; Quarterly to Biannually -60 minutes, tune up visit designed to provide both an early detection in decline to your well-being, provide treatment as indicated and concurrently provide a review of your personal home exercise program as well as any appropriate progressions. Our long-term goal is for your liberation from prior sources of pain and suffering while also supporting your lasting involvement with your life interests allowing you to continue enjoying life to the fullest! | $130 |
PACKAGES
Five 60-minute Care Plan Treatment Session Package* $475
Ten 60-minute Care Plan Treatment Session Package* $945
* ALL Packages are valid for one year from purchase and may be transferred among immediate family members.
CONSIDER OUR TREATMENT APPROACH AND BREAKTHROUGH PATH TOWARD HEALING
We are not big on limitations – neither are you, which is why you’re here. Your body has the amazing ability to adapt and to persevere in almost any circumstance. This is the vessel that has carried you through life valiantly to date, yet the accumulation of such demands sometimes awakens us to the necessity to also rest and replenish and to address our pain or injuries.
When you recognize your body is in need of a healing assist, we are here for you. Providing you with the combined expert services in a healing atmosphere detached from the limitations posed by insurance providers affords you a personalized level of care that ultimately provides you with a breakthrough path to fully living once again.
In my 23 years of experience, I have learned the actions of third-party payers pressuring for immediate diagnoses, insisting on confining treatments, and interfering with the therapy we want to provide, often hurts the patient’s progress, and hinders our ability to reach your goals. Please familiarize yourself with the information below which explains how I have structured an ability for you to utilize a treatment approach that emphasizes your well-being above all else. Yes, there was a learning curve for me to get here and there also will be a small hurdle for you as well, yet in the end I am confident you will recognize the replenishment of fully living once again will be an investment with an abundant return I truly look forward to working with you. Please, contact me with any questions you have.
WHAT IS DIRECT-PAY PHYSICAL THERAPY?
In a direct-pay treatment model, the physical therapist provides clinical treatment based on the need of each individual without third party insurance reviews, network restrictions and visit limits. Physical therapy services are provided in a manner that both parties have determined will help to reach treatment goals most efficiently.
Documentation for evaluations, treatment visits, and progress notes are performed just like a standard physical therapy practice and comply with all legal requirements. The patient pays at the time of service, allowing the therapist to focus attention on providing the best possible service while keeping administrative costs low. You may pay for services using cash, check, credit or debit card, HSA or FSA account.
CAN MY COMMERCIAL HEALTH INSURANCE BE BILLED FOR DIRECT-PAY PHYSICAL THERAPY SERVICES?
Some insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide some payment for services received “out of network.” Going out of network means that you can choose to see a physical therapist who is not a participating provider with your insurance company. Many patients choose to receive services out of network in order to see the physical therapist of their choice.
The end goal of documentation and billing is the same – delivering on commitment – it’s just that, in the case of direct-pay services, it is the patient who is submitting the insurance claim and will be reimbursed rather than the provider. We recommend speaking with your insurance company prior to beginning with us if you are planning to submit for reimbursement.
The payments you make may or may not be reimbursable by your insurance company under your out-of-network physical therapy benefits; the exact percentage depends upon your plan. You are responsible for determining what your benefits are and obtaining any necessary physician referrals and/or pre-authorizations for services. We are not responsible if your health plan denies, in whole or in part, your claims for our services. If you have out-of-network benefits, Healing Calm Physical Therapy will provide you with an invoice at the time of service, and you may at your discretion submit that invoice and receipt to your insurance company for potential out-of-network reimbursement. The invoice has all of the necessary information (business name and address, tax ID, national provider identification, license numbers, etc.) as well as the ICD-10 (diagnosis) and CPT (billing) codes. You may choose to submit bills following each visit, one time per month, or at any other interval that is convenient for you.
MY INSURANCE CARRIER IS MEDICARE - ARE THERE ANY SPECIAL RULES THAT APPLY TO PHYSICAL THERAPY SERVICES?
Outpatient physical therapy services are generally covered under Medicare Part B, provided the service is considered medically necessary to treat a disease or condition. Under current Medicare regulations, physical therapists are not allowed to accept direct pay from Medicare beneficiaries for services that may be covered under Medicare, even if the services provided meet all treatment, documentation, and HIPAA requirements and have been prescribed by their physician.
Since we are not Medicare enrolled providers, we cannot submit claims to Medicare and Medicare will not pay for our services even though the same services might be paid by Medicare if you obtained them from a Medicare enrolled provider. In some cases, a Medicare beneficiary may pay cash for services that are no longer considered medically necessary, for example a “maintenance” or “wellness” program. Medicare may also allow cash payment for services beyond the Medicare cap for therapy services. If you are interested in learning more about whether we are able to offer you our physical therapy services for your current condition please call the office.
WILL I END UP PAYING MORE FOR DIRECT-PAY PHYSICAL THERAPY?
In many cases, the out-of-pocket expenses for a course of physical therapy will actually be LESS for services provided at Healing Calm Physical Therapy. In large part, this is due to the ability to charge less per visit, with these charges being well below the national average charge submitted to insurance in a typical outpatient practice.
On average, most patients have insurance deductibles of $5,000 or more. The average PT clinic bills insurance $250 per session, the cost of which is the patient’s responsibility until they meet their deductible.
We keep our treatment prices affordable while providing exceptional care. Healing Calm Physical Therapy can charge less because the simplified direct-pay fee structure streamlines billing and does not require hiring billing personnel or paying fees to a third-party billing service. This allows us to focus all energy on patient care, and allows patients to make informed decisions regarding the costs of their health care choices.