Insurance Info

How do patients pay for services?

Billing through health insurance

Most patients opt to have us bill their health insurance for physical therapy. After you call our office to schedule and register, our billing specialist will contact your insurance company to verify your coverage and then explain your benefits to you. We know that insurance issues can be very confusing. We are here to help you understand your coverage details such as deductibles, coinsurances, out-of-network benefits, visit limits, and benefit maximums.

Private Pay

We have many patients who opt to pay for their physical therapy privately, without billing health insurance. For these patients, we offer a discounted flat-rate hourly visit fee.  This is roughly a 40% discount of our insurance-billed rates, which reflects the “typical” reimbursement we would get from insurance for our services.

Some of the reasons patients choose private pay for physical therapy include:

  • simplicity of payment
  • immediate access
  • affordability if under a high deductible policy
  • low or no out-of-network coverage
  • insurance benefit runs out
  • uncovered diagnoses or services
  • continuation of care
  • no physician referral (if required by insurance)
  • periodic personal consultations

Some patients choose to pay privately for additional services, such as:

  • massage therapy
  • Pilates and Tai Chi classes
  • Pilates 1:1 training
  • Lecture on Schroth scoliosis method
  • Scoliosis group exercise classes
  • Videotaped biomechanical analysis
  • Custom foot orthotics
  • Sport-specific services (golf, running, cycling, throwing, gymnastics, etc.)
  • Onsite visits to gym, home, etc.

Please contact us if you'd like more information about costs for these services.

What if you are not in my insurance network?

If we are out of network with your insurance, it is typically for one of three reasons:

  • Your insurance is not offering contracts directly with small private clinics such as Spinal Dynamics.
  • Your insurance has presented us with a contract that does not sufficiently cover the high level of expertise and services we provide. Negotiations for a more reasonable contract have failed. If we proceeded with the present contract, we could no longer offer 1:1 full hour appointments, or employ the experienced staff necessary to provide you with the care you expect and deserve.
  • You are covered by a small insurance we have not been in touch with yet. If this is the case, we will happily take the opportunity to contact your insurance and inquire about becoming an in-network provider.

We apologize for the inconvenience of being out of network. We encourage you to contact both your insurance and the employer who provides the insurance to advocate for our practice being in-network under fair contract terms. Ultimately, this could help you and other patients have better access to us in the future.

If time allows, we have offered complimentary consultations for those patients that are coming to us out of network and need more specific information before choosing our clinic over an in-network provider. We believe we are unique and offer exceptional care. We therefore see the value in a complimentary consultation where a patient can learn more about our services in order to make a more informed decisions about their therapy. Contact our office to see if this option is available to you.

Will you discount my care if I am out of network?

It is not legal or ethical for providers to routinely discount deductibles or co-insurances portions. If you are under significant financial hardship, contact our office about possible financial hardship exceptions.

We accept Medicare, Worker’s Compensation and most commercial insurances. Our staff will work with patients and staff from referring practices to verify insurance coverage and ensure a clear understanding of insurance-covered and private-pay services.

 

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