financial information
The insurance world is complicated and ever-changing. At Peak Rehabilitation, we’re committed to providing you with the highest level of customer service.
Our front office staff will work directly with your insurance company to help you understand what your deductible may be, and if you have co-payments or co-insurance. We also work with workman’s compensation.
Direct Access
Georgia is a state that allows direct access to physical therapists. This means you are able to be evaluated and treated by a physical therapist without needing a prescription from your physician. We can now work as an integral part of your healthcare team, while providing cost-effective access points to care. With healthcare costs continuing to rise, many conditions can be successfully evaluated and treated without expensive diagnostic testing, saving you time and money. At Peak Rehabilitation, we believe access to care and cost containment are important factors that play into direct access.
Financial Policy
We are committed to help make your experience with our practice an enjoyable one. All patients must complete the entire patient registration packet and sign before seeing the physical therapist. Because you have a financial responsibility that obligates you to ensure full payment of your bill, we want to address the following issues:
Review YOUR “Schedule of Benefits”
We urge you to review your insurance policy’s “Schedule of Benefits”. It will help you understand the agreement you have with your insurance company. You should call your insurance company with any specific questions related to your policy in reference to out-patient physical therapy benefits in an office setting. You need to accurately verify and understand your policy’s deductible, co-payment, co-insurance, visit limitations, effective annual calendar renewal date, and any pre-authorization requirements. NOTE: Many insurance companies are now requiring YOU (the patient) to obtain a referral form from your primary care physician before your physical therapy begins. You should have received notification concerning this change to your benefits from your insurance company. Please understand you will be responsible for any balance that isn’t covered by your insurance due to no referral being obtained. Make sure to review your benefits and if you should have any questions call your insurance company.
As a courtesy, we will verify your coverage, but we will not guarantee the accuracy of the information we receive. There are numerous policies available, which makes it impossible for us to know every patient’s policy. Your insurance policy is a contract before you and your insurance company. You are responsible to know your level of coverage, and you are ultimately responsible for the full payment of your bill.
Insurance Information
We need complete and accurate information about your policy. We will submit claims to your health insurance company for you. We do not file third-party insurance claims. You are responsible for payment of any deductible, co-pay, and co-insurance as determined by your contract with your insurance company. You are responsible for any amount or services not covered by your insurer.
Changes in Coverage
It is your responsibility to inform us of any and all changes of insurance coverage during the course of treatment. Failure to do so may result in denial of coverage by your insurance company. Therefore, you will be responsible for all charges.
In-Network
You are responsible for meeting the in-network deductible before your insurance will begin to reimburse for the services rendered. It is your responsibility to be informed of the status of your deductible. Any amounts applied to your deductible are due upon statement. We do not have any influence with the insurance company regarding deductibles. You are responsible for co-payments and/or coinsurance as specified in your “Schedule of Benefits.” You are also responsible to pay for any services that are received, but not covered under your policy. Copays are due at the time of service. If you have a deductible; we ask that you begin at the first visit paying a position towards the amount of your deductible.
Out-of-Network
You are responsible for meeting the out-of-network deductible before your insurance will begin to reimburse for the services rendered. You are responsible for copayments and coinsurance. You are also responsible for the difference between billed charges and your insurance company’s maximum allowable charges when specified by your contract. Your out-of-network benefits for out-patient physical therapy will be clearly explained in your insurance policy’s “Schedule of Benefits.” We will submit claims for payment to your insurance company.
Medicare
Peak Rehabilitation is a Medicare-approved provider of out-patient physical therapy. All Medicare policy holders need to have a physician’s referral, or prescription prior to starting as a physical therapy patient. Your initial physical therapy plan of care must be certified by your physician, and if your physical therapy continues beyond 30 days after the date of the first certification, the plan of care will need to be recertified every 30 days by your physician. It is our responsibility to be sure that the plan of care is certified, and this may require you to follow-up with your physician more frequently.
Secondary Insurance
If you have a secondary insurance, you must present it at your initial visit. The same policies and responsibilities apply to the use of secondary insurance. You are responsible for the accuracy of the insurance information we use to submit the claim and you are ultimately responsible for the full payment of your bill.
Work Comp
We require written approval/authorization from your employee and/or worker’s compensation carrier prior to your initial visit. If your claim is denied, you will be responsible for payment in full.
Personal Injury, Liability, Auto, or Involvement of an Attorney
As mentioned above, we do not file third party insurance. Because these legal cases can be involved and not settled for long periods of time, we ask patients to pay for their treatment and be reimbursed by the benefits obtained when these cases are finally settled. We will file your personal health insurance. However, if the claims are denied for any reason, you are responsible for the full payment of your bill. Our office does not accept “Letters of Protection” from an attorney.
Minors
A parent or legal guardian must accompany a minor patient at the time of the initial visit. The parent or legal guardian is responsible for full payment as outlined in the above financial policy. The parent or legal guardian who accompanies the minor patient to the office will have full responsibility for the payment should any dispute arise. Please be sure to send co-pays for each visit with minor.
Disputes
Our Financial Policy is designed to promote due diligence and a “proactive” rather than a “reactive” strategy. With your participation, this policy will minimize and potentially eliminate errors, miscommunication, and bad information with regard to your insurance or other financial arrangements for payment. We will not become involved in disputes between you and your insurance company regarding, but not limited to, deductibles, co-insurance, co-payments, covered services, usual and customary charges and pre-authorizations.
Uncovered Supplies
Throughout the course of your treatment you may need a brace or other therapeutic supplies recommended by your physician or physical therapist. Peak Rehabilitation will not submit claims for braces or other therapeutic supplies to your insurance company. Therefore, full payment for these supplies is due at the time or service or purchase. You may submit the receipt for these purchases on your own to your health insurance company.
Your Statements
Patient statements will be mailed out monthly. As a courtesy, Peak Rehabilitation will submit claims to your health insurance company after each visit and we will apply payments received to your account. If needed, we will re-submit these claims to ensure payment of your benefit for covered services. In the event that repeated submission of claims does not satisfy your bill for the services rendered, you will be responsible for the full payment of your bill. In addition, any balance remaining after your health insurance has paid in your responsibility.
Payments
We accept cash, check, Visa, MasterCard, American Express, Discover, Care Credit, and money orders. There will be a $30 service charge for all returned checks. If you have insurance, balances will be considered current from the date you insurance pays its portion.
Collection Accounts
We will work with you to avoid sending your account to a collection agency. In the event of default on your account, your account will be turned over to a collection agency. You will be responsible for the unpaid balance of your account and also the fees charged by the collection agency.
Missed or Cancelled Appointments
We require the cancellation of any appointments to be made prior to 24 hours before your appointment. An initial appointment that is not cancelled within 24 hours of the visit will be billed $75. A $50 charge will be billed for the second appointment missed or cancelled within the 24 hour period. With the third missed or cancelled appointment during the 24 period the patient will be excused from the practice.
If your deductible has not been met, Peak Rehabilitation requires a payment every visit toward your policy’s deductible.
These Payments are Due at Time or Service
- Co-pays required by your insurance policy.
- If your deductible has not been met, Peak Rehabilitation requires a payment every month toward your policy’s deductible.
- If you are a Self-Pay patient, full payment of fees must be received for the services rendered at the time or service.
- Exercise equipment and other products and supplies are not covered by insurance and must be paid for at the time they are received.
THANK YOU FOR CHOOSING Peak REHABILITATION!
For many of us, pain has become a part of our everyday lives.
The simplest of tasks–even sitting still–cause discomfort. We can help!