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Standard Insurance Policy:
• Coverage depends upon your insurance company and the specific plan you have chosen.
• You may need a current prescription, referral, or authorization for physical therapy services based on your insurance plan.
• Co-pays are due at the time of service.
• Benefit details are not a guarantee of payment.
• If your plan requires pre-authorizations, AIPT will complete and submit all required documents.
• Authorizations are based on the insurance company’s medical necessity review and criteria, not on plan benefit limits.
• If your authorization is “pending” you may still choose to have physical therapy to avoid a delay in care, however you will be accepting the financial responsibility should the authorization be denied.
• You are required to have a prescription for physical therapy.
• You must be discharged from any home health care services or agency prior to initiating outpatient physical Therapy. Medicare will not pay for both home health and outpatient care simultaneously.
• Medicare has a SHARED dollar limit on Physical Therapy and Speech Therapy for each insured per calendar year. In order for us to track your allowed amount, we must have an approximate amount used at any other facility for speech or physical therapy. If we do not have these amounts we can only track what has been used at our facility. This may result in additional out of pocket expenses to you.
Auto PIP/Third Party:
• We will bill your PIP if you have a claim open and you have medical coverage with your auto insurance policy.
• If you do not have a direct PIP Claim you can choose to have us submit to your personal insurance or pay at the time of service at the Self-Pay rate described below. Payment at settlement with a third party is on a case by case basis. You may be required to make payments until settlement.
• For patients without insurance coverage, or for those patients that have exceeded insurance benefits, a 20% discount is available for full payment at the time of service.
Paying Your Bill:
• You will receive a monthly statement in the mail for any non-covered or unpaid balances on your account. Paperless Billing is Available.
• All unpaid balances that exceed 120 days will be assigned to a third party collection agency.
• Payment plans due to financial hardship will be considered upon special request.
• A fee of $25.00 will be charged for any check returned by the bank for Non-Sufficient Funds.