Important Insurance Information

Insurance Participation Verification

Insurance companies list their preferred providers in a variety of different ways. Unfortunately, we don’t have any control over this process. Depending upon the insurance company, you may find our clinics listed as providers under the following headings:

Company Name: Core Physical Therapy, PC

Clinic Names:

Provider Name: “Joe Physical Therapist” PT

Today’s complicated reimbursement climate is in a constant state of flux. It is your responsibility to fully understand all the details of your particular plan.

If you have a deductible, then your deductible must be satisfied before the insurance company will pay for treatment. You are responsible and will be billed for any unsatisfied deductible amount. You can obtain this information from your insurance customer service representative.

Office co-pays are due at the time of service. The co-pay amount on your insurance card may not be the co-pay amount for physical therapy visits. You can obtain this information from your insurance customer service representative.

Your co-insurance amount is the amount not covered by your insurance plan. You can obtain this information from your insurance customer service representative.

If your insurance policy requires a prescription from your primary care physician (PCP) or non-physician practitioner (NPP), you must obtain a current prescription in order for your plan to pay for physical therapy services. You must have a current prescription for the duration of your physical therapy care.

If your policy requires a referral or pre-authorization on file, you will need to contact your PCP’s referral coordinator and ask that a current copy be sent to both your insurance company and our office.

Be aware that prescriptions, referrals, and pre-authorizations have expiration dates and/or a set visit limit. Check to be sure your paperwork has not expired prior to your first visit. We will assist you in tracking expirations of prescriptions, referrals, or pre-authorizations once you have begun care with us.

All our physical therapists are not preferred providers for all physical therapy plans. It is important for you to know whether your physical therapist is a preferred provider for your plan. If your PT is not a preferred provider for your plan, you will not be eligible for in-network benefits. You may want to reschedule with another provider to receive in-network benefits.

Physical Therapy or Rehabilitation benefits can include occupational therapy, speech therapy, massage therapy, and/or acupuncture. In addition, naturopathic – physical medicine and chiropractor office can provide and bill for physical therapy services. These services can be paid out of the same benefit limit. Please check with your insurance company when you are seeing multiple practitioners.

Keep in mind that Core Physical Therapy can only track your plan and prescription limits for services provided at one of our offices. It is your responsibility to track services received from other practitioners in other offices. If you exceed your plan limits, you are responsible for payment of the services not covered by your plan.