Dunn Physical Therapy accepts most insurance plans, including (but not limited to) Aetna, BCBS, CIGNA, Medicare, and United Healthcare. We will file insurance claims for our patients with participating providers. Our billing department will verify your physical therapy benefits for you prior to your first visit. Your applicable copay/coinsurance/deductible will be due at time of service.
In the State of North Carolina, you do not need a referral from a doctor to see a physical therapist. Some insurance plans may require the referral for payment and we will verify this information and assist you with obtaining the referral if needed.
We fully understand the financial constraints of each patient and we will offer payment options to help assist you during the process. We encourage you to speak with our Billing Manager at (919) 388-0111 or email us at email@example.com should you have questions or concerns regarding your insurance plan. We do NOT want your recovery to be halted due to financial difficulties.
We know that the world of insurance coverage can be confusing, so we have tried to give you a few informative definitions to assist you in understanding your benefits. Per our contracts with insurance companies, we are required to collect co-pays, co-insurances, and deductibles at time of service.
Co-pay: A copay is a flat fee that you will pay at every visit to our office. We are a specialist office, so your plan might differentiate copay amounts to your Primary Care Physician and a Specialist. This amount usually does not change with each visit, however certain plans require an additional coinsurance on evaluations/re-evaluations. (Example: If you have a $20 co-pay for specialist office visits, you would pay $20 to our office each visit.)
Co-insurance: A co-insurance is a percentage that you will pay of your charges. Your charges may differ from visit to visit because they depend on which procedures were performed on that day. Because your co-insurance is a percentage of that total charge, the amount you pay may differ as well. We calculate total charges based on the contracted fees that we have with your insurance company, so an adjustment is made before collecting your percentage.
Some insurances have a flat, per visit rate for physical therapy services. In these instances, your percentage would result in the same fee each time because the charge visit does not vary based on procedures performed. (Example: If you have a 20% coinsurance, and your charges for the day totaled $100, you would pay $20 for that visit.)
Deductible: A deductible is an amount that your insurance requires you to pay directly to providers before your insurance company will pay its portion of the benefit. The deductible can apply to multiple services, so often you will meet it through a combination of charges from different offices. You would be required to pay the full charges of your visit (adjusted based on our contracted fees with your insurance company) until your deductible is met.
Example: If you have a $500 deductible, then a 20% co-insurance, and your visit charges totaled $100, you would pay $100 for the first 5 visits, then $20 for the visits after that.
If you believe that you have already met your deductible elsewhere, please let our billing department know and we can explain your options to you.
Visit Limits: Some plans specify a limit on the number of physical therapy visits allowed per plan year. Sometimes this is combined with other services such as chiropractic care or occupational therapy. Other times, the visit limit applies to PT services only. It is each patient's responsibility to keep up with the number of visits they have used. Once you have exhausted your visit limit, your insurance will often not pay for additional visits. We offer a courtesy rate for these instances, if your therapist determines that more visits are necessary. We are happy to assist you in planning ahead in these situations, so that we can come up with an effective plan for your optimal recovery.
Some insurances require pre-authorization in order to approve additional visits. This may involve paperwork and pain scales that must be completed by the patient. Failure to complete and return these forms on the same day they are given to a patient may jeopardize insurance coverage, resulting in the patient being held responsible for the cost of future visits. We make every effort to give you the tools necessary to maximize your insurance benefits.