Physical Therapy and Health Insurance
Helpful Tips Regarding Health Insurance
As the office manager and “first impressions specialist” at OPTI, one of my many duties is to work with your health insurance company in order to ensure proper reimbursement for physical therapy services. It can be overwhelming and confusing as to how health insurance works so here is some helpful information for all people seeking PT services.
- The state of Nebraska allows patients to have “direct access” to physical therapy, which means that you do not need a doctor’s prescription for physical therapy in order to receive services. However, some individual health insurance companies require a doctor’s prescription for authorization prior to starting physical therapy. The best thing you can do is to contact your health insurance by calling the customer service number on the back of your health insurance card to ask specifically what your physical therapy benefits are so that you are informed prior to starting your physical therapy treatments.
- OPTI is in-network with most major health insurance companies! However, individual insurance plans cover physical therapy differently. Some require a co-payment for every office visit while other plans involve a deductible and co-insurance. Again, the best thing you can do is to contact your health insurance by calling the customer service number on the back of your health insurance card to ask specifically what your physical therapy benefits are so that you are informed prior to starting your physical therapy treatments.
- If your health insurance coverage is through Tricare, you will have to have your primary care physician complete an authorization form for physical therapy before your first visit.
- If you go to the doctor for a follow up visit after initiating PT services and the doctor would like you to continue with PT, it is a good idea to have the doctor give you a new prescription. Many health insurance companies require a copy of the doctor’s prescription to continue covering the costs of PT. Often times, we have to send this information to the health insurance companies along with progress notes from the physical therapist in order to have continued coverage by your health insurance company for further PT services.
- If you do not understand your health insurance benefits for physical therapy services, we would be happy to call and check for you!
- If you do not have health insurance, OPTI also has a private pay option meaning that you can pay cash for your services. Feel free to contact OPTI to discuss the private pay option.
What makes OPTI unique from other physical therapy clinics is the guarantee that you will receive one-on-one care with the same physical therapist every single visit. Healthcare can be expensive so OPTI wants to make sure each individual patient is getting the attention they deserve and that their time spent in the clinic is worth their money. This model of care speeds up recovery and improves outcomes!
Lori Koehn (Office Manager/Insurance and Billing)