Insurance and Physical Therapy: What You Need to Know

Dealing with medical insurance can be confusing for everyone involved. It can be difficult to get a clear answer from your insurance company about what services are and are not covered, and your provider may not be able to give you a clear answer either. Insurance can be even more difficult to deal with when you are trying to get specialized services like physical therapy. To obtain benefit information, there often has to be a concerted effort between the patient and the clinic. To understand more about your role and your physical therapy clinic’s role in this process, consider these useful tips.

Your Clinic’s Role

When you call to schedule an appointment with a new physical therapy provider, they will likely be able to tell you if they are in network with your insurance. When you choose an in-network provider, you typically have lower costs than if you choose one who is not in network. If there are other patients in the clinic with your same insurance, the clinic insurance coordinator may already know some things about your benefits. Your provider will likely try to determine what your insurance copayment will be at the time of the visit, and they may also request a benefits breakdown from your insurance company.

Your Role

In order to obtain the most accurate information from your insurance company, it can often be easiest for you to contact them directly. You can try to get a breakdown of benefits sent by email, which can let you know if you have physical therapy coverage on your policy. They may also be able to direct you to physical therapists in your area who are in network with your insurance carrier. Some insurance companies have mobile apps that allow you to obtain this information as well. If you are unsure of what health coverage you have or how to contact the company, consider speaking to your HR manager at work.

While navigating the waters of medical insurance is no easy feat, it can be easier when you understand the most efficient ways to go about the process. It is important that you do your research before your first appointment, as you do not want to show up and have a long wait time due to insurance conflicts or questions. When scheduling your first visit with a physical therapy clinic, ask what steps you can take to make the insurance verification process as easy as possible for everyone involved.
Contact a physical therapist, like a physical therapist from AmeriWell Clinics, for more information today.