RATES & INSURANCE
|
All treatment sessions are one-on-one and are scheduled for either 1 hour or 30 minutes. The rate for treatment sessions and other services vary, so please call us at (718)-569-5513 to inquire about pricing.
We are a fee-for-service clinic that is not in-network with any insurances. Upon request, receipts can be provided that include the necessary codes to send self-claims to your insurance company. Why is my insurance not billed at Miller Physical Therapy?The short answer to this is that insurance companies dictate or strongly influence the treatment that patients receive at “in-network” clinics. In order to provide the treatment we believe all patients deserve, we don't deal with these insurance restrictions.
The longer answer: We are an out-of-network practice because we insist that physical therapy be offered at a higher standard. Being "in-network" doesn't make this possible. Due to progressively worsening reimbursement rates and pressure from insurance companies, the therapists at in-network clinics have to see at least 2 patients per hour (usually many more) and they often use technicians and assistants to provide much of the actual patient care. The care often includes modalities like heat packs and ultrasound, and the majority of a patient’s time at the clinic is spent doing exercises they could do on their own time. Furthermore, these types of clinics tend to require patients to attend 2-3 appointments per week. We do not believe that modalities are nearly as effective as our hands-on treatment, and we also do not agree with having patients pay to perform exercises in the clinic that they can easily perform at home or at a gym. All of our patients receive one-on-one care and hands-on treatment from a Doctor of Physical Therapy in every session. Most sessions are a full hour unless the patient chooses 30 minute sessions. With this long-session, one-on-one treatment approach, the plan of care for the vast majority of our patients only involves one appointment per week. When you consider the time savings of fewer trips to the clinic and the value of resolving your pain so much faster than average, the out-of-pocket expense at Miller Physical Therapy is a bargain. How Can I Actually Save Money With Miller Physical Therapy?
As deductibles and PT copays have skyrocketed in recent years, many of our patients who have high PT copays or have not met their deductible pay less out of pocket for our treatments than they would if they went to a clinic that “takes their insurance.”
So before deciding on where to get PT based solely on which clinics “take your insurance,” make sure you know how much you’ll be paying at your in-network options versus an out-of-network clinic like ours … These days, some insurance plans provide zero coverage for PT visits or require copays of over $50/visit. And if you have a deductible to meet, you’ll likely end up paying the full bill for your PT sessions until you meet the deductible (and these bills are often $200+ per session). However, you usually won’t start receiving those $200+ bills until after you’ve been getting care for 6-8 weeks and have racked up an enormous total balance (again, often being asked to attend PT 2-3 times per week). And guess what else… just because you’re paying $200+ per session at a clinic that is in-network with your insurance, does not mean that your insurance is applying that full amount towards your deductible! They often only apply the amount that they have agreed is reasonable for your PT sessions which is, of course, far less than the amount the PT clinic actually charges. Most people are quite unaware of the games their insurance companies play in order to pay out as little as possible and maximize their profits. So as you weigh your PT options, it’s very important to:
* One other thing to consider is whether or not you have just one deductible or if you have both an in-network deductible and an out-of-network deductible. If you have two deductibles, then claims from an out-of-network clinic like ours will not apply to your in-network deductible. With all the above information, you can now get a real sense of what your true costs will be, what level of care you’ll be getting, and then make the best decision on where to receive your physical therapy treatment. Can I bill my insurance for reimbursement of my out-of-network expenses? This depends on the insurance you have, but YES, most NON-Medicare patients can send “self-claims” to their insurance company for their treatments at our clinic. You should be able to print claim forms off your insurance company’s website, and send it in with the needed receipts and treatment codes that will be provided upon request at our clinic. We also recommend our patients consider using "Reimbursify." This is a service that, for a small fee, will send in your self claims for you. All you need to do is copy the information from the bills you receive from us after each visit. They'll handle the rest. The amount of reimbursement or application towards your deductible is completely dependent on your insurance plan. If you call your insurance company to inquire about what you can expect to receive, you should ask about reimbursement for “out-of-network Physical Therapy” expenses sent in via self-claims. Medicare Beneficiaries: The US government has some interesting laws that control where Medicare beneficiaries can spend their healthcare dollar and persuade healthcare providers to enroll in their system. Because we are not Participating Medicare Providers, we can only accept Medicare beneficiaries as patients when the patient does not want Medicare billed for any PT services. This request to not involve Medicare in payment must be made up front by the patient and be made of the patient’s own free will. In other words, if you’re a Medicare beneficiary and are adamant about seeing us for your care even though we are not participating Medicare providers, we can help … However, the only way we can provide you with PT services is when you truly don’t want Medicare involved and you ask up front that Medicare not be billed or involved in your physical therapy care. If you do want to use your Medicare benefits for physical therapy, we cannot provide you with treatment at our clinic but we can help you find a good Medicare provider in your area. |