Insurance

PhysioWorks is an Out-of-Network Provider

Today’s health-care market is rapidly changing, with ever-increasing pressure on providers to provide more and better care at lower cost. Unfortunately, in many cases this pressure results in therapy visits that are rushed, use cookie-cutter treatment protocols, aides providing at least some patient care, or even doubled-up treatment sessions. Under the traditional insurance-based model, Physical Therapists may be limited in treatment options and are burdened by an overwhelming level of bureaucracy. Even with the best intentions, Physical Therapists practicing under this model will struggle to fully utilize their skills to give patients the care they deserve.

PhysioWorks, Sport and Wellness, Inc. proposes doing therapy differently. We will see you for the amount of time that is needed, not mandated or pressured by insurance.  We will use individualized treatments that are well evidenced. We will show you how to do exercises and will review them if you have questions, but we will not repeat the same ones again and again. In doing this, we expect to be able to treat you with fewer sessions and expect that the overall cost will be similar to that of going through a traditional insurance-based clinic.

Can I file for reimbursement from my insurance provider?

Although PhysioWorks is an out-of-network (OON) provider, in many cases you will be able to file for reimbursement for therapy care from your insurance company. Being OON means that PhysioWorks does not have the extra overhead required by an insurance-based clinic for billing and insurance, and we pass that savings on to you. Our fees reflect the actual cost of providing your therapy, and are similar to what you might pay as a ‘cash-pay’ client at a traditional therapy practice. We will provide you with a detailed bill containing all the information your insurance provider needs to process your reimbursement, and will be happy to help if your claim encounters difficulty. For more details on how to learn about your OON coverage, how to submit a reimbursement claim, and how to estimate what your total out-of-pocket cost would be at PhysioWorks compared to a traditional therapy practice, see our Insurance Worksheet.

 

If you are a Medicare patient we cannot offer you Physical Therapy for services that Medicare covers. We can, however, offer running assessments and other Wellness products as these are not services that Medicare covers. This will not change until legislatively Physical Therapists are able to opt out of Medicare like many other medical professions.

How to get reimbursed

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