1.How do I know if my insurance covers therapy visits?

Every Insurance policy has different coverage for physical therapy just as it varies for all medical services. The best way to find out what your insurance covers is to have our highly trained staff contact your insurance company for you. We will be able to use language and specific medial coding to get the most accurate benefits. Your insurance company however will only be able to give us a quote of benefits, not a guarantee of payment. Claims are processed by your insurance company based on your policy and sometimes are different from what we are quoted.


2.What’s the difference between my copay, my deductible and my coinsurance? Do I still pay copay after meeting my deductible?

Every Insurance policy has different coverage for physical therapy just as it varies for all medical services. The best way to find out what your insurance covers is to have our highly trained staff contact your insurance company for you. We will be able to use language and specific medial coding to get the most accurate benefits. Your insurance company however will only be able to give us a quote of benefits, not a guarantee of payment. Claims are processed by your insurance company based on your policy and sometimes are different from what we are quoted.


3.What’s the difference between my copay, my deductible and my coinsurance? Do I still pay copay after meeting my deductible?

The first thing to be aware of when you are learning how your insurance covers services is medical providers will bill each service independently and those services will be paid independently according to your plan’s benefits. For example if you sprain your ankle and see one of our physicians. Our provider examined you, took an x-ray, and gave you a brace and crutches. Each of these four items will be billed separately. A copay is a fixed amount required by your insurance company for a specific medical service most common of which is office visits. Copays can vary depending on the provider and service you are receiving. A deductible is the amount you pay before your health insurance begins to pay. Your deductible is for services which are not subject to a copay usually services other than office visits like x-rays, procedures, and durable medical equipment (DME). Coinsurance is your share of the costs of specific services. It’s usually figures as a percentage of the total allowed charge for the service. You start paying your coinsurance once your deductible has been met. So depending on your policy you may be subject to all three in one visit, but not for one specific service. In the example listed earlier the office visit will likely only be subject to a copay. The additional services will be subject to your deductible up to its limit, after which you will be responsible for the coinsurance.


4. What should I do if I am running late to my appointment?

Please contact our office immediately. We will not accept patients who are more than 30 minutes late. During peak hours we may need to reschedule the appointment after 15 minutes. The main thing is to contact us.


5. How can I get my medical records?

We recommend you set up access to our patient portal (use hyper link here) where you will have access to your medical records as needed. Otherwise medical record requests must be done in writing and in person by the patient or their guardian. We will give a CD of medical records at no charge however if you require printed versions a charge may apply.


6. Will the therapist see me without a referral?

Our policy is not to see patients for therapy without a referral from your PCP. If you think you need physical therapy consult with your physician first. If you do not have a physician call our office and we can set an appointment to see one of our physicians.


7. My insurance doesn’t list you as an “In Network” provider. How can I know for sure? Can I still see your doctors even if your not listed as a preferred provider?

LSMC attempts to be “In Network” for most insurances, The best way to know is to contact your insurance directly and give the Physician or providers name you wish to see. Additionally, our highly trained staff can contact your insurance for you and verify your benefits. Every insurance has different policies regarding Non-preferred providers. Some allow for you to see them while others do not. Some will have reduced benefits or increased patient responsibility. Again, we recommend that our team verify your particular benefits.