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Insurance Information

It is important that our patients be familiar with their own insurance policy. We are happy to call and verify insurance benefits for a patient’s individual plan. We file claims daily, and collect copays at the time of service. Patients are ultimately responsible for any amounts not covered by insurance. To better assist you, we ask that new patients bring their insurance card with them for their initial evaluation.

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We are members of numerous insurance plan networks, including Aetna, Anthem, Humana, Medical Mutual and UnitedHealth Care insurance policies. We accept Workers Compensation, Automobile Insurance, and are a certified provider of services for Medicare patients. Our office staff can aid in determining if we are in-network with a particular policy, or if out-of-network benefits apply.

Some insurance policies require additional authorization. Our office staff will ensure that we are compliant with any required authorization requests as dictated by an insurance policy.  Patients are expected to complete all insurance-required paperwork in a timely manner to ensure authorization requests can be processed correctly.

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As a reference, here are some commonly used insurance terms that may help in understanding an individual policy:

Copay: A co-payment is a per-person, per-visit amount a patient is required to pay before an insurance company will cover the cost of your care. For example, if an insurance plan has a $40 copay, the patient must pay $40 per physical therapy treatment session.

Deductible: A specified amount of money that an insured person must pay before an insurance company will pay for a claim. For example, if an insurance plan has a $500 deductible, the patient must pay $500 in covered services before insurance will pay for services.

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Coinsurance: Co-insurance is a pre-determined percentage of costs covered by a health care service after a patient has satisfied their deductible. For example, if a patient has a $500 deductible and 80%/20% co-insurance, insurance will pay 80% of applicable service costs and the patient will be responsible for 20% of applicable service costs after paying all of the $500 deductible.

Explanation of Benefits (EOB): An explanation of benefits, or EOB, is a statement sent by a health insurance company to providers and covered individuals explaining medical treatments and services the patient received. The EOB includes the service, the amount billed, the amount covered, the amount the insurance company paid, the amount the patient must pay, and the date of service.