Prescriptions/Referrals: It is the patient’s responsibility to obtain all prescriptions and/or referrals as required by their insurance. (Please note that referrals can only come from primary care physicians
Authorizations: Our office will obtain any authorization required at the time of the initial evaluation. Most authorizations, depending on the carrier, require a prescription and initial evaluation for authorization requests. Authorizations are NOT a guarantee of payment. The patient is ultimately responsible for all fees incurred as well as knowing their insurance benefits.
Medical Reviews: Insurance carriers can delay claims processing pending a medical review of the treatment received. All patient documents including evaluation, re-evaluation, prescriptions, tests and treatment notes are forwarded to the re questing insurance for review. Services can be denied if determined by the insurance carrier to not be deemed medically necessary. Maintenance (services not showing significant improvement), recreational (i.e. return to sports or leisure activ ities) services are not considered medically necessary and can be denied.
Please be sure to always give the front desk the most updated insurance cards and prescription/referrals. Benefits for outpatient physical therapy will be verified at the initial evaluation. We strongly recommend that all patients verify their own insurance benefits prior to treatment. We are not responsible for misinformation given to us by your insurance carrier.