Kid Playing with Bubble

Fees & Policies

Fees & Policies
Do you take my insurance?

We are considered an out of network with all insurances, but will provide you with a Superbill to provide your insurance company.  By providing you with the Superbill, you can submit to your insurance for them to reimburse you within your policy agreement.  We are happy to show you how to use the Reimbursify App, which makes submitting Superbills fast and easy.  If you have Medicaid, you are unable to submit your bill for reimbursement.  

 

Do I need to do anything with my insurance company beforehand?

If you plan on submitting a Superbill to your insurance to be reimbursed, then we recommend contacting your insurance company prior to the initial evaluation....some insurances require pre-authorization, some require a prescription from your MD, every insurance is different even within the same company.  

Here are some questions to ask when you call to help you determine what you may get reimbursed. Please note this is not an all inclusive list and does not guarantee reimbursement from your insurance company.

  • Before meeting with an out-of-network provider, do I need to get approval first?

  • Do I need to get a prescription from my MD first?

  • For services received by an out-of-network provider, how much does my plan cover?

  • Is there a limit to the number of sessions per year my policy allows? If so, how many?

  • Does my plan cover the following CPT codes?

    • 97001/2/3 (PT EVAL Low/Mod/High)​

    • 97110 (Therapeutic Exercise)

    • 97112 (Neuromuscular Re-education)

    • 97140 (Manual Therapy)

    • 97530 (Therapeutic Activities)

    • 97535 (Self Care Management)

Why is Peace PT out-of-network with my insurance?

By being out-of-network, Peace PT can be transparent with the costs of your healthcare, while making choices with you about your child's needs and not letting an insurance company dictate what they need.  As the provider of physical therapy services, we can concentrate on providing these services to help your child.

Have you ever paid your co-pay at the Doctor's office and then months later receive a surprise bill for a portion of that visit? By paying at the time of service, you will not have any surprise bills months later when therapy has finished.  Often times, it will end up being cheaper to pay at the time of services, especially if you have a high deductible plan, due to our prices being cheaper than what insurance would charge.

Please understand that decisions about coverage are made by your insurance company. Your insurance company can help you to understand the procedures for obtaining coverage. It is your responsibility to work this out with your insurance company.  The information provided is to assist you, but does not guarantee your insurer will reimburse you for the services provided.

 

Can siblings come to appointments?

We discourage siblings from coming to appointments.  These can be delicate topics at times and there will be parent education throughout the session.  Siblings, as cute as they are, can provide distractions that can keep the session from being optimal.

 

How many sessions will it be?

Everyone is different, but on average 6-8 visits spread out over a few months.  However, in more complex and involved cases there may be more visits needed.  You have the right to a Good Faith Estimate that we can provide.

 

Why is there a cancellation fee?

By running a solo practice I am able to provide your child with specialized care.  There are many children who could use this spot if you don't give 24 hours notice. If I am able to fill this spot with short notice, I will not charge you.