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How to Determine Your Insurance

Benefits for Physical Therapy

Where to start:

  1. Call the toll free number for customer service on your insurance card. Select the option that will allow you to speak with a customer service representative, not an automated system.

  2. Ask the customer service provider to quote your physical therapy benefits in general. These are frequently termed rehabilitation benefits and can include occupational therapy and speech therapy as well as physical therapy.

  3. Make sure the customer service provider understands you are seeing a non-preferred or out-of-network provider.

 

Questions to ask:

  • Do you have a deductible? If so, how much is it? Has it been met yet?

  • What percentage reimbursement do you have? (60%, 80%, 90%)

  • Does the rate of reimbursement change if you are seeing a non-preferred provider?

  • Does your policy require a written prescription from you primary care physician to participate in physical therapy?

  • Does your policy require pre-authorization or a referral on file for outpatient physical therapy services? If yes, do they have one on file?

  • Is there a dollar amount or visit limit per year? If yes, what is it?

  • Do you require a special form to be filled out in order to submit a claim? If yes, how do I obtain it?

  • What is the mailing address you should submit claims/reimbursement forms to?

  • Is there an online website where I can submit a claim? If so, what is it?

 

How to submit:

  1. Developing Strides Therapy will provide you with the necessary documentation (i.e. treatment notes and invoices) to submit to your insurance.

  2. Submit all claims to the mailing address or online website provided by your specific insurance company.

  3. It is important to submit all documentation because a deductible must be satisfied before the insurance company will pay for therapy treatment. Submitting the bills will help you reach the deductible amount. Please contact us if you have any further questions or would like help understanding you benefits.