medical insurance policy

At In Motion Physical Therapy, we will file claims with your insurance company, but we feel it is very important for patients to understand their benefits. We strongly suggest that you contact your insurance company by calling the number on the back of your card(s) and asking pointed questions. Only your insurance company can answer these questions definitively, as each carrier administers multiple plans. In the event that claims are denied due to plan limitations, you will be responsible for paying our self-pay rate, which is $80 per visit.

Questions you should ask:

Is In Motion “in network” for my plan?

Do I have capitation for physical therapy (PT)? If yes, what does that mean, and what is my capitated site for PT?

Does my plan require an insurance referral for PT? How do I obtain that?

generic checklistWhat is my financial responsibility for PT?

  • Do I have a deductible? Has it been met?
  • Do I have a copay? Must I meet my deductible before I start paying copays?
  • Do I have coinsurance? Must I meet my deductible before I start paying coinsurance?
  • Have I met my out of pocket maximum?

Do I have a limit on the number of PT visits I am allowed?

What is my plan year? How does that impact my deductible/coinsurance/copay/number of visits?

Does my plan require an authorization for PT?

Does my plan require pre-certification for PT?

If there is secondary insurance, are my benefits coordinated properly?

Medical insurance claim form with pen glasses calculator and writing handFor a worker’s compensation or motor vehicle accident claim:

  • What insurance carrier is handling the claim?
  • What is my medical claim number?
  • What is my adjuster’s name and phone number?
  • What was the date of injury/accident?
  • Is there a limit to my medical expense coverage?