Patient Portal
Request Appointment
Free 15 min Assessment

Insurance

We are pleased and honored that you and/or your referring physician have trusted us with your care. We hope that after your first visit you will feel valued and well taken care of. Physical therapy is a tool, a pathway to get you back to your goals. Our highly trained staff members at Bounce Back PT strive to do their best to make your experience pleasant. As part of this relationship, we wish to review expectations of your financial responsibility as outlined in our Financial Policy.

PLEASE READ THE FOLLOWING INFORMATION CAREFULLY

The Bounce Back PT Billing Department can assist with insurance benefits verification as a courtesy to the patient. The patient is ultimately responsible for verifying their own benefits and Bounce Back PT will not be held liable for any balances or miscalculated payments on behalf of the insurance company. Please provide insurance cards on the first visit to ensure that claims are submitted promptly.

All co-payments, co-insurance, and deductibles are due at the same time of service.

For all IN-NETWORK deductible plans, if you have not met your deductible, we will collect $125 for the initial evaluation and $110 for each subsequent visit. Co-insurance and fees not covered by your insurance policy will be billed to you upon receipt of insurance remittance. In the rare case the insurance denies claims because information needs to be verified by you, the balance will be shifted to you until the issue is resolved with your insurance company. If you are unwilling to call the insurance company to give the required information, you will be responsible for the entire amount of the bill. PAYMENT IS EXPECTED AT THE TIME OF SERVICE.

For ALL OUT OF NETWORK plans, we will collect $175 for the initial evaluation and $125 for each subsequent visit. We will submit to your insurance carrier at your request with the understanding that they may deny coverage for our services as we are an Out-of-Network Provider. We will then balance bill you the remainder. Co-insurance and fees not covered by your insurance policy will be billed to you upon receipt of insurance remittance. In the rare case the insurance denies claims because information needs to be verified by you, the balance will be shifted to you until the issue is resolved with your insurance company. If you are unwilling to call the insurance company to give the required information, you will be responsible for the entire amount of the bill. PAYMENT IS EXPECTED AT THE TIME OF SERVICE.

For the Self-Pay Option, we will collect a $175 flat fee at the time of service for your evaluation. For return visits, the self-pay rate is $125/hour or $50/15 ($100/30) minute session. These visits will not be submitted to your insurance company and will not go toward your deductible or out-of-pocket maximum. PAYMENT IS EXPECTED AT TIME OF SERVICE.

It is important to understand that the patient is under contract with their own insurance company. The amount owed to the provider (Bounce Back PT) is 100% determined by the patient's policy. This includes unmet deductibles, co-pays, or co-insurance. The amount owed to the provider (Bounce Back PT) is never determined by Bounce Back PT. This includes unmet deductibles, co-pays, or co-insurance. In general, it is not acceptable for a patient not to pay the amount owed to the provider (Bounce Back PT) because it is a breach of the contract with the patient's company. In addition, Bounce Back PT is in-contract (in-network) with most insurance companies and therefore, where applicable, will write off anything over what is allowable by contract. Billing is done only on a daily basis to all insurance companies. A statement reflecting your balance is generated once per month. It is accurate as of the time the statement is generated. Only patients with positive balances at the time statements are generated receive statements.

However, based on the timing of your insurance company's processing of your claims, your balance could change immediately after the statement is generated. As that continuously occurs throughout your time with us, consideration for those changes will be given on the next statement and so on. The final statement after your discharge from therapy will provide an accurate final accounting after all your claims have been processed by your insurance company.

Please consider this information as you view your statements and as you communicate with our office and our billing service about them. All information provided to you is based on the financial status according to what your insurance company says you owe as of the time the statement is generated not as of the time of your inquiry. Provided we have your credit card information on file or have made other arrangements with you, BBPT will charge your positive statement balance to your credit card on the 15th of each month. The amount charged will match what your statement indicates is owed. The amount owed considers what your insurance company says you owe in the explanation of benefits they provide and any payments you have made at the time of service as of the time the statement is generated.

Please do not ask the billing department to adjust any charges, deductibles, or co-pays over what is allowed by insurance, as it is generally not permitted for them to do so. It is VERY important for the patient to take responsibility in knowing his/her individual benefits and what insurance will allow so unexpected balances do not occur. The Bounce Back PT Billing Department files with many insurances and most offer several different plans. Therefore, it is the patient who must make sure the benefits checked are what match their plan.

In the case the patient needs a service that is not covered by the in-network agreement, Bounce Back PT will notify the patient to see if the patient agrees to the service. The billing department will arrange to charge and bill the patient accordingly.

If you do not have In-Network Medical Insurance, please speak with our billing coordinator to discuss self-pay options. Please note: There is no payment plan option for our self-pay patients.

Third Party/Workers' Comp/Motor Vehicle Accident (MVA) Patients: We are happy to see personal injury and motor vehicle accident patients. The billing department will need information such as claim number, adjuster's name, contact phone number and mailing address. Should the Third Party/Workers' Comp or MVA company deny our claims, the claims will be submitted to your medical insurance or become your responsibility. Please let us know if you have an attorney involved along with his/her name and phone number. Parents and guardians are responsible for payment for their dependents at the time service is rendered.

Monthly billing statements are sent to patients with a personal balance. We ask that upon receipt of such a statement, payment is sent to our office within fifteen (15) days of receipt. if you have a financial hardship or you are unable to pay the balance in its entirety, please contact our billing coordinator to discuss payment options. If your account becomes delinquent and you have not established or met payment options with our billing office, your account will be turned over to our outside collection agency and your account will be assessed a collection fee of 33 and 1/3% (thirty-three percent of the outstanding balance.

Helpful Definitions:

When you come to the financial office or are even reading your Explanation of Benefits from your insurance company, there are terms that are used often that you may not understand. Below we have provided sample definitions of these terms for you in hopes that this will help you better understand some of your coverage. (Note that your insurance company may define these terms differently).

Deductible:

The amount you owe for covered health care services before your health insurance or plans begins to pay. If your deductible is $3000, your plan won't pay anything until you have met your deductible for covered health care services subject to the deductible. The deductible for covered health care services is subject to the deductible. The deductible may not apply to all services.

Co-insurance:

Your share of the costs of a covered healthcare service, calculated as a percentage. For example, if your visit costs $100 and you have a 20% coinsurance, you are responsible for paying $20. Your insurance company then covers the other 80%.

Co-payment:

Co-payment (co-pay) is the set fee for a specific service that is determined by the insurance provider. Our office will collect payment at the time of the date of service.

*This is a quote, not a guarantee of benefits. We advise you to contact your insurance company for your own verification. Our financial policies have been provided for your review. Should you have any questions, please notify our billing department.*

*Please Note: Starting November 1, 2018, there will be a 2.5% convenience fee added to all credit/debit/HSA card account transactions. I am aware that I can pay with cash or check for no fee.

I have read and I understand Bounce Back Physical Therapy's Financial policies.

We accept almost all insurances available but we are out-of-network with Aetna, Health Partners, Keystone, Cigna, and United Healthcare.