First, it’s important to understand how physical therapy treatment sessions are impacted by out-of-network insurance benefits
We are out-of-network providers of physical therapy. Reimbursement is dependent on your insurance plan’s out-of-network coverage. For example, out-of-network benefits for United Healthcare may be 70:30, meaning that you will be reimbursed 70% of our fees that the insurance company deems reasonable and customary after meeting your out-of-network deductible. Based on the pricing of your initial consultation or treatment session, post-reimbursement at the above rate typically translates to a $90 out-of-pocket cost for one full hour treatment session.
“As a courtesy for our patients, we can verify your out of network benefits and electronically submit insurance pre-certification and claims on your behalf to your insurance provider. Once your out of network deductible has been reached, your insurance company will reimburse you directly depending on your out of network benefits.”
Time & Cost Comparison between in and out-of-network reimbursement
Example is based on 70% out of network reimbursement.