PHYSICAL THERAPY QUICK FACTS
BILLING AND PAYMENTS
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For Back, Joint and Muscle Pain
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Physical therapists are movement experts, who offer cost-effective treatment for conditions that improve mobility, relieve pain, reduce the need for surgery and prescription drugs, and allow patients to be active participants in their own recovery.
Movement is essential for quality of life, ability to earn a living, participate in home, family, social, recreational, and sport activities, and so much more. Movement helps to prevent obesity (which is responsible for at least 18% of US adult deaths), crucial for physical independence, and can reduce the risk of heart attack and stroke, hip fractures and fall risks, and knee arthritis, among other benefits.
With low back pain, there is often an over-reliance on advanced imaging which increases likelihood for surgery and injections. This results in increased cost of care, where often less expensive conservative management may result in similar outcomes.
Additionally, physical therapy has been proven as effective as surgery for meniscal tears and knee arthritis, rotator cuff tears, spinal stenosis, and degenerative disk disease, among many other conditions.
Source: APTA
http://www.moveforwardpt.com/Benefits/Default.aspx#.VbD6nDgo7IU
At New Life, our mission is to empower our patients in body, mind, and spirit to do the things in life that make your life worth
living. This is a mission that is lived out by every clinician and patient services team member.
Our values are to honor God, empower people, serve reliably, and grow generously. We live out our values with respect, integrity, compassion, and excellence.
Respect – We celebrate the exciting diversity of all people and the inherent dignity of each person.
Integrity – We honor the commitments and promises we make by doing what we say we will do.
Compassion – We serve humbly with passion and kindness.
Excellence – We strive always to be our best and to make our best better.
At New Life, your outcomes matter to us, and we strive to deliver excellent service for an exceptional value. Our physical therapists routinely participate in continuing education, are residency and fellowship trained clinicians, board-certified specialists, and their expertise is often sought out to teach on a local, state, and national level.
You can expect that your physical therapy treatment will be provided by a licensed physical therapy provider, as we do not utilize athletic trainers or unlicensed aides in the delivery of our skilled physical therapy services. Additionally, at New Life, you are treated with one-on-one, individualized care lasting anywhere from 30-60 minutes, not simply as a number.
The choice of physical therapy is always yours. Referrals are not required, and we gladly accept any referral from any physician, despite which physical therapy location may be included on the referral. When researching and selecting a physical therapist, feel free to utilize our worksheet to compare and choose the best physical therapist for you!
PT Facility Comparison Worksheet
Cash Pay Services
Whether you have a high deductible you know you will never reach, or have maxed out your physical therapy benefits, you can always come to New Life and receive a cash pay, time-of-service discount for services. We offer different service levels to meet your treatment and budget needs.
Initial Evaluations:
Follow Up Appointments:
Each physical therapy provider has a contracted rate with individual insurance companies, called a fee schedule. The average charge below is what New Life bills all commercial insurances. Please note that worker’s compensation, and all government payers are on a different fee schedule. Average charge/unit data is pulled from the website www.wisconsinpricepoint.org . We encourage you to familiarize yourself with costs of any potential sites you are looking to do your physical therapy at. In addition to cost, you should ask who is delivering the services (PT vs. PTA vs. Aide vs. Trainer), what specialty certifications or advanced education the clinicians have, outcomes the facility can report on, as well as patient reviews/testimonials.
| New Life – All Locations | $59.67 |
| Divine Savior Hospital, Portage | $127 |
| St. Clare Hospital, Baraboo | $129 |
| Berlin Memorial Hospital (CHN) | $141 |
If you have any questions regarding your physical therapy benefits or coverage, we are available to explain these at any time. A few general terms to understand include deductible, co-insurance, and co-payment.
Medical billing. It’s complicated. We get it. We’re here to help.
Here at New Life, we’ll help you navigate the complex billing procedures and help you understand your benefits and coverage.
New Life submits claims to your insurance carrier on your behalf. Physical therapy services are paid on a procedural code basis, not on a visit basis. Some of these codes are time-based (based on how much time was spent doing components in that code) vs. untimed-based (billed based on procedure regardless of time spent for the procedure).
For services provided in-network we have a pre-contracted fee schedule that your insurance company will reimburse at. Based on your particular plan, you may have a copayment or coinsurance based on that reimbursed fee schedule. After being billed, New Life and the client will receive an explanation of benefits showing specific codes billed on a particular day, insurance payments, and any patient responsibility.
Please note that average units/codes billed per visit is 2-4 based on a 30 to 60 minute follow up treatment visit.
Please do not hesitate to contact our Office Manager, Brandon Spoon, with any questions or concerns.
As a courtesy, New Life will call to verify your outpatient physical therapy service coverage and benefits and will communicate the quote we receive from your insurance company. Please note that this is solely a quote of benefits and not a guarantee of payment from your insurance carrier or payment plan guaranteed by New Life. We encourage all clients to confirm their insurance company’s coverage of physical therapy services, by phone or by referring to their member benefit handbook. We have a worksheet below for you to fill out your benefits as you read in your handbook/are quoted from your call. If there is a difference, or if you have any questions regarding your coverage or benefits please feel free to contact our office manager, Brandon Spoon.
Our goal at New Life is transparency with our costs and to empower patients to be able to make best value-based decisions for their health care. In attempt to do this, we can estimate what your cost per visit may be based on the quote of benefits from your insurance carrier. Please be aware that this is an estimate. Co-payments must be collected at time of service. Estimated co-insurance can either be paid at time of service or billed later with a credit card guarantee on file. Please see financial policy for further detail.
We encourage every patient to also call their insurance company or consult their benefit manual to verify that what New Life is quoted by your insurance company, matches what you know or were quoted regarding your physical therapy benefits. We can work through any discrepancies together up front. Use this benefit counseling worksheet when calling your insurance company.
Benefit Counseling Home Worksheet
At New Life, whether you have a high deductible or a higher co-insurance, we have various payment plan options that we offer to fit your budget. Due to insurance requirements, co-payments are due at time of service and payment plan options cannot be applied to co-payments. We offer estimate “pay as you go” payment plans and also payment plans once your insurance has been billed and your exact patient responsibility amount is available. Please contact our office manager, Brandon Spoon, to discuss our available plans and what might work best for you.
