OUR COMMITMENT TO COST TRANSPARENCY

We believe you deserve to know what your care will cost before you begin treatment. That’s why we provide clear, upfront estimates for your total treatment costs.

As an outpatient clinic, we’re able to keep your costs lower than hospital-affiliated clinics, where care is often billed as “inpatient” and can be two to three times more expensive for the same services.

If you have questions about your estimate or want to compare costs, our team is here to help you make informed decisions about your care.

How you and your insurer share costs

Sally’s Insurance Plan Example

Patient Profile
Sally Smith
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Coverage Period
Jan 1st – Dec 31st
Before Sally reaches her deductible
Sally is typically in good health.​
Her plan doesn’t have a co-pay for physical therapy and she pays any costs until she reaches her deductible​
After Sally reaches her deductible
Sally has seen various healthcare professionals and her total costs have exceeded $1,500.
Her plan pays a % of the covered healthcare services until her out-of-pocket-limit. The % split is known as the co-pay.
After Sally reaches her out-of-pocket limit
Sally has seen healthcare professionals often and her total costs have exceeded $5,000​.
Her plan pays full cost of covered health care services for the rest of the year.
Treatment Cost = $165
Sally Pays = $765
Plan Pays = $0
Treatment Cost= $165
Sally Pays 20% = $
‍‍
Plan Pays 80% = $132
Treatment Cost = $165
Sally Pays 0% = $0
Plan Pays = $165

OUR INSURANCE BILLING PROCESS

Step 1: Patient calls health insurance provider before first visit to understand physical therapy benefits and treatment cost share.Blue oval with text explaining that at the time of service, the patient pays copay or share of treatment cost, and pre-authorization will be gained on their behalf as a courtesy.Step 3 bubble stating health insurance company sends Explanation of Benefits (EOB) to patient and pelvic therapy specialists.Blue oval with orange circle containing number 4 and text about invoicing balance between patient share of cost on EOB and patient paid share on payment card.

COMMON HEALTH INSURANCE TERMS

In-Network Providers

An in-network provider is a healthcare professional or facility that has a contract with an insurance company to provide treatment at set negotiated rates. We may be an in-network provider with your insurance company (see partners above).

Cash Based Provider

Collect the entire payment from the patient and provide superbill for the patient to submit in order to receive reimbursement. The terms “cash-based provider” and “out-of-network provider” are often used interchangeably. However, out-of-network providers are always credentialed—and therefore recognized by the insurance company.

Prior Authorization or Pre-Certification

Pre-certification is the process of obtaining eligibility, certification and/or authorization from your health insurance plan prior to admission and receiving treatment. Failure to obtain pre-certification from certain providers can result in additional costs to the patient.

Deductible

The amount you owe for covered services, per policy period, before your health plan begins to pay.

Savings Account

We accept health savings account (HSA) or flexible spending account (FSA) cards as a form of payment, and we are also proud Medicare and Tricare providers.

Out-of-Network Providers

​An out-of-network provider is a healthcare professional or facility that is credentialed with but has no contractual agreement to charge a specific rate with an insurance company. The insurance company recognizes the provider as being a legitimate medical professional—it knows things like the provider’s name, national provider identification (NPI) number, professional license number.

Uninsured

If you have no health insurance plan.

Co-Payment or “Co-Pay”

A fixed amount you pay for a covered health care service, usually when you receive the service. Your co-payment is counted towards the total cost of care.

Out-of-Pocket Limit

The most amount of money you will pay during a policy period before your health plan begins to pay 100% of the allowed amount.

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