Running Outdoor

Making Sense of

C A S H - B A S E D   

P H Y S I C A L    

T H E R A P Y

What You Need To Know

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C A S H - B A S E D    T H E R A P Y

How does cash-based therapy work?

AH Concierge Physical Therapy is a cased-based physical therapy practice meaning it is considered fee for service and out-of-network for your health insurance policy.  One benefit of fee for service is that you know up front how much a visit will cost up front, no bills surprising you 4-6 weeks later when billing has gone through insurance. You will receive high-quality, personalized care that decreases the total number of visits you will typically need. At AH Concierge Physical Therapy our goal is to keep the number of patients seen low so that we can spend more time with each person and developing your plan of care. You will have better access to your physical therapist during the day and evening hours, as well as on the weekends. 

For those not planning on submitting for reimbursement, a referral is not necessary to be seen for cash-based services which means we can see you sooner and prevent chronic issues!

P P O    P O L I C Y

I have a PPO policy, how does cash-based therapy fit in?

With a Preferred Provider Organization (PPO) or a Point of Service (POS) plan then you may be eligible to receive reimbursement.  To see what your policy offers, call them directly and ask if they cover out-of-network physical therapy and if there are any special forms you need your therapist to fill out. Your therapist will put together all of the relevant information and give it to you to submit to insurance yourself. You may see up to 60% reimbursement, ask your insurance what they offer

A physician referral will likely be necessary to receive reimbursement. 

H M O    P O L I C Y

I have an HMO policy, how do I find out if I have covered out of network services?

If you have an HMO they typically do not reimburse for any out-of-network physical therapy. However, you may call and ask your insurance provider about this and if it will be applied to your out of pocket/deductible

M E D I C A R E

Does AH Concierge Physical Therapy accept Medicare?

AH Concierge Physical Therapy is currently non-participating with Medicare but will bill Medicare for you. For individuals with only Medicare and no secondary that means you are responsible for your 20% co-insurance, which typically runs around $20. This will be paid online prior to services being rendered. For individuals with a secondary insurance, you will have to submit the claim yourself for the 20% co-insurance. AH Concierge Physical Therapy recommends getting a referral for physical therapy to help prove medical necessity, which is required to receive reimbursement from Medicare.