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What Out-of-Network Physical Therapy Means at Churchill Orthopedic

Out-of-Network Physical Therapy

Out-of-Network Physical Therapy can sound scary.  When the PT is not a member of the insurance plan, patients often are required to pay the full amount of a treatment upfront, then are given a ’superbill’ to submit to their insurance. This can mean a couple of things for the patient. One is that they have to wait a period of time to receive reimbursements for their PT care, and secondly, they may have to argue with their insurance carrier about what may be covered. This can pose a real headache for many patients. Of course, primary care and specialist providers want to refer in-network providers of PT to save patients any hassles and make sure cost isn’t a barrier to recovery. Referring physicians must balance this goal with referring to practitioners who may provide a higher level of care, by virtue of providing one-to-one care, as in most out-of-network settings. We do things differently at Churchill Orthopedic Rehabilitation by facilitating the process for your out-of-network care, and we guarantee that your experience with us will be far superior to any in-network experience. The choice, ultimately, is yours.

Will insurance cover out-of-network?

Every insurance plan is different. HMO plans do not cover out-of-network costs, except in cases of emergency. PPOs offer more flexibility and cover partial payments for out-of-network providers.

In-Network vs. Out-of-Network Physical Therapy  

Health care payments are complicated—at times, it can be like speaking another language. Insurance companies use terms like in-network and out-of-network physical therapy. It can be challenging for patients to know how much each service costs and if they are getting the best deal.

Here’s how it works. Insurance companies negotiate lower costs with in-network healthcare providers. The term “in-network” means the PT is included in your plan because the insurance company contracted a discount with them. “Out-of-network” means the PT doesn’t have a special deal with the company, but it does not mean your insurance won’t cover some of the cost. Providers are not bound by the insurer’s rules. We can work with insurance companies and provide the best care possible at the lowest price to patients.

The Churchill Difference

At Churchill, we care more about providing exceptional physical therapy than we do about who pays the bill. We treat all patients the same, regardless of their insurance network. Once a patient has met their deductible, we accept their insurance payment. Referring physicians can rest easy that their patients will receive the highest quality care without breaking the bank. 

Our billing staff is here to help answer any questions you may have. Call the office to talk with Stephanie to discuss how the plan will work for your circumstances. We will work with your insurance company to determine the cost based on your remaining deductible if any. Patients recovering from surgery or injury should talk to their doctor about using Churchill for physical therapy. Give us a call at 201-833-1333.

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