Clear answers to your insurance, billing and reimbursement questions.
Yes, but we contract with you, the patient, to provide the best care possible. We are in-network with BCBS, Medicare, and several Workman Compensation policies. We are contracted with Tricare.
Out-of-network insurance carriers will allow you to submit an itemized bill from us to your insurance carrier for out-of-network reimbursement, or we can submit the claim for you as a courtesy. Please call for details.
Please read below on how the changes in many health insurance plans and deductibles have actually made it cheaper to not use your insurance for some services if you have high PT copays or a high deductible.
Insurance companies strongly influence the treatment a patient receives at an in-network clinic, which can result in patients not being able to receive beneficial services. We refuse to allow that to be what dictates how you are treated at ProFormance Therapy and Wellness.
We contract with you, the patient. Not the insurance company. But you can seek reimbursement for our services. Sometimes, paying cash or pursuing non-network treatment is actually CHEAPER!
ProFormance prefers to operate as a non-network practice with many insurances because the business model necessary for an all in-network practice to survive rarely allows for the high-level care we insist on giving our patients.
Since deductibles and PT copays have skyrocketed, many of our patients have high PT copays or have not met their deductible for the year. Paying out-of-network can sometimes cost less than a patient would pay at a clinic that accepts and bills their insurance.
By using our out-of-network options, you may receive more care, fewer insurance limitations, and a better overall experience – at a lower cost.
Insurance Benefits Worksheet
Most NON-Medicare and NON-Tricare patients can send “self-claims” to their insurance company for their treatments at our clinic.
You should be able to print claim forms off your insurance company’s website and send them in with the needed receipts and treatment codes that will be provided upon request at our clinic.
The amount of reimbursement or application towards your deductible is completely dependent on your insurance plan. You can call your insurance company and ask about reimbursement for “out-of-network Physical Therapy” expenses sent in via self-claims. Please download the provided “Insurance Benefits Worksheet” to better understand your financial responsibility.
