Billing & Insurance
We’ve taken the headache out of billing.
Everything about your visit to West Coat Spine is made as easy as can be by our team–and that includes billing. Your road to recovery can be complicated enough, so we’ve worked hard to make our processes easy for you.
When it comes to billing, it’s as simple as this:
- First, we verify your benefits so that we know how much your copay for physical therapy will be.
- When you visit, we collect the copay and apply it to your account with us.
- We take care of submitting a claim to your insurance company so they are aware of your appointment. It can take the insurance company up to 45 days to process a claim.
- Once it has been processed, we review the claim and let you know if you have a balance or a refund coming your way.
How Does Billing Work ?
At West Coat Spine, we offer a personalized, one-on-one treatment philosophy with physical therapists who will keep your long-term wellness at the forefront of their minds throughout your entire recovery. The boutique environment at our clinic offers a casual and comfortable setting for you to reach your unique goals, whatever they may be—improving mobility, reducing pain, restoring function, or preventing injury.
It’s important not to feel limited when it comes to finding the right physical therapy clinic for your treatment. We know that many roadblocks exist when it comes to choosing the right physical therapist, insurance benefits that are difficult to understand being one of them. At West Coat Spine, we’ll happily help you to understand your coverage before you begin treatment so that there are no surprises. For those who don’t have insurance or prefer to pay out of pocket, we accept cash payments as well. So now, the burning question:
Do you take my insurance?
Yes, we accept all insurances and are in-network with Blue Cross Blue Shield, Humana, Medicare, Tricare, and United (Optum). We also accept Workers’ Comp, Auto Claims, HSA, FSA, and cash-based payments.
My insurance provider isn’t listed there. Can I still receive treatment at Therapydia?
Absolutely! If your insurance provider is out-of-network, that only means that we don’t have a specific, pre-negotiated contract with them. Fortunately, most insurance companies offer out-of-network benefits which very often cover a significant portion of your treatment costs, although the percentage may differ compared to a provider that is in-network. We know that maneuvering through your physical therapy benefits can be confusing, but we’re here to help (seriously, we do this all day). We’re happy to call your insurance company on your behalf to help you figure it out. We’ll also help you submit a claim form to your insurance in order to receive reimbursement.
Why is West Coat Spine an out-of-network provider?
By choosing to work with us, you’ll receive one-on-one treatments with a physical therapist for the entire duration of your treatment. We are proud to offer a high level of care customized to your goals and needs because we know that quality care delivered in a thoughtful manner will help you get better, faster. While other in-network clinics may utilize a “shared treatment” approach—seeing multiple patients at once, passing off patients to aides or assistants, etc.—West Coat Spine embodies a different philosophy of care. We believe that individual attention with a physical therapist is the fastest route to an efficient recovery.
Am I responsible for a copay at the time of visit?
Coverage under each plan varies significantly but we can contact your insurance provider prior to your first visit to see what your benefits include. It’s possible that you’ll be responsible for a copay—a set amount each visit that you pay in addition to what your insurance pays—or a coinsurance amount. Either way, we’ll let you know.
What is coinsurance?
Depending on your coverage (not applicable to everyone), coinsurance is your share of the costs of a health care service, not due at the time of service but billed later. It’s a percentage that kicks in after you’ve reached your plan’s deductible. Ex: Your insurance might pay 80% and you would be responsible for 20%.
What is a deductible?
An insurance deductible is the amount of money that your insurance provider sets that you have to meet or exceed before it will start covering your services. For example: If your deductible is $500, you have to spend $500 of your own dollars before they cover any of your expenses. Until you meet that deductible, you’re responsible for the full price of your visit.
If you have any insurance questions or concerns, feel free to give us a call to ask! As mentioned above, we’re happy to help you understand your coverage before you begin treatment so that there are no surprises. We don’t want you to worry about anything besides beginning your path to lifetime wellness!
Am i covered?
We know that insurance can seem complicated, so if you have any questions about your insurance or about how billing works, we encourage you to contact our helpful billing department at any time at firstname.lastname@example.org
Don’t let the headaches associated with billing and insurance stand in the way of getting the pain relief that you deserve.