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FAQs

Q. collapse sectionIs Choice One Physical Therapy covered by my insurance?
collapse sectionQ. How do we help you?
Q. Should I contact my Insurance Company?
Q. How do I find out how many treatments insurance will pay for?
Q. What do we need from you?
Q. Why is Choice One Physical Therapy not a preferred provider with every insurance company?
Q. What do the insurance terms mean?



Q. collapse sectionIs Choice One Physical Therapy covered by my insurance?
A: Choice One Physical Therapy has active contracts with most major insurance companies. We also bill first party auto insurance, worker’s compensation, and accept private payment. We are happy to bill insurance as a courtesy to our patients, and will assist you by attempting to determine before your first visit what your physical therapy benefits are at that time. 

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collapse sectionQ. How do we help you?
A: After you make an appointment at our clinic, our billing specialist will contact your insurance company and prepare an Eligibility Verification Form. This form summarizes benefits quoted us by your insurance company. You will receive a copy of this information at your first Sound Physical Therapy appointment.

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Q. Should I contact my Insurance Company?
A: We strongly recommend that each client is familiar with their insurance contract coverage for Physical Therapy, and to contact your insurance company if you have any questions about your coverage.

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Q. How do I find out how many treatments insurance will pay for?
A: Physical Therapy benefits are usually considered part of Physical Medicine and Rehabilitation services.  Your insurance may limit the number of treatments per year, and/or a specific dollar amount you can spend for these services.  Massage Therapy, Chiropractic treatment, Occupational and Speech Therapy can also be included in this group.  If this is the case, your Rehabilitation insurance dollars or number of visits allowed are spread among all of these services.

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Q. What do we need from you?
A: At Choice One Physical Therapy, we strive to provide good customer service by communicating to you any insurance coverage issues that may arise. To do this we need your correct insurance info, address and phone numbers. We ask that you alert us with any concerns, problems and changes as they arise. We also appreciate your understanding that the patient portion of payment will be made promptly.

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Q. Why is Choice One Physical Therapy not a preferred provider with every insurance company?
A: We are a small, independently owned clinic and strive to deliver high quality care at a reasonable cost.  Each patient receives 55 minutes of 1-1 care with the Physical Therapist at every treatment.  In order to deliver this level of care, we need to be reimbursed by insurance companies at a reasonable rate.  If an insurance company has lowered their rate of reimbursement to below the level required to cover the cost of delivering care, we have chosen to be out of network providers for that insurance company.  In this case the patient would be expected to pay the out of network rate of reimbursement established by that insurance company, which is a higher fee.

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Q. What do the insurance terms mean?
A: Below are some of the more common insurance terms that you will encounter when using your Physical Therapy benefits.  Please contact your insurance company for further clarification of these terms. 

Co-Payment:
This is the amount the insurance company has decided the patient will pay on the day of service. 

Allowed Charges:
 
An “allowed charge” is the amount an insurance company will pay for services received by their client that is provided by an in-network provider.  The in-network contract we have with an insurance company requires us to accept the “allowed charge” for any services we provide.    

Co-insurance
Your contract may state that you are required to pay a percentage of the allowed charges. For example, you may have an 80% - 20% plan, which means that the insurance company will pay 80% and you will pay 20% of the allowed charges.

In-Network benefits:
This is the benefits your insurance company will pay if Sound Physical Therapy has a contract with them.  After the insurance company receives our bill for services delivered, they will determine the allowed charges they will pay for this service.  We are bound by our in-network contract with the insurance company to accept their determination of allowed charges. 

Out of Network benefits:
This is the benefits that your insurance Company will pay if we are not a preferred provider with that company.  In this case, the patient is responsible for a higher portion of the total bill.

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Schedule your Appointment!


1810 Mulkey Road, Ste. 101
Austell , GA 30106

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How do we help you?


A:
After you make an appointment at our clinic, our billing specialist will contact your insurance company and prepare an Eligibility Verification Form. This form summarizes benefits quoted us by your insurance company. You will receive a copy of this information at your first Sound Physical Therapy appointment.

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