Our treatment sessions are exclusively one-on-one with a skilled therapist and can be scheduled for either 1 hour or 30 minutes. Information regarding the rates for our treatment services can be found on our rates page. We operate as a fee-for-service agency and do not have affiliations with any insurance networks. However, upon request, we can furnish you with receipts that include the necessary codes to facilitate self-claims to your insurance provider.
"Why don't we bill insurance at H&E Therapy at Home, and can this save you money?"
In short: H&E Therapy at Home operates as a cash-based direct-access concierge physical therapy clinic. This model enables us to deliver tailored treatment based on individual needs, free from the constraints of insurance referrals and predefined treatment dictated by insurance companies.
Not only does this approach benefit your treatment quality, but it often results in lower out-of-pocket costs for patients when compared to clinics that accept insurance. How is this possible?
Recent years have seen a significant rise in deductibles and physical therapy copays. Many of our patients with high PT copays or those who haven't met their deductibles end up paying less for our treatments than they would at an in-network clinic.
Some insurance plans may offer no coverage for PT visits or require copays exceeding $50 per visit. If you have a deductible to meet, you'll likely be responsible for the entire bill for your PT sessions until the deductible is met, often resulting in bills of $200 or more per session.
Furthermore, even if you pay $200+ per session at an in-network clinic, your insurance may apply only a fraction of that amount toward your deductible, as insurance companies typically negotiate lower rates with healthcare providers.
Many individuals are unaware of the tactics insurance companies employ to minimize payouts. Therefore, when deciding where to receive physical therapy, it's crucial to:
1. Inquire about the percentage of the total PT bill you'll need to pay at an in-network clinic, especially if you have an outstanding deductible. If you're responsible for 100% of the bill until the deductible is met, ask the prospective PT clinic for the average bill they submit to insurance companies.
2. If you've met your deductible, find out your copay amounts and the frequency of treatment.
3. Consider the level of care you'll receive and the value of one-on-one treatment.
4. Assess the impact of missed work or family time due to PT sessions.
5. Determine if you have both in-network and out-of-network deductibles.
By considering these factors, you can make an informed decision about your physical therapy treatment.
Payments are due at the time of service and can be made using cash, check, credit/debit card, or HSA accounts.
Regarding insurance reimbursement for out-of-pocket expenses, this depends on your insurance plan. Most non-Medicare patients can submit "self-claims" to their insurance company for treatment. You can obtain claim forms from your insurance company's website and send them in with receipts and treatment codes provided upon request at our clinic. The amount of reimbursement or application toward your deductible depends on your insurance plan.
For Medicare beneficiaries, specific regulations govern the use of Medicare benefits. We can only accept Medicare beneficiaries as patients when they explicitly request not to have Medicare billed for PT services. In other words, if you're a Medicare beneficiary and wish to receive care from us without involving Medicare, we can accommodate your request. However, if you want to use your Medicare benefits for physical therapy, we are unable to provide treatment at our clinic but can assist you in finding a suitable Medicare provider in your area.