Order/Prescription for Therapy. It is a requirement that an order or prescription for therapy come from your doctor/surgeon for government insurance (Medicaid/Medicare) and some commercial insurance. Many commercial insurance plans allow for direct access or self-referral please check with your plan to see if a referral is needed. This must be presented at your evaluation. This can be faxed from your doctor/surgeon to your clinic of choice or you may bring it with you to the appointment.
Paperwork. There will be a medical questionnaire that we require to be filled out for therapy. This questionnaire helps our therapists get an insight into what you are experiencing for your specific diagnosis. It is important for you to fill out this paperwork to the best of your ability before your evaluation appointment. Be honest. There are no wrong answers, and the more information you can give our therapists, the better it will help them devise your specific exercise plan for therapy and make your outcome more successful. Consents for Treatment will also need signed by the patient, or parent/legal guardian for minors and people unable to sign. This needs to be signed at the first appointment and is good for 90 days.
Identification. At your first visit please have your Photo ID (or a photo ID of a parent/legal guardian if patient is a minor) and Insurance card(s). If your therapy needs are the result of an accident (automobile/work related) approval forms, with claim numbers, billing address, etc. will be needed as well. This will help us update your chart and to ensure all billing is properly handled.
Insurance. It is ultimately you, the patient’s, responsibility to know your insurance benefits. The front office staff may be able to call on your behalf if you have questions or need clarification of your benefits. However, there are some insurance companies that will only talk to you, the subscriber. Most insurances offer therapy benefits but some do have limitations to services. Important things you need to know when calling your insurance:
- Your Diagnosis Code. This will be listed on your therapy order from your physician.
- Services are offered through Mercy Hospital-you want to make sure Mercy is in network with your insurance.
- Services are offered as Outpatient but are Hospital Based.
- Visit limitations-there may be a maximum limit on visits your insurance will cover for the calendar year. There are times we can request additional visits through documentation of progress (but approval is dependent on your insurance company)-your attendance/participation is vital to this.
- There may be a co-pay per visit or charges may go against your deductible.
- Always document who you spoke to and request a Reference Number for the Phone Call. This will aid if you need to call back with questions for any reason.
Know that the office staff is there to help guide you throughout your therapy. Please do not hesitate to ask any questions!