FREQUENTLY ASKED QUESTIONS
Below you will find answers to several frequently asked questions. If you have a question that is not answered on this page, feel free to contact Eminence Physical Therapy by phone or email. Your therapist will be happy to answer any questions you might have.
Frequently Asked Questions
1. Do I need a prescription from my doctor?
Eminence Physical Therapy requires a prescription for "Physical Therapy Evaluation and Treatment" in order for you to receive services. You must provide this to your therapist prior to your first scheduled appointment. This prescription may come from your primary care physician, oncologist, surgeon, vascular physician, physician's assistant, or nurse practitioner.
2. What is the advantage of a cash-based physical therapy practice?
With cash-based physical therapy, you and your therapist collectively decide on how
3. Will my insurance company reimburse me for physical therapy services provided by a cash-based practice?
4. How flexible are the appointments?
5. What can I expect during my first visit?
During your ﬁrst visit you can expect the following:
6. How long are the treatment sessions?
All cancer rehabilitation appointments are 60 minutes. Due to the complexity of
7. How long will I require physical therapy services?
8. What If I have Medicare or Medicaid?
9. What if I need compression garments to manage my swelling?
10. What should I wear?
11. Should a family member be present with me during any of my treatments?
12. Is my therapist licensed?
13. Who will see me?
14. Georgia is a direct-access physical therapy state. Why does Eminence Physical Therapy require a prescription from my doctor?
Georgia is a direct PT access state, which means a physician’s prescription is not required to initiate a physical therapy evaluation and treatment. With direct access, if your therapist determines that you will require more than 21 calendar days or more than 8 visits of treatment after the initiation of a physical therapy plan of care, your therapist will advise you to contact your physician to obtain an appropriate referral for continuation of treatment.
Eminence Physical Therapy requires a prescription prior to treatment as often the complexity in the treatment of lymphedema and cancer diagnoses will surpass the 21 days or 8 visit time frame for treatment. Your insurance company may also require a physician’s prescription on file if you plan to file a claim for reimbursement of services provided by Eminence Physical Therapy.
15. Can my insurance be billed for cash-based physical therapy services?
Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide payment for services received “out-of-network”. Going out-of-network means that you can choose to see a physical therapist who is not a participating provider with your insurance company. Many patients choose to receive services out-of-network in order to see the physical therapist of their choice. The end goal of documentation and billing is the same - getting paid. In the case of cash-based services, it is the patient who is submitting claims and waiting for reimbursement rather than the provider.
16. The therapist for Eminence Physical Therapy is an out-of-network provider-what does this mean?
This simply means that the therapist has not entered into a contract with individual insurance companies to receive reimbursement based on their contracted rates. There are MANY insurance companies, each with their own contracted rates and regulations, and Eminence Physical Therapy’s energy is best spent working with patients. It is important to note that in-network provider status is not currently based on education, experience, skills, or treatment outcomes, but is often determined by the number of providers in a demographic area.
17. Will I end up paying more for cash-based therapy?
In many cases, the out-of-pocket expenses for a course of physical therapy will actually be LESS for services provided at Eminence Physical Therapy. In large part, this is due to the ability to charge less per visit, with these charges being well below the national average charge submitted to insurance in a typical fee-for-service outpatient physical therapy practice in which deductibles must be met and therapy visit co-pays apply. Eminence Physical Therapy can charge less because the simplified cash-based fee structure streamlines billing and does not require hiring billing personnel or paying fees to a third party billing service. This allows Eminence Physical Therapy to focus all energy on patient care, and allows patients to make informed decisions regarding the costs of their health care choices.
18. How do I find out my insurance benefits for outpatient physical therapy?
Complete the Insurance Benefits Worksheet here, which will help you determine your physical therapy benefits. Keep in mind that Eminence Physical Therapy is an out-of-network provider for all insurance companies, so be sure to notify your insurance company that you want to determine your physical therapy benefits for an out-of-network provider.
19. What steps are involved in submitting a claim to my insurance company?
The process is actually quite simple: Eminence Physical Therapy will provide you with an invoice at the time of service if requested, and you may submit that invoice and receipt to your insurance company for reimbursement. The invoice has all of the necessary information (business name and address, tax ID, national provider identification, license numbers, etc.) as well as the patient’s ICD-10 (diagnosis) and CPT (billing) codes. You may choose to submit bills following each visit, one time per month, or at any other interval, typically up to one year following your treatment visit. Your insurance company may also require that you send in a medical claim form with your invoices. Please contact your insurance provider for specific details on how to submit your claims.