Billing and Insurance
At TOSPT, we’ve made billing simple.
We know that the road to recovery can be frustrating and 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 much will my treatment cost?
What insurances does TOSPT accept?
TOSPT works with the majority of insurance carriers, as well as out-of-pocket- benefits for most plans, including:
- AARP Medicare Complete
- Amerigroup Medicaid (Limited)
- Amerigroup RealSolutions (Only Medicare replacement NOT Medicaid)
- Amerivantage Wellmed Aria
- Assurant Health
- BCBS Blue Advantage HMO
- BCBS CHIP & STAR (Limited)
- BCBS Health Select
- Champ VA
- Christus US Family Health Plan
- Community Care Collaborative (CCC or MAP) – Austin clinics only
- Community First
(Only Medicaid approved)
- Community First Star Kids (Only Medicaid approved)
- Connected Senior Care Advantage
- Coventry/First Health (Limited)
- Global Sports Services GreatWest
- Health West Humana Humana Gold Plus Humana HMO Premier
- Humana POS
- Liberty Mutual (Limited)
- Mail Handlers Benefit Plan
- Medicaid Traditional
- Medicare Railroad
- Molina (Limited)
- Molina Star Kids (Limited)
- National Choice Care
- Orchid Medical
- Point Comfort Underwriters
- The Reny Group
- Tricare for Life (Secondary to Medicare)
- Tricare Prime (Limited) Tricare
- Standard (Limited) TriWest VA
- UHA Managed Care Unicare
- UHC Golden Rule
- UHC Compass EPO
- United Healthcare Chronic
- United Healthcare
- Dual Complete Focus
- UT Health Austin
Do you have a High Deductible
If you’re wanting to seek care but you’re worried about the cost and not sure how your health plan works, you’re not alone.
Navigating the healthcare system can be stressful – financially, emotionally, and physically. But as we know, putting off care now leads to needing more care later… and spending more later, as well. This is especially true of musculoskeletal injuries and conditions. It’s a fact that getting the right PT early results in less imaging, opioid medication, injections, and surgery.
Let us help you get the care you need – without breaking the bank. We’re well versed in High Deductible Health Plans and have a variety of options at our disposal to ensure that you’re not putting off feeling better due to cost concerns.
Here’s what you need to know:
What is a High Deductible Plan?
A High Deductible Health Plan (HDHP) is an insurance plan that requires patients to pay a large amount of their healthcare costs out of pocket before their insurance kicks in to help lighten the load. According to the IRS, in 2019, a health plan is considered an HDHP if….
- The deductible is $1350 or more, for individuals
- The deductible is $2700 or more, for families
Additionally, more than 90% of persons enrolled in an Exchange Plan are in High Deductible Health Plans, in which the average deductibles are even higher: $3572 for an individual and $7474 for a family.
How can TOSPT help?
At TOSPT, we’re committed to providing our patients with the highest quality care, and that doesn’t just mean on the treatment table. We’re always searching for options to make physical therapy a reality for each and every one of our patients, regardless of their financial situation. Thus, we offer a variety of affordable payment and financing options, including:
TOSPT has partnered with CareCredit to offer flexible payment plans for our patients. CareCredit provides convenient payment options so that you can get the treatment you want and need while paying for it over a period of time, often without incurring interest charges. It’s ideal for co-payments, deductibles, and treatments not covered by insurance. Search for your local clinic here and complete the CareCredit Application to find out what monthly payment options are available for you.
Flexible Spending Accounts & Health Savings Accounts
FLEXIBLE SPENDING ACCOUNTS & HEALTH SAVINGS ACCOUNTS
Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) are a great option for those looking to use pre-tax dollars to pay for physical therapy.
Flexible Spending Accounts are set up through your employer and must be used by the end of each enrollment year. Health Savings Accounts allow you to spend money on qualified health expenses or medical costs not covered by your insurance. There is no deadline for withdrawing funds from an HSA, and unlike FSAs, anyone can set one up. All plans are different – it’s best to contact your insurance provider for details on eligibility and benefits.
Accepted Insurance Plans
We accept a variety of health insurance plans for patients needing musculoskeletal care. We’ll work with you and your health plan to make the payment process as easy and hassle-free as possible. For more information or questions on coverage, please contact your insurance agent or give your local clinic a call.
The therapists at TOSPT are specialists, not generalists, which means you get results in fewer visits, saving you time and money.
The Bottom Line
Don’t delay or avoid physical therapy due to your high deductible plan. If you have questions about your specific plan, payment options, or the Care Credit process, let’s discuss it! Our expert billing team can help. Email Billing@tospt.com.