Cumming Physical Therapy Questions

Cash-based physical therapy is strictly a contract between the physical therapist and client. Many insurance companies impose restrictions on treatment plans such as visit limits and types of activities performed. During a cash-pay service, you pay upfront with cash, credit, or debit at the time of care. This reduces costs for us and, for you. 

By removing the barriers of insurance, it allows for our physical therapist to personalize a treatment plan for you. This ensures we are on the most efficient road to recovery, often resulting in quicker healing times and even a lower total cost.

Usually, insurance is filed for each and every visit to a traditional physical therapy clinic. 

The bills are based on activities performed or time spent with the patient. The insurance company then reimburses the clinic at rates that vary from clinic to clinic. 

You should know that these rates are not determined by your therapist's skills or the outcomes that come from your sessions. Rather, the clinic negotiates the best reimbursement rate based on how many PTs they have, number of rotations, number of patients, and more. 

Insurance involving third-party payers often interferes with our personalized treatment plans. We are dedicated to getting you better as efficient as possible. Cash-based services allow us to avoid the restrictions placed on our services. 

Yes. Put simply, you will file your insurance with an "out-of-network" provider. This means that your doctor simply does not have a contract with your insurance company. 

Instead of the insurance company choosing your doctor for you, you get to choose someone you know is dedicated to your personalized treatment plan. 

Apex PT will provide you with the documentation you will need to submit a claim to insurance for services you paid for. You will then be waiting for reimbursement, instead of the clinic. This way, we can spend as much time or resources as we need to make sure your treatment has you on the quickest road to recovery. 

You will be surprised to know that cash-based services often cost less out-of-pocket than using insurance. In choosing to pay upfront it lowers our operating costs; therefore, we can charge less than the typical bill submitted to insurance. Not only that, because we are not bound by insurance restrictions, we can give our patients more effective therapy that often results in fewer sessions (meaning less overall cost!)

This depends on your specific insurance, but YES, some non-Medicare patients can send "self-claims" to their insurance company for their treatments at our clinic. 

You should be able to print claim forms off your insurance company's website and send it in with the needed receipts and treatment codes that will be provided at our clinic. 

The amount of reimbursement or application towards your deductible is completely dependent on your insurance plan. If you call your insurance company to inquire about what you can expect to receive, you should ask about reimbursement for "out-of-network Physical Therapy" expenses sent in via self-claims. 

The US government has some interesting laws that control where Medicare beneficiaries can spend their healthcare dollar and persuade healthcare providers to enroll in their system. Because we are not a Participating Medicare Provider, we can only accept Medicare beneficiaries as patients when the patient does not want Medicare billed for any PT services.

The request to not involve Medicare in payment must be made upfront by the patient and be made of the patient's own free will. 

If you are a Medicare beneficiary, please contact us for more information.

If you wish to use APEX and understand we are not a participating provider, we may be able to help you if you provide a written agreement that specifies you will not involve Medicare of Medicare Supplemental insurance in your payment for care at Apex Physical Therapy. 

Glad you asked! Just go to "Book An Appt." and fill out the form. We will contact you ASAP to schedule an appointment.