Insurance FAQ's

Insurance FAQ’s

• What is a deductible?
  • A deductible is the amount you pay for health care services before your health insurance begins to pay. This starts over at the beginning of your benefit period which is usually at the beginning of the year.
• What is coinsurance?
  • Coinsurance is your share of the costs of a health care service. It's usually figured as a percentage of the amount the insurance company allows to be charged for services. You start paying coinsurance after you've paid your plan's deductible.
• What is a copay?
  • A copay is a fixed amount you pay for a health care service at the time the service is rendered. The amount can vary by the type of service. Physical Therapy services sometimes have a dedicated copay, or follow the Specialist copay.
• When do I have to pay?
  • Payment is due at the time of service. For your convenience we accept cash, check, all major credit cards, flexible spending accounts, as well as Care Credit.
• Do I need a referral to schedule an appointment?
  • No, North Carolina is a “direct access” state for a physical therapy evaluation. This means that our patients do not need a referral, or a prescription from their doctor to receive a physical therapy evaluation. Read our blog to learn more about this subject.
• Do you accept my insurance?
  • We are in-network with most major insurance companies including: BlueCross and BlueShield, Medicare, Medicare Advantage Plans, Medcost, and Tricare. If we are not in-network with your insurance company, you may have out of network benefits that you can use, or you can request gap coverage or an in-network exception. If you have any questions concerning your insurance, please contact our office for information.
• Do I have to have insurance to be seen at your practice?
  • No, we provide self-pay services for those without insurance, or who choose not to use their insurance benefits. Please call our office with questions.
• Will my insurance cover compression garments?
  • All insurance companies have different guidelines for coverage of Durable Medical Equipment (DME). We check benefits before each patient’s appointment and inform patient of costs before ordering any garments. If you have any questions about your insurance please contact our office and we will be happy to help.
• Will my insurance cover post-mastectomy bras and breast prostheses?
  • The Women’s Health and Cancer Rights Act (WHRCA) helps protect women who have undergone breast cancer treatment. This federal law requires insurance companies to cover these products. Each insurance company will have different benefits and you should contact your insurance company or our office for more information on your particular benefits.

Our office makes every effort to verify insurance benefits prior to your first appointment. However, it is the patient’s responsibility to know their insurance benefits and requirements. Contact your insurance company directly for this information. It is also the patient’s responsibility to pay their deductible, copayment and any other charges at the time of service.