PATIENTS

During your first visit, I'll conduct an Initial Evaluation. This entails discussing the history of your concerns and going over detailed medical history, conducting a thorough musculoskeletal evaluation, developing a treatment plan together focused on your goals and what's important to you, and starting on some exercises to get us going in the right direction. All appointments are 60 minutes long. Please wear comfortable loose fitting clothing for your sessions. 

The straightforward answer is no, I won't bill your insurance even if you have it. Upon request, I can provide a "superbill" with instructions for you to submit the claim to your insurance company for reimbursement after your session. It will be treated as an "out of network provider" claim.

BUT MORE IMPORTANTLY, why would I operate this way? 

My belief is that your treatment is more important than the insurance company's guidelines. Over the years, insurances have clamped down and limited certain treatment interventions, number of visits allowed, and time a PT can spend with a patient in order to preserve their bottom dollar. Some companies even employ obscure computer algorithms to calculate the number of "approved" visits a patient can receive (and more companies are moving this way). The quality of care patients receive at Insurance-Based Clinics has unfortunately faltered because of this. To balance out limitations and progressively reducing reimbursement from insurances, PT clinics must increase the number of patients each PT sees per day on their schedule. This means less time with each individual patient. 

 At SILVER STAR PHYSICAL THERAPY, I am independent and direct-pay. Which means no other cooks in the kitchen with your treatment. Our focus can be where it should be...on you as the patient and doing what we need to get you feeling better. 

Unfortunately, this answer is complex. Medicare is different than other insurances. Because of specific wording in their regulations, Physical Therapists cannot be fully independent from Medicare and still must follow their restrictions. Their rules state that Medicare prohibits non-Medicare providers from accepting cash from clients for treatments that are covered under Medicare. 

BUT if a treatment isn't covered by Medicare (ex: "health and wellness exercise instruction"), YOU CAN be seen at Silver Star Physical Therapy. However, you cannot request reimbursement from Medicare after your session. 

- Please call or email me to find out coverage details and ask any questions you may have. -

The simple answer is NO REFERRAL NEEDED to receive treatment at Silver Star PT. But, if you plan on submitting a "superbill" to your insurance, you may need a referral from your Primary Care Provider to receive reimbursement. Check with your insurance company if this is required or not. 

The number of visits you'll need will depend on what's going on. There's no cookie cutter answer and it varies from person to person. During the initial evaluation, we will discuss your plan of care and what works for you. Average number of visits can range from 4 to 12.