Our pricing philosophy
and
What we mean by
#yourhour
What we offer
transparency in cost
1:1 patient to physical therapist ratio
100% personalized care
skilled care your entire treatment session
same therapist every time
mindful focus on you and your goals
What we avoid
wasted time
wasted money
compromised care
shared appointment times
overbooking
treatment by support staff
How can we do that? We do not bill your insurance company.
why it works and why it matters
the direct impact on your care
Treating two to four patients by the same physical therapist at the same time is a common reality of many PT offices due to the uncertainty of if, when, and how much the insurance company will pay. This directly affects the bottom line of the mainstream practice. The only way to make a profit is to treat as many patients as possible without compromising care too much.
We do not depend on your insurance company for payment which does two major things.
We are not waiting for payments (or partial payments).
We do not need to purchase costly resources required to optimize the billing of insurance companies.
the direct impact on your wallet
Guess what else this model does for you? Saves you money.
With quality and personalized care, you need fewer visits to reach your goals.
No “surprise bills” from the insurance company also known as Balance Billing.
you can still use your insurance
Even in our “cash based” model of care, your payments to us can still apply towards your deductible and you may receive reimbursement if applicable. This is possible if you choose to submit your bill to your insurance company using your out-of-network benefits. This is typically done online.
After your treatment session, you will receive an invoice called a superbill to your email if you have indicated on your paperwork that you would like to receive one. This is the document that contains all of the demographic information and codes the insurance company will need to submit your claim. We do not guarantee approval or reimbursement, however we do encourage you submit your claim.
To have the best experience with this process, we recommend calling your insurance company before your first appointment to:
1) find out how to submit your claim
2) make sure we follow all of their rules upfront.
3) know upfront how much to expect to be reimbursed.
The new No Surprises Act
The No Surprises Act went into effect on January 1, 2022, under Section 2799B-6 of the Public Health Service Act. This act was created to protect consumers from balance billing, also known as surprise medical bills. Graham Physical Therapy does not participate in balance billing. Furthermore, Graham Physical Therapy's billing policy is transparent in nature as each visit is $150, the number of visits is recommended and never required, and these recommended visits are openly discussed with each patient at any point of time in their plan of care. However, this notice serves the purpose of informing you of your right to request a Good Faith Estimate prior to receiving services. A Good Faith Estimate is a comprehensive list of estimated services that are expected to be required throughout your plan of care and contains an estimate of your total cost of treatment. Your Good Faith Estimate must be received 1 business day prior to receiving services. For services provided in 2022, you can dispute a medical bill if your final charges are at least $400 higher than your good faith estimate. To dispute a medical bill, you must file your dispute claim within 120 days of the date on your bill and retain a copy of your Good Faith Estimate.
Helpful links to better understand the No Surprises Act:
https://www.cms.gov/files/document/nosurpriseactfactsheet-final508.pdf
If you have any questions, please ask using this contact form.