Physical Therapy

If you have Medicare Part B insurance, Medicare will cover 80% of the treatment options. If you have a supplemental insurance plan, the remaining 20% should be covered by that. If you do not have a supplemental plan, you will pay cash for the remaining 20% at the time of service.

For Medicare to cover your visits, you first need to have a referral faxed to us at 803-658-4025

Not sure which insurance you have or what it covers? Call us – we can help!

We accept Medicare and Blue Cross Blue Shield, which includes Blue Essentials, BlueChoice HealthPlan, Medicare Advantage, State Health Plan, Blue Option℠, and Preferred Blue® (PPC and FEP).

For all other insurances, we offer a cash price / private pay discount! We can provide you with a superbill receipt (superbills are medical reimbursement receipts) which can be submitted for reimbursement to your insurance provider. We do recommend you contact your insurance to confirm reimbursement amounts.

I only accept Medicare. However, you will receive a superbill receipt, which is a detailed medical receipt that allows you to bill your insurance or HSA/FSA directly.

Insurance Forms for Patient Reimbursement:

https://statesc.southcarolinablues.com/web/public/brands/statesc/resources/forms-and-documents/ for Blue Cross Blue Shield.

https://www.aetnainternational.com/en/individuals/make-most-of-plan/how-to-make-claim1.html for Aetna

https://www.uhc.com/member-resources/how-to-submit-a-claim for UHC

https://www.ucppoplans.com/co/resources/submitting-a-claim for Anthem Blue Cross

https://www.cigna.com/memberrightsandresponsibilities/member-forms/medical-claim-form/ for Cigna

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE

MEDICAL BILLS

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

Cover emergency services without requiring you to get approval for services in advance (prior authorization).

Cover emergency services by out-of-network providers.

Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact: https://llr.sc.gov/pt/licensure.aspx

Contact.PT@llr.sc.gov

Tel: (803) 896-4655

110 Centerview Dr, Columbia SC

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.

If applicable: Visit https://www.commonwealthfund.org/publications/maps-and-interactives/2021/feb/state-balance-billing-protections for more information about your rights.

$190 for Evaluations, $170 for all follow-up treatment sessions.

$240 Assessment (Head-Toe) flexibility, strength, speed, and agility with a detailed report.

This Good Faith Estimate explains your therapist’s rate for each service provided. Your therapist will collaborate with you throughout your treatment to determine how many sessions and/or services you may need to receive the greatest benefit based on your diagnosis(es)/presenting clinical concerns.

You can pay with cash, check, Zelle, or credit card.

Please contact us to discuss payment and cash discounts.