home-image

Insurance Q&A

At MRPT Physical Therapy we believe quality patient care is paramount. We want to Insuranceprovide you with the highest possible level of care.

Why are you out of network?
We offer a concierge service.
You will be seen on time, you will not be kept waiting.
All of our treatments sessions typically last about 60 minutes and are conducted in private treatments rooms with one of our highly skilled and experienced therapists who fully understands your particular condition.
We do not use junior aides or assistants.

In order to provide this level of care we are not in network with any insurance plans.

Do you take my insurance?
Often we cannot give a straight yes or no answer to the question "Do you take XYZ insurance?" as you will appreciate every plan is different.

Most insurance plans (PPO/POS) will have out of network benefits
We may accept assignment (direct payment) from certain CIGNA PPO plans that reimburse at "Usual and Customary" rates.  Prior to your first visit we will call to ascertain your particular insurance coverage and/or requirements. We will advise you of this information before you start physical therapy.
Please be aware that verification of insurance benefits is not a guarantee of payment.

We do not accept assignment (direct payment) from Medicare, AETNA, some CIGNA plans, United Healthcare, Oxford, Blue Cross Blue Shield, GHI, United Empire Plan and Medicaid plans. You will need to pay for treatment at the time of service and, as a courtesy to you, we will submit your claims directly to the insurance company.
You will then receive any reimbursement directly from your insurance company. Typically, you should receive back 70/80% of our billed charges after any deductible.  (some plans may only reimburse at 50/60% of our billed charges). Please note that certain plans may reimburse at rates that are not "Usual and Customary" but are based on a percentage of Medicare rates.

What are Usual and Customary Rates?
Usual and Customary rates are standard reimbursement rates that insurance companies should use for payment. Fair Health is a database available to consumers that shows the Usual and Customary rates for each zip code here is the link to the database where you can estimate your out of pocket costs.
All of our billed charges are within the Usual and Customary allowances for our zip code

What are your policies?

Financial Policies
All fees, including co-payments and co-insurance, are expected at the time of your visit. We accept payments by Cash, Credit Card and Check.

Cancellation Policy
We will confirm your appointment 2 days in advance. If you miss your appointment or cancel without giving us 24 hours notice we reserve the right to charge you a $150 cancellation fee.

Why should I not just go to an In Network Provider?
Over the years insurance companies have cut their reimbursement rates for Physical Therapy to extremely low levels.
This has resulted in many practices who are "in network" with your insurance plan turning into "factories" with a therapist seeing 3-4 patients per hour with the help of PT Aides and Assistants.
You health is important, should you not have the best possible care?
An "In Network" Physical Therapist cannot provide the same level of quality care as us.