Do I need a physician referral for physical therapy?
No. You do not need a script or referral from a physician. In the state of North Carolina, physical therapists have direct access.
Why is insurance not billed at Mountain Wellness & Physical Therapy?
Is it possible to save money in the long run this way?
In many ways, insurance companies dictate or strongly influence the treatment that patients receive at “in-network” clinics, and we refuse to allow that to be the case at Mountain Wellness & Physical Therapy.
After having worked for many years at an in-network clinic, I was expected to see at least 2 patients per hour and to use techs and assistants to assist with treatment of those patients. I was also expected to use modalities that were reimbursable by the insurance company, but not as effective as other treatments. This was not the fault of the clinic that I worked for but was a means of survival due to the insurance reimbursement business model.
Our business model is built around patient care. All of our patients receive one-one-one care and hands on treatment from your physical therapist on every visit. Most mobile visits are 60 minutes to optimize each treatment session. Our telephysio services are set up in 15 minute increments. Because of the one-on-one sessions, we are able to see the majority of our patients one visit a week. When you consider the time savings of our mobile PT coming to you, or meeting you via our digital services, fewer trips to a clinic and the benefit for resolving your pain faster then average, then the private pay expense at Mountain Wellness & Physical Therapy is well worth the value.
Can I submit billing for out-of-network benefits to my insurance company?
Yes! Receipts can be provided that include the necessary codes to send self-claims to your insurance company.
Insurance is an agreement between the client and their insurance provider. Please take the appropriate steps to call the insurance provider to discuss out-of-network benefits. Most insurances allow you to print claim forms off your insurance company’s website, and send it in with the needed receipts and treatment codes that will be provided upon request at our clinic.
The amount of reimbursement or application towards your deductible is completely dependent on your insurance plan. If you call your insurance company to inquire about what you can expect to receive, you should ask about reimbursement for “out-of-network Physical Therapy” expenses sent in via self-claims.
We are also listed on the app, Reimbursify, for a quick and seamless claim form for most insurances.