AthletePlus Physical Therapy & Spine

8 am - 6 pm Springdale

9 am - 5 pm Greenwood
479-751-8437
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FAQ

Home » FAQ

Insurance and Payment Questions

a

What is Your Financial Policy?

The following FINANCIAL POLICY is included in your New Patient Packet

We want to thank you for choosing AthletePlus as your healthcare provider.  We are sure you understand that payment for this healthcare is your responsibility.  The following information outlines your financial responsibilities related to payment for professional services: Required at Check In:
  1. Current picture ID and current insurance card along with payment for current visit & any outstanding balance.
  2. If we are unable to confirm active coverage, you will be considered self pay and must pay for that visit.

Payment Options:  Check, Echeck, Credit Card (Am Ex, Master Card, Visa), Apple Pay, PayPal, Care Credit.

AutoPay/Recurring Payment Plans, Direct Self Pay/Membership Programs and Care Credit Financing available.
If Self Pay or being treated as self pay because of high deductible, ask for our Self Pay Policy.

Collections Policy – Balances held over 90 days are subject to 1% interest charge or will be sent to Collection Agency with patient responsible for all fees.

 

_______  Initial  *PLEASE NOTE THIS IS ONLY A VERIFICATION OF BENEFITS, NOT A GUARANTEE AND IS SUBJECT
TO CHANGE. ANY AMOUNTS NOT COVERED BY INSURANCE WILL BE YOUR RESPONSIBILITY.*

 

I understand I will be responsible for the amounts shown above. As a courtesy, we verify insurance benefits for patients. This in
no way guarantees that your insurance company will pay exactly as quoted, benefits cannot be guaranteed over the phone. This
facility is not responsible for obtaining or being aware of your policy requirement for referrals from your primary care physician,
pre-certifications, or limits with your specific policy. Your insurance policy is a contract between you and your insurance company; therefore the responsibility lies with you, the patient, to be aware of this information. We will assist you if necessary to help
you obtain this information. AthletePlus, is not obligated to withhold statements or to wait until settlement has been made
before receiving payment for services. I understand that payment will be collected at the beginning each visit. AthletePlus
does offer payment plans for your convenience; however we do reserve the right to refuse treatment if payment is not paid
as per this agreement.
 

* For MVA and/or Patients with Attorneys who will not use their Health or Auto Insurance: We agree to bill third party liable parties (ex. MVA/Attorney cases)  when we have all the claim information the patient has signed a medical lien.  The patient, at the time of service will be responsible for a $25 lien fee filed at Washington County Courthouse and an initial payment of $75 for the evaluation.  Should the third party be dismissed or limits exceeded,  the patient will be billed at our self pay rates and be responsible for any collection fees. Also, we will only hold these charges for up to 20 months unless payment is received and we will not negotiate fees at the time of settlement.
Categories: General Questions, Insurance and Payment Questions
a

Do You Offer Multiple Payment Options to Pay My Bill?

Yes, we pride ourselves on offering many different options:

Payment Options:  

  • Check or Echeck,
  • Credit Card (Am Ex, Master Card, Visa)
  • Apple Pay
  • PayPal
  • Care Credit.
  • Cash

Also Available:

  • AutoPay
  • Recurring Payment Plans,
  • Direct Self Pay
  • Membership Programs
  • Care Credit Financing available.


If Self Pay or being treated as self pay because of high deductible, ask for our Self Pay Policy.

Category: Insurance and Payment Questions
a

How Does the Billing Process Work?

 AthletePlus will electronically (or manually if electronically is not available) send your billed charges to your insurance company.  We will submit claims on your behalf to your insurance company. For billing questions, therapy@athleteplus.net or call 751-8437.

Below is information included in your New Patient Packet

We want to thank you for choosing AthletePlus as your healthcare provider.  We are sure you understand that payment for this healthcare is your responsibility.  The following information outlines your financial responsibilities related to payment for professional services: Required at Check In:
  1. Current picture ID and current insurance card along with payment for current visit & any outstanding balance.
  2. If we are unable to confirm active coverage, you will be considered self pay and must pay for that visit.

Payment Options:  Check, Echeck, Credit Card (Am Ex, Master Card, Visa), Apple Pay, PayPal, Care Credit.

AutoPay/Recurring Payment Plans, Direct Self Pay/Membership Programs and Care Credit Financing available.
If Self Pay or being treated as self pay because of high deductible, ask for our Self Pay Policy.

Collections Policy – Balances held over 90 days are subject to 1% interest charge or will be sent to Collection Agency with patient responsible for all fees.

 

_______  Initial  *PLEASE NOTE THIS IS ONLY A VERIFICATION OF BENEFITS, NOT A GUARANTEE AND IS SUBJECT TO CHANGE. ANY AMOUNTS NOT COVERED BY INSURANCE WILL BE YOUR RESPONSIBILITY.*

I understand I will be responsible for the amounts shown above. As a courtesy, we verify insurance benefits for patients. This in
no way guarantees that your insurance company will pay exactly as quoted, benefits cannot be guaranteed over the phone.
This facility is not responsible for obtaining or being aware of your policy requirement for referrals from your primary care
physician, pre-certifications, or limits with your specific policy. Your insurance policy is a contract between you and your
insurance company; therefore the responsibility lies with you, the patient, to be aware of this information. We will assist you
if necessary to help you obtain this information. AthletePlus, is not obligated to withhold statements or to wait until settlement
has been made before receiving payment for services. I understand that payment will be collected at the beginning each visit. AthletePlus does offer payment plans for your convenience; however we do reserve the right to refuse treatment if payment
is not paid as per this agreement.
 

* For MVA and/or Patients with Attorneys who will not use their Health or Auto Insurance: We agree to bill third party liable parties (ex. MVA/Attorney cases)  when we have all the claim information the patient has signed a medical lien.  The patient, at the time of service will be responsible for a $25 lien fee filed at Washington County Courthouse and an initial payment of $75 for the evaluation.  Should the third party be dismissed or limits exceeded,  the patient will be billed at our self pay rates and be responsible for any collection fees. Also, we will only hold these charges for up to 20 months unless payment is received and we will not negotiate fees at the time of settlement.
Category: Insurance and Payment Questions
a

Can I Go to Physical Therapy Without Seeing My Doctor First?

Yes and it is called Direct Access.  Currently, all 50 states and the District of Columbia (DC) allow patients to be evaluated by a physical therapist without a physician’s prior referral.  Physical therapists are well-qualified, both through formal education and clinical training, to evaluate a patient’s condition, assess his or her physical therapy needs and, if appropriate, safely and effectively treat the patient. Physical therapists are also well-qualified to recognize when patients demonstrate conditions, signs and symptoms that should be evaluated by other health care professionals before therapy is instituted. Restrictions in access to care cause delays in the provision of physical therapists’ services to individuals who would benefit from treatment by a physical therapist. Delays in care result in higher costs, decreased functional outcomes, and frustration to patients seeking physical therapy treatment. Eliminating arbitrary barriers results in timely, more effective care. For example, a 2012 study in Spine states if you hurt your back, starting PT within the first 14 days can save you on average over $2700.

Categories: General Questions, Insurance and Payment Questions
a

Who Pays for the Physical Therapy Treatment?

AthletePlus accepts and will file most insurances, but a copay or co-insurance may be required on your part. Some patients elect to be treated on a cash basis.  Payment Options:  Check,  Echeck, Credit Card (Am Ex, Master Card, Visa) Apple Pay, PayPal, Care Credit.AutoPay/Recurring Payment Plans, Direct Self Pay/Membership Programs and Care Credit Financing available

If Self Pay or being treated as self pay because of high deductible, ask for our Self Pay Policy.Speak with our business manager for details on insurance. We have flexible plans for those without insurance.  There may be more insurances that we accept so please call 751-8437 or email therapy@atheteplus.net. Here is a list of the insurances we currently accept:

  • Aetna
  • Aetna Workers Comp Access
  • Align Network
  • Ambetter
  • American PPO
  • Ancillary Care Services
  • Arkansas Managed Care Organization
  • Blue Cross & Blue Shield
  • Care Improvement Plus
  • Cigna
  • CorVel Corporation
  • Coventry/First Health/Medicare Advantra
  • Employers Health Choice
  • Evolutions Healthcare
  • FedMed
  • Fortified Provider Network
  • Galaxy Health Network
  • HealthLink of Arkansas
  • Heartland Therapy Provider Network
  • Integrated Health Plan
  • Medicare
  • Medicaid (Up to Age 21)
  • Municipal Health Benefit
  • National Comp Care
  • NovaSys
  • NPPN
  • Physician Health Choice /Wellmed [Limited Areas]
  • PPO Plus
  • Prime Health Services
  • Provider Select
  • Private Health Care System
  • QualChoice of Arkansas
  • Rockport Healthcare Group
  • Three Rivers Provider Network
  • TriCare
  • Tyson Preferred Network
  • UMR
  • United Health Care
  • USA Managed Care Organization
  • Windsor Health Plan
Category: Insurance and Payment Questions
Tag: Insurances accepted
a

What You Can Do to Get Your Insurance to Pay More for Physical Therapy Visits?

Talk with your employer/benefits manager. The employers who contract and pay for employee health care plans often have the most influence with insurers. Employers are interested in keeping their employees on the job and their premiums low, so providers who can help employees prevent injuries and avoid recurrence (as well as promote a healthy lifestyle) have particular appeal to them. Arrange a meeting with your human resources director or whoever is responsible for negotiating the terms of the company’s insurance plan.

Ask your human resources director or insurance company the following questions to determine if your current benefits package gives you access to appropriate physical therapy services:

1. Is your physical therapy benefit “bundled” with those of other providers of care? Physical therapy services should be listed separately in the benefit language so that access to necessary services is not compromised.

2. Does the benefit language permit access to physical therapists for each condition during the year? Benefit language should permit treatment of more than one condition in a calendar year (eg, ankle fracture in January and low back injury in July).

3. Does the benefit language permit access to physical therapists for each episode of care? A person may require more than one episode of care for the same condition. For example, someone with arthritis may receive physical therapy intervention for knee weakness in an attempt to avoid surgery. While this is often successful, some patients may still require surgery for the knee condition (eg, total knee replacement), which may require post-operative physical therapy treatment. The benefit language should support each “episode of care.”

4. Does the benefit language ensure coverage that facilitates restoration of function? Benefit language that restricts physical therapy care to a 60- or 90-day period imposes an arbitrary limit on recovery. In determining an appropriate physical therapy benefit that will allow an individual to return to his or her previous level of function, benefit language should reflect the normal amount of time that it takes to recover from an injury or from surgery.

5. Does the benefit language ensure coverage that promotes functional independence for those with chronic conditions? Someone who has a chronic condition may need to be seen periodically by a physical therapist. The physical therapist will determine if the individual’s home program, equipment, or adaptive devices should be modified. (For instance, children requiring orthotic devices will need modifications to those devices as they grow.) Benefit language should ensure that someone with a chronic condition may receive the kind of care that promotes personal safety and the greatest degree of function possible.

Category: Insurance and Payment Questions
a

Can You Help Me Choose an Insurance Plan?

Millions of Americans are offered a choice of health plans through their employers, but the question is “What makes a good health care plan?” Here are some things to consider when choosing a health plan.

  • Are you choosing a plan simply because it is the cheapest? This may not be the best way to go. Some inexpensive plans have a high deductible and no comprehensive coverage.
  • Is the plan accredited by the National Committee on Quality Assurance? This is a good indicator of quality.
  • Are your current doctors and specialists in the plan? If not, make sure you will be able to see a certain provider or specialist, such as a physical therapist, without too much added expense and difficulty.
  • Is physical therapy coverage adequate? If you should have an injury or illness requiring rehabilitation, you will need a plan that offers an unlimited number of visits to a physical therapist or that allows for the number of visits to be extended if needed.
  • Are there lifetime limits on benefits? If so, you could face a serious financial crisis if you or a covered member of your family suffers a major illness or injury.
  • Does the plan have an out-of-pocket maximum? In this case, once you have paid a certain amount (usually several thousand dollars) the plan would cover the rest.
  • How does the plan handle grievances and appeals? The procedure should be simple, timely, and accessible.
  • Does the plan permit use of out-of-network doctors, specialists, or hospitals? Called “point-of-service” option, this would allow you to see a provider, such as a physical therapist, who is not in your plan. There may be an additional cost, but it may be worth it.
  • What is the plan’s dis-enrollment rate? A high rate of members leaving the plan annually may indicate customer dissatisfaction.
Category: Insurance and Payment Questions
Tag: insurance plans
a

Can You Help Me With the Meaning of the Common Insurance Terms?

Navigating your way through health insurance benefits can be a challenge. It is very important to understand the terminology especially when deciding which benefits will work for you and finding a plan that will best meet your needs.

This brief glossary will provide insight for some of the more common terms when dealing with health insurance.
co-insurance: in indemnity, the monetary amount to be paid by the patient, usually expressed as a percentage of charges.
co-payment: in managed care, the monetary amount to be paid by the patient, usually expressed in terms of dollars. consumer driven health care (CDHC): refers to health plans in which employees have personal health accounts such as a health savings account, medical savings accounts or flexible spending arrangement from which they pay medical expenses directly.
deductible: the portion of medical costs to be paid by the patient before insurance benefits begin, usually expressed in dollars.
denial: refusal by insurer to reimburse services that have been rendered; can be for various reasons.
eligibility: the process of determining whether a patient qualifies for benefits, based on factors such as enrollment date, pre-existing conditions, valid referrals, etc.
exclusions: services that are not covered by a plan.
flexible spending arrangements (FSAs): an account that allows employees to use pre-tax dollars to pay for qualified medical expenses during the year. FSAs are usually funded through voluntary salary reduction agreements with an employer.
gatekeeper: in managed care, it refers to the provider designated as one who directs an individual patient’s care. In practical terms, it is the one who refers patients to specialists and/or sub-specialists for care.
health maintenance organization (HMO): a form of managed care in which you receive your care from participating providers.
health savings account (HSA): a savings product that serves as an alternative to traditional health insurance. HSAs enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.
managed care: a method of providing health care, in which the insurer and/or employer (policyholder) maintain some level of control over costs and utilization by various means. Typically refers to HMOs and PPOs.
member: a term used to describe a person who is enrolled in an insurance plan; the term is used most frequently in managed care.
open enrollment: a set time of year when you can enroll in health insurance or change from one plan to another without benefit of a qualifying evening.
out-of-pocket: money the patient’s pays toward the cost of health care services.
payer: the party who actually makes payment for services under the insurance coverage policy. In the majority of cases, the payer is the same as the insurer. But, as in the case of very large self-insured employers, the payer is a separate entity under contract to handle the administration of the insurance policy.
policyholder: purchaser of an insurance policy; in group health insurance, this is usually the employer who purchases policy coverage for its employees.
preferred provider organization (PPO): a form of managed care in which the member has more flexibility in choosing physicians and other providers. The member can see both participating and non-participating providers. There is a greater out-of-pocket expense if member sees non-participating providers.
premium: the cost of an insurance plan shared by employer and employee.
provider: one who delivers health care services within the scope of a professional license.
reimbursement: refers to the payment by the patient (first-party) or insurer (third-party), to the health care provider, for services rendered.

Category: Insurance and Payment Questions
Tag: Insurance terms

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You are Here Because…

  • You Want to Know if We Accept Your Insurance
  • You Want to Learn About Physical Therapy & How It Can Help
  • You are in Pain & Want Your Life Back & May or May Not Have Seen Your Doctor Already
  • Your Doctor Said You Need Physical Therapy & Gave You a Referral Script
  • All of the Above

Testimonials

Exceptional will be my word. First thing that comes in my mind.
E.E. - 73 yr old female after Total Knee Replacement
Great experience. Always felt motivated to work my hardest and knew that the therapists were truly caring about my recovery.
M.D. - High school athlete with knee and ankle pain before AthletePlus
Very professional, kind people who answered each question I had throughout the program. The program was challenging, yet possible for someone with my injuries to complete. The E-Stim sessions seemed to help, also. I completed the exercises I was directed to do at home each day to strengthen my back.
S.G. - Female with Si and low back pain before AthletePlus
a nice place everyone is nice to you here. they care about you a lot they want you to get better.
V.N - Male with neck and back pain before AthletePlus
Fantastic, I would recommend it to anyone and a nice friendly caring atmosphere. They will help you with what ever your needs are.
G.K. - 71 yr old male with hip pain before AthletePlus
Excellent, Chris predicted 3 months of work and it was just at 3 months. I have great range of motion now in my shoulder. Chris and Rodney pushed me and the work paid off. Lindsi is always cheerful, helpful and sweet. x
J.S. - Female after shoulder replacement at Ozark Orthopaedics
Professional staff who are concerned about their patients. Also best program ever.
A.A. - 17 yr old football player with knee pain
It was really good, they help me recover faster then I thought. Definite 10/10. * Update: This patient recently set a school record in 400 m in track in 2016
Elite high school athlete treated after ACL surgery
they defiantly helped me get my knees back to where i wanted them and even make them stronger.
S.V. - 15 yr female with bilateral knee pain before AthletePlus
Overall a very positive experience. The staff has been very professional and have provided me with not just therapy, but a method to continue my work outside the center. All the exercises provided have been such that they can be integrated into my normal workout routine. This should allow me to work on any problems on my own in the future. I have been very pleased with the progress I made and with the program.
G.G. - Male with low back pain before AthletePlus

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