Frequently Asked Questions
20.
Flare-ups are not uncommon. If you have a flare up
(exacerbation), give us a call. We may suggest you come back
to see us, return to your doctor, or simply modify your daily
activities or exercise routine.
In most cases, you have the right to choose any physical
therapy clinic. Our practice is a provider for many different
insurance plans.
The best thing to do is give us a call and we will attempt to
answer all of your questions.
Forty-three states have some form of direct access. Some
state physical therapy practice acts require a diagnosis before
a patient can see a therapist (this is the case in California,
Michigan, and Colorado to name a few). Other states allow
patients to go directly to physical therapists. In most cases, if
you are not making significant improvement within 30 days,
the therapist will refer you to/back to your physician.
In most states, physical therapists cannot make a medical
diagnosis. This is something that your medical doctor will
provide for you.
Physical therapists are important members of your medical
team. At this point in time, physicians are typically the health
care providers that will provide you with a medical diagnosis.
Billing for physical therapy services is similar to what happens
at your doctor's office. When you are seen for treatment the
following occurs:
The physical therapist bills your insurance company, Worker's
Comp, or charges you based on CPT (Common Procedure
Terminology) codes.
Those codes are transferred to a billing form that is either
mailed or electronically communicated to the payer.
The payer processes this information and makes payments
according to an agreed upon fee schedule.
An EOB (Explanation of Benefits) is generated and sent to the
patient and the physical therapy clinic with a check for
payment and a balance due by the patient.
The patient is expected to make the payment on the balance if
any.
It is important to understand that there are many small steps
(beyond the outline provided above) within the process.
Exceptions are common to the above example as well. At any
time along the way, information may be missing, mis-
communicated, or misunderstood. This can delay the payment
process. While it is common for the payment process to be
completed in 60 days or less, it is not uncommon for the
physical therapy clinic to receive payment as long as 6 months
after the treatment date.
Some patients will need to continue with home exercises.
Some may choose to continue with a gym exercise program or
a personal fitness program. Others will complete their
rehabilitation and return to normal daily activities. It is
important that you communicate your goals to your therapist,
so he/she can develop a custom program for you.
The therapist should be licensed in the state.
The first visit should include a thorough medical history and
physical examination before any treatment is rendered.
The patient goals should be discussed in detail during the first
visit.
Care should include a variety of techniques which might
include hands-on techniques, soft tissue work, therapeutic
exercises and in some cases heat, cold, electrical stimulation
or ultrasound.
Do they have a service that can address your problem?
Do they take your insurance or are they willing to work with
you if they are not a preferred provider?
They should be conveniently located. Since sitting and driving
often aggravate orthopedic problems, there should be a very
good reason for you to drive a long distance for rehabilitation.
What are the hours of operation?
Can they provide satisfaction survey results?
The therapist should provide the treatment.
Can you briefly interview the therapist before the first visit?
Ask your family and friends whom they would recommend.
The therapist should be licensed in the state.
The first visit should include a thorough medical history
and physical examination before any treatment is rendered.
The patient goals should be discussed in detail during the
first visit.
Care should include a variety of techniques which might
include hands-on techniques, soft tissue work, therapeutic
exercises and in some cases heat, cold, electrical
stimulation or ultrasound.
Do they have a service that can address your problem?
Do they take your insurance or are they willing to work with
you if they are not a preferred provider?
They should be conveniently located. Since sitting and
driving often aggravate orthopedic problems, there should
be a very good reason for you to drive a long distance for
rehabilitation.
What are the hours of operation?
Can they provide satisfaction survey results?
The therapist should provide the treatment.
Can you briefly interview the therapist before the first visit?
Ask your family and friends who they would recommend.
Is my physical therapist licensed?
Physical therapists (PT's) and physical therapist assistants
(PTA's) are licensed by their respective states.
What happens during my first visit?
During your first visit you can expect the following:
Arrive at your appointment with your paperwork completed
(you can download it from our website - here Paperwork)
You will provide us with your prescription for physical therapy.
We will copy your insurance card.
You will be seen for the initial evaluation by the therapist.
The therapist will discuss the following:
1. Your medical history.
2. Your current problems/complaints.
3. Pain intensity, what aggravates and eases the problem.
4. How this is impacting your daily activities or your
functional limitations.
5. Your goals with physical therapy.
6. Medications, tests, and procedures related to your health.
The therapist will then perform the objective evaluation which
may include some of the following:
1. Palpation - touching around the area of the pain/problem.
This is done to check for the presence of tenderness, swelling,
soft tissue integrity, tissue temperature, inflammation, etc.
2. Range of Motion (ROM) - the therapist will move the joint(s)
to check for the quality of movement and any restrictions.
3. Muscle Testing - the therapist is checking for strength and
the quality of the muscle contraction. Pain and weakness may
be noted. Often the muscle strength is graded. This is also
part of a neurological screening.
4. Neurological Screening - the therapist may check to see
how the nerves are communicating with the muscles, sensing
touch, pain, vibration, or temperature. Reflexes may be
assessed as well.
5. Special Tests - the therapist may perform special tests to
confirm/rule out the presence of additional problems.
6. Posture Assessment - the positions of joints relative to
ideal and each other may be assessed.
The therapist will then formulate a list of problems you are
having, and how to treat those problems. A plan is
subsequently developed with the patient's input. This includes
how many times you should see the therapist per week, how
many weeks you will need therapy, home programs, patient
education, short-term/long-term goals, and what is expected
after discharge from therapy. This plan is created from input
from you, your therapist, and your doctor.
Each treatment usually lasts between 30 and 60 min
There are dozens of different types of treatment interventions.
Here is a list of treatment interventions:
Active Range of Motion (AROM)
Active Assistive Range of Motion (AAROM
Stationary Bicycle
Gait or Walking Training
Isometrics
Isotonics
Soft Tissue Mobilization
MobilizationProprioceptive Neuromuscular
Facilitation (PNF)
Posture Training
Progressive Resistive Exercises (PRE)
Passive Range of Motion (PROM)
Stretching/Flexibility Exercise
Cryotherapy or Cold Therapy
Neuromuscular Electrical Stimulation (NMES)
Neck Traction
Heat
Iontophoresis
Pelvic Traction
Transcutaneous Electrical Nerve Stimulation
(TENS)
Ultrasound
Whirlpool
Massage may be part of your treatment. Rehabilitation
specialists are trained in a variety of techniques that may help
with your recovery. Deep tissue techniques may be part of the
rehabilitative process. Massage is used for three reasons
typically - to facilitate venous return from a swollen area, to
relax a tight muscle, or to relieve pain.
More than half of all Americans are suffering from pain.
Whether it is a recent episode or chronic, an ABC
News/Stanford study revealed that pain in America is a serious
problem. However, many do not even know that physical
therapists are well equipped to not only treat pain but also its
source.
Physical therapists are experts at treating movement and
neuro-musculoskeletal disorders. Pain often accompanies a
movement disorder, and physical therapists can help correct
the disorder and relieve the pain.
You have probably heard of the profession of physical therapy.
Maybe you have had a conversation with a friend about how
physical therapy helped get rid of his or her back pain, or you
might know someone who needed physical therapy after an
injury. You might even have been treated by a physical therapist
yourself. But have you ever wondered about physical therapists-
-who they are and what they do? Many people are familiar with
physical therapists' work helping patients with orthopedic
problems, such as low back pain or knee surgeries, to reduce
pain and regain function. Others may be aware of the treatment
that physical therapists provide to assist patients recovering
from a stroke (e.g., assisting them with recovering use of their
limbs and walking again).
The ability to maintain an upright posture and to move your
arms and legs to perform all sorts of tasks and activities is an
important component of your health. Most of us can learn to live
with the various medical conditions that we may develop, but
only if we are able to continue at our jobs, take care of our
families, and enjoy important occasions with family and friends.
All of these activities require the ability to move without
difficulty or pain.
Because physical therapists are experts in movement and
function, they do not confine their talents to treating people who
are ill. A large part of a physical therapist's program is directed
at preventing injury, loss of movement, and even surgery.
Physical therapists work as consultants in industrial settings to
improve the design of the workplace and reduce the risk of
workers overusing certain muscles or developing low back pain.
They also provide services to athletes at all levels to screen for
potential problems and institute preventive exercise programs.
With the boom in the golf and fitness industries, a number of
physical therapists are engaged in consulting with recreational
golfers and fitness clubs to develop workouts that are safe and
effective, especially for people who already know that they have
a problem with their joints or their backs.
The cornerstones of physical therapy treatment are therapeutic
exercise and functional training. In addition to "hands-on" care,
physical therapists also educate patients to take care of
themselves and to perform certain exercises on their own.
Depending on the particular needs of a patient, physical
therapists may also "mobilize" a joint (that is, perform certain
types of movements at the end of your range of motion) or
massage a muscle to promote proper movement and function.
Physical therapists also use methods such as ultrasound (which
uses high frequency waves to produce heat), hot packs, and ice.
Although other kinds of practitioners will offer some of these
treatments as "physical therapy," it's important for you to know
that physical therapy can only be provided by qualified physical
therapists or by physical therapist assistants, who must
complete a 2-year education program and who work only under
the direction and supervision of physical therapists.
Most forms of physical therapy treatment are covered by your
insurance, but the coverage will vary with each plan. Most states
do not legally require patients to see their physicians before
seeing a physical therapist. Most of the time all you have to do
is ask your doctor if physical therapy is right for you.
Reference: APTA
You and others may be referred to physical therapy because
of a movement dysfunction associated with pain. Your
difficulty with moving part(s) of your body (like bending at
the low back or difficulty sleeping on your shoulder, etc.)
very likely results in limitations with your daily activities
(e.g. difficulty getting out of a chair, an inability to play
sports, or trouble with walking, etc.). Physical therapists
treat these movement dysfunctions and their associated
pains and restore your body's ability to move in a normal
manner.
Who is better to see, a PT that works for a physician or a PT
that owns a private practice? We leave it up to you to draw
your own conclusions but here are some facts. The studies
indicate there were more treatments (visits per patient were
39% to 45% higher in physician owned clinics) and the cost
was greater for those patients that attended a physician owned
physical therapy practice (both gross and net revenue per
patient were 30% to 40% higher) (1).
Another study indicated that licensed and non-licensed
therapy providers spent less time with each patient in
physician owned clinics and physical therapy assistants were
substituted for physical therapists. (2)
Another older study concluded "Therapists who had treated
patients through direct access were significantly more likely to
believe that direct access had benefited them professionally
and benefited their patients than were therapists who had not
practiced through direct access."(3)
We believe that we can provide you with the highest quality of
care available and do it in a cost-effective manner.(4) You will
work closely with your physical therapist and in most
instances, your case will be managed by the same physical
therapist from the beginning to the end of your experience with
us.
"Joint Ventures Among Health Care Providers in Florida," State
of Florida Health Care Cost Containment Board, 1991.
Federal Office of the Inspector General May 1, 2006 - This
report calls into question billing processes done by non-
physical therapist owned practices.
In most cases, health insurance will cover your treatment.
Click on our insurance link to the left for a summary of
insurances we accept and make sure you talk to our
receptionist so we can help you clarify your insurance
coverage.
You will be evaluated by one of our licensed and highly trained
physical therapists and he/she will also treat you during
subsequent visits. Unlike some clinics, where you see
someone different each visit, we feel it is very important to
develop a one-on-one relationship with you to maintain
continuity of care. Since only one physical therapist knows
your problems best, he/she is the one that will be working
closely with you to speed your recovery.
Orthopedic Physical Therapy
Manual Therapy
Geriatric Physical Therapy
Sports Rehabilitation
Fitness and Wellness
Hand Therapy
Women's Health
Industrial Rehabilitation
Pediatric Physical Therapy
Aquatic Physical Therapy
Cardiac and Pulmonary Rehabilitation
Neurological, Spinal Cord Injury, and Traumatic Brain Injury
Rehab
Balance, Dizziness, and Vertigo Rehabilitation
Amputee Rehabilitation
Wound Care
ECS (Clinical Electrophysiologic Certified Specialist)
Lymphedema Rehabilitation
Osteoporosis Rehabilitation and Prevention
For many patients, one of the primary objectives is pain relief.
This is frequently accomplished with hands-on techniques,
modalities such as ultrasound, electrical stimulation, and/or
heat or cold therapy. Movement often provides pain relief as
well. Your physical therapist will provide you with the
appropriate exercises not only for pain relief but to recover
range of motion, strength, and endurance.
In some cases, physical therapy techniques can be painful. For
example, recovering knee range of motion after total knee
replacement or shoulder range of motion after shoulder
surgery may be painful. Your physical therapist will utilize a
variety of techniques to help maximize your treatment goals. It
is important that you communicate the intensity, frequency,
and duration of pain to your therapist. Without this
information, it is difficult for the therapist to adjust your
treatment plan.
This is highly variable. You may need one visit or you may
need months of care. It depends on your diagnosis, the
severity of your impairments, your past medical history, etc.
You will be re-evaluated on a monthly basis and when you see
your doctor, we will provide you with a progress report with
our recommendations.
You should wear loose fitting clothing so you can expose the
area that we will be evaluating and treating. For example, if you
have a knee problem, it is best to wear shorts. For a shoulder
problem, tank tops is a good choice, and for low back
problems, wear a loose fitting shirt and pants, again so we can
perform a thorough examination
Make sure you bring your physical therapy referral (provided
to you by your doctor) and your payment information.
If your insurance is covering the cost of physical therapy,
bring your insurance card.
If you are covered by Workers' Compensation, bring your claim
number and your case manager's contact information.
If you are covered by auto insurance or an attorney lien, make
sure you bring this information.
You can also print out the required paper work on fill it out at
your leisure before coming for your appointment
