How does the billing process work?
An EOB (Explanation of Benefits) is generated and sent to the patient and to the physical therapy clinic with a check for payment and a balance due by the patient. The patient is expected to make a 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, which provide opportunities for a delay in the billing 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 from a third-party payer as long as 6 months after the treatment date, at which point you may receive a bill for any remaining balance. We offer you the option to pay as the EOBs are received or wait and pay once all your EOBs are received. Similar to most doctor office we require the copays and deducible payments upfront. Exceptions are common to the above example as well.
It is important to remember that the verification of benefits from a third-party payer does not guarantee payment. Third-party payers review claims individually and reserves the right to refuse payment. If this happens you are responsible for the unpaid balance. We recommend that patients check their own benefit plans as third party payers are known for making mistakes and misquoting benefits.