Cumming Physical Therapy Questions

Cash-based physical therapy is a contract strictly between the physical therapist and the client. Many insurance companies impose restrictions on treatment plans, such as visit limits or the types of activities performed. With a cash-pay service, you pay upfront with cash, credit, or debit at the time of care. This reduces costs for both us and you.

By removing the barriers of insurance, our physical therapist can personalize a treatment plan for you. This ensures we are on the most efficient road to recovery, often resulting in quicker healing times and even a lower total cost.

Usually, insurance is filed for every visit to a traditional physical therapy clinic.

Bills are based on activities performed or time spent with the patient. The insurance company then reimburses the clinic at rates that vary from clinic to clinic.

You should know that these rates are not determined by your therapist's skills or the outcomes of your sessions. Instead, the clinic negotiates the best reimbursement rate based on how many PTs they have, the number of rotations, the number of patients, and more.

Insurance involving third-party payers often interferes with our personalized treatment plans. We are dedicated to helping you get better as efficiently as possible. Cash-based services allow us to avoid the restrictions placed on our services.

Yes. Put simply, you will file your insurance claim with an "out-of-network" provider. This means that your doctor does not have a contract with your insurance company.

Instead of the insurance company choosing your doctor for you, you get to choose someone you know is dedicated to your personalized treatment plan.

Apex PT will provide you with the documentation you need to submit a claim to insurance for services you paid for. You will then be waiting for reimbursement, instead of the clinic. This way, we can spend as much time or as many resources as necessary to ensure your treatment puts you on the quickest road to recovery.

You may be surprised to learn that cash-based services often cost less out-of-pocket than using insurance. Choosing to pay upfront lowers our operating costs; therefore, we can charge less than the typical bill submitted to insurance. In addition, because we are not bound by insurance restrictions, we can provide our patients with more effective therapy that often results in fewer sessions (meaning less overall cost!).

This depends on your specific insurance, but YES, some non-Medicare patients can send "self-claims" to their insurance company for treatments at our clinic.

You should be able to print claim forms from your insurance company's website and send them in with the necessary receipts and treatment codes provided by our clinic.

The amount of reimbursement or application toward 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 submitted via self-claims.

The US government has laws that control where Medicare beneficiaries can spend their healthcare dollars and encourage healthcare providers to enroll in their system. Because we are not a participating Medicare provider, we can only accept Medicare beneficiaries as patients when the patient does not want Medicare billed for any physical therapy services.

The request not to involve Medicare in payment must be made upfront by the patient and must be done of the patient's own free will.

If you are a Medicare beneficiary, please contact us for more information.

If you wish to use Apex and understand we are not a participating provider, we may be able to help you if you provide a written agreement specifying that you will not involve Medicare or Medicare supplemental insurance in your payment for care at Apex Physical Therapy.

Glad you asked! Just go to Book An Appt and fill out the form. We will contact you as soon as possible to schedule an appointment.