Frequently Asked Questions (FAQs)
"What we have here is a failure to communicate"- Cool hand Luke
Frequently asked questions and answers ranging from your payment options to what makes Sports Driven truly exceptional.
Why do you now bill insurance?
The short answer...
To remove some of the access and payment barriers to sports rehab and to provide cost effective rehab options to sports minded consumers. Sports Driven is now able of offer the option of billing most insurance plans. Although we are able to bill insurance, we continue to offer "Self-pay" and "out-of-network" payment options. Some Preferred Provider Organizations (PPOs) will reimburse the consumer for physical therapy services. We can provide necessary coding and paper work as needed.
We strongly recommend that you contact your insurance provider (use the phone number provided on your insurance card) prior to beginning sessions at Sports Driven. HMOs typically will not reimburse for “out-of-network” services. It is your role to understand the benefits and limitations of your insurance policy.
The long answer….
To maintain our high standards of care and maintain our tight operating costs, we are only contracted with some insurance providers and are therefore considered an out of network provider for other plans. Insurance companies typically require a significantly discounted rate on fees in exchange for driving volume toward the contracted business. This arrangement requires an increase in patient volume in order to make up for reduced reimbursement. This in turn can result in decreased patient-to-therapist contact. We strive to maintain high standards of care regardless of payment type and insurance plan.
Although we are an out of network provider for some insurance plans, our physical therapy services may still be covered by your insurance. We are now able to bill both in network and out-of -network services.
Please be advised that it is your responsibility to understand the benefits and limitations of your insurance policy. We encourage you to call your insurance carrier to find out what is covered under your health care plan. In addition, the growing dissatisfaction with the limited coverage for rehabilitation by insurance companies has driven consumers to seek alternative measures that will assist them in returning to high levels of competition and fitness after injury.
Sports Driven is now able to bill most insurance plans. Why do you now accept insurance? We recieved many request from clients and other medical professional to include the insurance option. The cost of billing insurance continues to escalate. As does the complexity and time required to bill insurance companies. The rules of the game change rapidly and often without adequate notice. Those making the rules have control of the playing field and the rules. This arrangement creates an adversarial relationship between the consumer and the insurance company. Insurance companies impose restrictions on service in an effort to contain cost. In the effort to contain cost, insurance companies actually constrain services( “cost containment really means service constraints”) There are constraints on what is reimbursed, the number of visits approved and the services that are covered. Those services covered by insurance providers continue to change as does the amount of co-pays and consumer deductibles. That is why we continue to offer the "self-pay" option, but are also sensitive to the financial burden self-pay may cause. Hence the insurance option.
Sports Driven has made a purposeful and calculated decision to put the control back in the hands of the client. We advocate a return to Consumer Directed Care (CDC). Consumer Directed Care (CDC) means the patient or client is more involved in the selection of and payment for therapy services. We encourage the client to make informed decisions about their health care. We believe strongly that it is your insurance dollars and you should be able to be the “gate keeper.”
For more information on these new health plan options please see the link “payment options for health care.” In the resources area. (link- http://www.ustreas.gov/offices/public-affairs/hsa/)
How can I pay for my services?
We are truly a “Green Facility” (green hard cash that is). We gladly accept checks, debit and most major credit cards.
New more sophisticated options for payment include use of your health savings account (HAS), health reimbursement account (HRA), or flexible spending account (FSA).
How is Sports Driven different from other physical therapy clinics?
At Sports Driven, our goal is to provide the highest quality of care. To achieve this, your session is with a physical therapist or other licensed professional during your entire visit. Aides or unlicensed personnel are seldom used when treating physical therapy patients. Certified personal trainers may be used during performance training sessions.
Because consumers are looking for facilities that can provide sports specific training to groups and individuals, we have focused our attention on the recreational and athletic subgroup.
Sports Driven also provides injury prevention programs to youth and adult athletic teams in an effort to educate coaches, athletes and parents about the importance of neuromuscular and strength training. Sports Driven specializes in outpatient sports rehabilitation and utilizes functional-exercise based treatment. We are also very committed to providing the highest level of sports rehabilitation to athletes with physical disabilities.
How much does a sports rehabilitation session cost?
Not as much as you may think. Because we are now able to bill insurance companies you may have a co-pay and other out-of-pocket costs, but because we offer "self-pay" options, we are able to pass the savings on to the consumer.
Rehab pricing varies depending on services performed. "Self-Pay" Rehab sessions typically cost about $100 per session when paid for at the time of service. Initial and re-evals cost slightly more. We also offer discounted physical therapy packages for those who choose to use their Health Savings Account (HSA), HRA, FlexSpending accounts. We gladly accept cash, check, and most major credit cards.
Do I need a prescription from a physician for Sports Rehabilitation?
New Mexico is a Direct Access state which means that a client can seek rehabilitative care from a physical therapist without obtaining a physician's referral. However, most insurance companies require a physician's prescription for reimbursement to provide the diagnosis and to establish "medical necessity."
Is there a cancellation policy?
Yes. As a courtesy to the therapist and to other clients who may be on a waiting list, it is requested that 24 hours notice be given prior to any changes to appointment times.
Filed Under: F.A.Q.'s