Frequently Asked Questions

FAQs

What is cash based physical therapy?

Dr Rachael’s practice is considered an out of network and cash based provider. This allows her to offer private evaluations and treatments that otherwise would be controlled by insurance reimbursement requirements. Insurance companies often limit particular treatments and or limit the amount of time a physical therapist can work with a client.

However, you may be able to use your out of network insurance for care. Oftentimes our clients see up to 100% of coverage for their visits. It is important that you understand your out of network benefits to know how much your company would potentially reimburse you.

Here are a list of questions that you can ask your insurance company:

1) Do I have out of network benefits for physical therapy?
2) If yes, do I have an out of network deductible? If yes, how much is the deductible? And how much has already been met?
3) What percentage of reimbursement do I have? (60%, 80%, 90%, are all common)
4) Does the rate of reimbursement change because I’m seeing a non-preferred or out of network provider?
5) Does my policy require a written prescription?
6) Does my policy require pre-authorization or a referral on file for outpatient physical therapy services?
7) Is there a cost or visit limit per year? If Yes, what is it?
8) Is there a special form to be filled out to submit a claim? How do I obtain it? What is the mailing address I should use to submit claims?
9) Is there an online website where I can submit the claim?
10) How long does it take to review the claim & reimburse?
11) Is there anything else I need to know to see an out of network provider?

Do I need a physician referral or prescription?

Michigan is a direct access state which means that a client can see Dr Rachael and her team for rehabilitation over a period of 10 visits or 21 days before needing to be referred back to the client’s physician for continued care. Dr Rachael’s practice is able to offer unlimited visits for health and wellness physical therapy. Physical therapists offer rehabilitation when you are not able to perform activities of daily living at a functional and pain free state. Health and wellness physical therapy is offered when you are functional with your activities of daily living and want to continue on a journey to work towards optimal health.

Do you take health spending account (HSA) or flex spending account (FSA)?

Yes, your HSA/FSA can be used to pay for care. The practice will provide you with a detailed receipt for you to give to your financial institution. Please review the rules and regulations regarding the use of funds in these accounts before your appointment to ensure eligibility.

How often are treatments scheduled?

It is Dr Rachael’s goal that you are an active participant in your care. However, the frequency of your PT treatments will be determined by the severity of your condition and or symptoms. With you as an active participant in your care, it may result in less visits needed to be successful in your healing journey. Typically patients are scheduled for 1 hour session once a week or every other week for 3-6 weeks.

Why choose out of pocket physical therapy?

Understanding your insurance is important. You may pay less for personalized physical therapy with Dr Rachael’s practice while having better results in fewer visits than with a physical therapist that takes insurance and requires high co-pays for each visit.

The visit(s) with in-network providers typically are not the same length of time. In addition, you will be required to see your physician, prior to using your physical therapy insurance, because insurance companies in the state of Michigan require a referral and prescription.

If you are paying for physical therapy either way, why not pay for a more personal and specialized approach? You will also have the added benefit of having the same physical therapist see you in clinic or meet with you virtually.

  • No co-pays, deductibles, or co-insurance.
  • Use your HSA/FSA.
  • This may be a most cost effective alternative to a high deductible plan.
  • Same cost every treatment, and no waiting and wondering what you will have to pay.
  • Unlimited annual visits for health and wellness physical therapy.
  • Same obstetric trained, doctor of physical therapy every visit

Can I bring my baby?

Yes of course you may bring your baby! However, having a one on one solo session is preferred by many of our mama clients. This will enable you to focus on your healing during the session. It is understandable for many reasons if you need to bring baby for nursing, child care, and more. If baby is present, and needs time for cuddles, nursing, and or diaper changes, this may limit the amount of work that we are able to do in your visit and may extend the needed amount of visits. Due to scheduling, we will need to end on time in order to honor the time of the next client. There is a lobby area where a family member or friend may sit with baby during your visit. In addition, there are several coffee shops, restaurants, walking trails, and the Rochester Municipal Park near by for your family member or friend to spend time with baby.

Are you a Medicare provider?

Medicare prohibits non-Medicare providers from accepting cash for clients that are covered under Medicare. Dr Rachael Miller’s practice is not a Medicare participating provider and therefore can only see clients on Medicare for health and wellness exercise instruction only. Health and wellness physical therapy is not reimbursable by Medicare and the services would be paid for directly by the client.