Insurance Information

Do I need a physician's referral to receive physical therapy?

 

Depending on your specific insurance contract, the answer to this question could be yes or no. You see, in the State of Maryland, physical therapists are legally permitted to practice autonomously and operate independently. Since we practice in a direct-access state, if your insurance plan authorizes self-referral to physical therapy, a physician referral is not necessary for you to be seen by a licensed physical therapist. However, please check with your insurance carrier since many health insurance plans require a physician's referral for physical therapy in order for the treatment to be covered. We also offer treatments, services, and/or products that do NOT require a referral and are available on a self-pay basis.

 

 

Does my health insurance cover physical therapy?

 

To ensure payment by your insurance company, our intake staff is well-versed in what information is necessary to get your visits with us authorized by your insurance carrier. At the time of the initial appointment, we must have a signed referral or consultation form from your medical practitioner (your physician, nurse practitioner, physician's assistant, podiatrist, or dentist). If your treatment here is being covered by health insurance, there are no exceptions to this policy. We will do our best to expediently verify your insurance coverage and obtain authorization for treatment. We are informed by the insurance carriers that verification is not always a guarantee for payment for services provided, therefore, it is recommended that you personally confirm the specifics of your coverage. A parent or legal guardian must accompany anyone under age 18 for their appointment. We will do our best to expediently verify your insurance coverage and obtain authorization for treatment. We are informed by the insurance carriers that verification is not always a guarantee for payment for services provided, therefore, it is recommended that you personally confirm the specifics of your coverage.

 

Our providers participate in most all of the major health insurance commercial plans and managed care organizations (MCOs) in the metropolitan area. We are participating providers in the health plans and commercial carriers listed below. If your plan is not listed, we will be unable to file a claim on your behalf. However, we can provide you with a form that you can submit to your insurance company to instruct them to send reimbursements directly to you.

 

Please be aware that with any health plans, there may be deductibles and copayments for which you could be responsible. We will do our best to identify and inform you of your responsibility for payment on your initial visit.

HEALTH PLANS

We participate with the following insurance companies:

 

  • AETNA US Healthcare

  • Blue Choice

  • Carefirst Blue Cross-Blue Shield of Maryland (all products) 

  • CHAMPUS / TRICARE

  • CIGNA Healthcare

  • Chesapeake (formerly IWIF Worker's Comp)

  • Comp Management, Inc.

  • Corvel CorCare

  • Coventry

  • Employers Health Plan (EHP)

  • Federal Blue Cross-Blue Shield

  • First Health/Mail Handlers

  • Great West

  • HealthNet

  • Johns Hopkins Health Plan

  • Kaiser Permanente of the Mid-Atlantic States

  • Kemper

  • MAMSI/ALLIANCE/ M.D. IPA/ Optimum Choice/Alliance

  • Medicare

  • National Capital Blue Cross-Blue Shield

  • Optum

  • Private Healthcare Systems (PHCS)

  • Travellers

  • Trigon Blue Cross Blue Shield

  • United Healthcare                                                                                                                                                                                          PLEASE NOTE: Insurance providership panels change periodically. If your insurance carrier is not found on the list above, please call the office and ask if we are providers with your insurance carrier.

QUESTIONS ABOUT YOUR BILL

What billing or insurance information will I receive?

​You will receive an explanation of benefits from your insurance company when we submit our bill to the company.  After your insurance has paid, we'll provide you with a statement of your account. Payment for services rendered is requested within 30 days.

 

How long will it take to get things settled with the insurance company?

Generally, it takes from 30 to 60 days to obtain payment from an insurance carrier.​

 

​I received a notice that my insurance company has paid on my bill -- but I can't understand how they calculated their payment amount. Do you know?

​If we have received any such information from your insurance company, we'll be glad to share it with you. However, for answers to any questions about insurance payments, deductibles, or co-payments, you generally need to check with your insurance company.

 

 

​Who do I call if I have questions about my bill?

Esterson & Associates Physical Therapy outsources our billing to a local private medical billing company. You may call the billing company weekdays from 9:00 am through 4:00 pm or your may email them by clicking the button below.

 

 

Esterson & Associates Physical Therapy

Two West Rolling Crossroads
Suite 100-102
Baltimore, MD 21228
Phone  (410) 747-1600
Fax       (410) 747-5202
E-mail  Info@EstersonTherapy.com

HOURS OF OPERATION

 

Monday -  Thursday        8:00 am - 8:00 pm

Friday                                 8:00 am - 4:00 pm
Saturday                           Closed
Sunday                              Closed

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© 2015 Esterson PT