Insurance

Insurance and Financial Policies

The Hruska Clinic currently contracts with Bluecross/Blueshield PPOMidlands ChoiceCoventry (as of 10-01-08), and Medicare. You will be responsible for any deductibles, co-pays, co-insurance and any services not covered by your plan. We strongly encourage you to check with your insurer regarding your specific physical therapy benefits prior to your initial appointment. Should your plan include a co-pay for physical therapy, we ask that it be paid at each visit.

Midlands Choice and Coventry plans require a prescription/referral for physical therapy from your primary doctor. Please contact your physician before your first physical therapy appointment to help ensure receiving full insurance benefits for your services with us.

If you are covered by Medicare, you will need a prescription for physical therapy from your medical doctor. A referral from a different health professional, such as a dentist or chiropractor, will not be accepted by Medicare. Once you have received a prescription, it will expire for use in thirty days. Therefore, please schedule your first appointment within that thirty day time period.

Effective January 1, 2006, a financial limitation (therapy cap) was placed on outpatient rehabilitation services received by Medicare beneficiaries. These limits apply to outpatient Part B therapy services from all settings except the outpatient hospital clinics. The cap imposed by Congress for physical and speech therapy (combined) per calendar year is $1840. If you have either of these services in an outpatient facility, please contact Medicare to find out how much of your $1840 remains for this calendar year.

If your health insurance company is not listed above as a contracted or networked insurance, you will be responsible for all amounts not paid by your plan. Payment will be due each visit.  If you do not have health insurance and are self-pay, payment in full is required at the time of service.

Other Payers

Workers Compensation

Your workers compensation carrier will be billed for your physical therapy charges. In the event these claims are denied, you will become financially responsible for all charges. In the event that you seek legal representation in the settlement of your claim, we ask that you adhere to the policies listed under “Personal Liability/Litigation”.

Motor Vehicle Accident (MVA)

Your automobile insurance will be billed provided your policy covers auto med-pay. If that benefit is not available, claims will be submitted to your health insurance provider. In the event that you seek legal representation in the settlement of your claim, we ask that you adhere to the policies listed under “Personal Liability/Litigation”.

Personal Liability/Litigation

If you are working with an attorney for your claim, and are not yet to the point of settlement, our financial policy is as follows:

  • If your account balance reaches $500, you will be required to pay a 10% payment monthly, or $50.
  • If your account balance reaches $1000, we ask that you continue to make 10% monthly payments, or $100.
  • Should your account balance reach $1500, you will be seen on a pay-as-you-go basis.
  • If your claim is denied, you are to assume full responsibility for payment.
Self-Pay

Self-paying patients are required to pay in full at the time of service for each visit.