How Does Health Insurance Pay For Physical Therapy in Boise

by Gavin Morrison on April 24, 2014

How to monitor the cost of your physical therapy in Boise.

The per visit cost for physical therapy when you have health insurance is related to the co-insurance rate or the co-pay amount determined by your policy.Woman-Med-Bill

After your annual deductible has been met the insurance company begins paying for therapy. However there is still a portion of the cost that is the responsibility of the patient. This is the co-pay or the co-insurance.

A co-pay is a flat rate per visit. It is usually between $10 – $40 per visit, depending on your policy. This will be the same amount at every visit.

A per visit co-insurance payment is a little harder to predict because it is based on a percentage of the cost of each visit, Which can vary from visit to visit. Your policy determines the amount of co-insurance that you pay for therapy. Some policies require as little as 10% others can go up to 70%.

The cost of each visit may vary slightly depending on what kind of therapy is performed. Massage type therapy is a different cost than exercise type therapy. Each visit will usually have some combination of these two types of therapy. Therapy appointments at our clinic last for 1 hour and cost around $100 – $130 per visit. A 20% co-insurance payment would be somewhere between $20 – $30 per visit.

Some clinics require co-pays or co-insurance estimates to be paid at every visit and others will bill you for the total at the end of each month or the end of your therapy. We bill our patients at the end of their therapy unless they would like to be billed otherwise.

The best way to keep track of how much co-insurance you owe is to look at the paperwork that your insurance company sends you.

Once the insurance company receives and processes the claims that are sent in by the therapy clinic they send out what is called an “explanation of benefits” (EOB) to the patient. It usually takes about 3 – 4 weeks for the insurance company to process claims. You should start receiving EOBs form the insurance company around the 4th week after your first visit.

BCI EOB

The EOB will show the date of the therapy appointment (date of service), how much the original charges were for that date, how much the insurance discount was, the total amount allowed by the policy for that date, and the percentage of that amount that the patient is responsible for (co-insurance). If you have not met your deductible it will be applied to the deductible instead of co-insurance.

Monitoring your EOBs is a good way to anticipate the cost of your therapy and cross-reference the amounts with invoices from the therapy clinic.

At our clinic we are happy to verify your benefits with your insurance company and give you an estimate of your co-insurance payments. For more information call us today at 208-608-0958

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