Pamela Said:

can i be billed for physical therapy visits from 5 years ago that were never billed to my insurance?

We Answered:

*second answer*
Since you were covered for the other visits, it sounds like it is a billing error. The billers are human. They can over look claims if there are consecutive days. I would contact your insurance tomorrow and see what their timely filing limit is. Most reps are more than happy to call a provider especially when they know that this is a viable case. They are hounded by the providers for payment and this may be some release for them to prove to them although they work for a doctor that does not make them as smart. So make the call. Find the T/F limit and go from there. If the rep is not willing to work with you as some of the other people stated ask for a sup. They may give you the run around but be polite, courteous and just say that you would like the reassurance from someone higher up. No offense to the rep even if the issue is documented. Make it clear that this is a large bill and quite old. Good luck and you mail email me directly if I can be of further assistance.


*original answer*
Here's the thing. If the provider was contracted with your insurance company then they should have a timely filing deadline. Be it 90, 180, or 365 days. If they were contracted then that is the legal binding you are looking for. You will have to do some research on this. First I would contact the insurance company to find out their timely filing deadline and to see if that provider was contracted on the date of service, if you had coverage for that type of service. Depending on the answers there, depends on what you do next. If they were contracted with your insurance then you can call them and let them know what you know and say they can not bill you. Also most insurance companies require an authorization for PT. You may have been required to get a referral as well. Do you have any more information that you are able to share?

Richard Said:

Would I be responsible for physical therapy bills if my lawyer takes over the payments?

We Answered:

I'm not an attorney, and you really should clarify this through your attorney and physical therapist. Generally speaking, though my understanding is that you remain responsible for all bills - they are simply held due until your case settles. Your well being is more important than a few Hundred dollars in your pocket now. Usually, the medical bills are part of the settlement and then some "pain and suffering" for your trouble. You won't get rich but your bills should be paid.

Tara Said:

If workmans comp initially refused the claim but then sent me to physical therapy, does this mean they pay?

We Answered:

Yes - and your private insurance carrier has likely already "subrogated" - sent them the bills for it.

They would pay your private insurance back, though, not you. You cannot collect twice from two different insurances, once from your private insurance to pay the bill, and once from workers comp to pocket. That's double dipping, and illegal.

Ben Said:

Does Any 1 know about physical therapy billing?

We Answered:

?

Suzanne Said:

need cpt codes for physical therapy billing?

We Answered:

These lists are NOT inclusive.

Cigna's 2005 listing
http://www.cigna.com/health/provider/med…
See page 4 of 6

Federal Register list, 2004
http://www.facs.org/ahp/cptcodes.pdf

Paul Said:

Starting my own Physical Therapy business and need to know how to get patients?

We Answered:

The Private Practice Section of the American Physical Therapy Association has a lot of good information. They're at http://www.ppsapta.org/

You might also contact the Health Policy & Administration Section. They're at http://www.aptahpa.org/

And if you have any particular focus (pediatrics, geriatrics, etc.), contact the section dealing with that. A link to all the sections is at http://www.apta.org/AM/Template.cfm?Sect…

PT Magazine (published by APTA) also has had a lot of articles on getting patients. It's at http://www.apta.org//AM/Template.cfm?Sec…

Very, very brief overview: A lot of PTs get most of their business from referrals from physicians. That means persuading physicians that they should refer their patients to you.

There's a growing trend, though, for PTs to take advantage of direct access and market directly for patients, similar to what chiropractors do. Often, that involves offering niche or specialized programs. For instance, some PTs are heavily into sports activities. They've developed special screening programs for high school athletes, for instance. Or they target a niche market like golfers. Often, in these cases, the PTs are going after cash-based services, rather than those reimbursed by insurance.

Check out the sites I listed above. They'll help.