PAYMENT FAQS

 

DO I NEED A REFERRAL?

No, you can make an appointment directly. In Pennsylvania, direct access licensed PTs can treat a patient for 30 days before needing a physician referral or signature on the plan of care.* If I anticipate that your care may extend beyond the first 30 days, I will collaborate with your primary care physician to ensure you get the care that you need.

 

*If you plan to submit a claim to your insurance, it is possible that they may require a referral in order for you to be reimbursed. Check with your insurance company prior to your initial visit if you plan to submit a self-claim. 

DO YOU ACCEPT INSURANCE?

In order to ensure that you receive quality one-on-one care (the type of care that I insist on providing), I choose to remain out-of-network with commercial insurance companies and non-participating with Medicare. Why? Because in-network practices typically need to maintain a high volume of patients in order to stay in business. I believe that the care that I can provide in focused, one-on-one sessions is more effective in a shorter period of time than the traditional in-network physical therapy business model. In this model, patients will often spend less time and money in working toward their functional goals.

WHAT IS THE LOCATION OF SERVICES?

All services will be rendered in the comfort and convenience of your own home or office space.* Dr. O'Bright is a traveling therapist and will bring all required equipment for therapy to you. Please ensure that your meeting space has enough free space to accommodate a standard size folding treatment table.

 

Because of the nature of home/office visit operations, there may be slight time adjustments in the start of your appointment. You will receive a notification when the therapist en route with an ETA; if this time no longer works for you, Dr. O'Bright will do everything possible to ensure that you are rescheduled to a time that suits your needs.

*If you prefer to meet in a more neutral location, Dr. O'Bright has developed partnerships with several local gyms & fitness studios where services may be rendered. Use the contact form or call to inquire about a location that suits you. The therapist reserves the right to refuse to treat in spaces that are unsafe or unsanitary for the patient or therapist.

WHAT ARE YOUR RATES?

All rates include cost of services, materials & linens, as well as compensation for therapist travel and equipment set-up.

I AM A MEDICARE BENEFICIARY. CAN I SEE YOU FOR PT SERVICES?

Because I am not a Participating Medicare Provider, I can only accept Medicare beneficiaries as patients when the patient does not want Medicare billed for any PT services. This request to not involve Medicare in payment must be made up front by the patient and be made of the patient’s own free will. In other words, if you’re a Medicare beneficiary and are adamant about seeing me for your care even though I am not a participating Medicare provider, I can help you. However, the only way to provide you with PT services is when you truly don’t want Medicare involved and you ask up front that Medicare not be billed or involved in your physical therapy care. 

 

If you DO want to use your Medicare benefits for physical therapy, I cannot provide you with treatment, but I have excellent relationships with other providers who can help and I can lead you to them.

CAN I SUBMIT A CLAIM TO MY INSURANCE TO REIMBURSE ME FOR PHYSICAL THERAPY OUT-OF-POCKET EXPENSES?

In many cases, YES! Most commercial payers (non-Medicare) will allow beneficiaries to submit their own claims for fees spent on out-of-network services. In order to have a better idea of what may be covered, I would recommend calling your insurance company to inquire about reimbursement for “out-of-network Physical Therapy” expenses sent in self-claims. For your convenience, links to claims forms for most local insurers are below. There is also a worksheet that you may want to use as a guide when submitting your claim. Complete the claim form and submit to your insurance with the needed receipts and treatment codes that will be provided to you upon request.

If you plan to file a claim for reimbursement to your insurance company, please use this form as a guide to keep track of necessary requirements. 

Claim forms for each major insurer in the Pittsburgh area are located at the bottom of the Payment FAQ page