Our billing office hours are 9am – 5pm Monday through Friday. The direct billing office number is 801-456-9900. You can also email a billing specialist through our Contact page.
Your Insurance Benefits:
Because you are ultimately responsible for your account regardless of insurance coverage, we highly recommend that you contact your insurance provider directly to learn your benefits. Your specific physical therapy benefits are determined by the insurance plan you or your employer has chosen. Most inquires about your individual benefits can be answered by contacting your insurance providers member services, with the contact information most often found on the back of your insurance card. Our office will provide you with an insurance benefit worksheet that will list your physical therapy benefits as they were quoted to us; however we recommend you confirm your benefits with your insurance plan as well. Keep in mind the benefits quoted by your insurance carrier are not a guarantee of payment by the carrier.
Common Insurance Terms & Definitions:
Allowable Fee: Maximum amount an insurer will pay for a medical procedure.
Claim: A bill for services rendered sent from your provider to your insurance carrier for reimbursement.
Co-insurance: Some insurance plans require that you pay a percentage of the cost of covered medical services (usually between 20% and 30%). For example, your insurance carrier might pay 80% and you would then pay 20% of the cost of a doctor’s visit or grouping of visits. The amount you pay is the co-insurance; this term is not equivalent to co-payment.
Co-payment: Some insurance plans require that you pay a flat fee for covered medical services at each visit to your health care provider. For example, you might pay a co-payment of $25 for each doctor’s visit. Co-payments are to be paid in the office at each time of service.
CPT®: Current Procedural Terminology. CPT® is registered trademark of the American Medical Association and is a system of providing medical procedures with numeric equivalents. Medical procedures are interpreted by your insurance carrier through this numeric system of coding, with each code assigned a dollar amount by your insurance plan’s fee schedule. Health care providers bill your health insurance carrier for procedures performed using this method.
Deductible: The amount you must cover for medical expenses before your insurance policy starts paying. Deductibles are usually made on an annual basis. For example, if your deductible is $250, you must pay that amount out of your own pocket each year before your insurance carrier will start covering the cost of procedures or treatment you receive.
EOB/EOR: Explanation of benefits/Explanation of reimbursement is the written correspondence, you and your provider receives, from your insurance carrier that details the determination on your claims. Our office will bill you directly off the EOB/EOR we receive from your insurance carrier.
Out-of-pocket maximum: The amount of co-insurance/deductible/co-pays you must pay before yourinsurance company will pay 100% of the allowed amount for claims.
Physical Therapist: Physical therapists apply research and proven techniques to help people get back in motion. All physical therapists are required to receive a graduate degree at minimum from an accredited physical therapist program before taking the national licensure examination that allows them to practice. Physical Therapist is legally protected term and licensed medical profession; physical therapy can only be administered by a licensed physical therapist or physical therapy assistant. Any individual claiming to provide physical therapy without a physical therapy license is engaging in unlawful conduct.
(Utah Dept. of Professional Licensing, State Practice Act: 58-24b-102, 58-24b-301, 58-24b-501)
For more information about the profession of Physical Therapy, visit: http://www.moveforwardpt.com
Referral: Although Utah allows patients Direct Access to physical therapy services, your insurance carrier may require a prescription from your primary care doctor to see a specialist (Physical Therapists are considered specialists) or receive a special test or procedure. HMO’s generally require that you obtain a referral for specialist care and procedures, while some managed plans allow you to self-refer (seek care from a Physical Therapist without a prescription).
Specialists: A doctor who is trained in a specific type of medicine, such as physical/occupational/speech therapists. Some health insurance plans require that you receive a referral from your primary care doctor before you can see a specialist.
Other Notes/Tips: In order to meet the financial needs of all of our patients we do offer payment plans. Our billing department must approve payment plans
We do offer a discounted self-pay per visit rate which may be less expensive than your out-of-pocket cost through your health insurance depending on the parameters of your health insurance plan