PRICING TRANSPARENCY
Our TRANSPARENCY IN PRICING is listed below:
PHYSICAL THERAPY EVALUATION (45-minute visit 1-on-1). 3 options:
- DIRECT BILL: For in-network insurance companies, will bill them directly after you've paid your deductible and co-pay.
- PRE-PAY $200.00: For out-of-network insurance companies that HAVE out-of-network benefits, you pay $200.00 to PTSportsPRO then get reimbursed from your insurance.
- SELF-PAY $150.00: For out-of-network insurance companies that HAVE NO out-of-network benefits OR NO INSURANCE you pay $150.00.
PHYSICAL THERAPY RE-VISIT (45-minute visit 1-on-1). 3 options:
- DIRECT BILL: For in-network insurance companies, will bill them directly after you've paid your deductible and co-pay.
- PRE-PAY $150.00: For out-of-network insurance companies that HAVE out-of-network benefits, you pay $150.00 to PTSportsPRO then get reimbursed from your insurance.
- SELF-PAY $125.00: For out-of-network insurance companies that HAVE NO out-of-network benefits OR NO INSURANCE you pay $125.00.
INSURANCE TRANSPARENCY
Our TRANSPARENCY IN INSURANCE is listed below:
Our credentialing team has been working with multiple insurance companies to become an in-network provider. However, this process is taking much longer than we expected. In the meantime, here are some guidelines as to how you can still be seen by us.
We are IN-NETWORK with the following insurance companies while we are working to confirm others:
- AETNA
- ASR PHYSICIANS CARE
- AUTO
- BLUE CROSS BLUE SHIELD- ANTHEM
- BLUE CROSS BLUE SHIELD-FEDERAL (BCBS FEP)
- BLUE CROSS BLUE SHIELD- MESSA
- BLUE CROSS BLUE SHIELD- PPO
- BLUE CROSS BLUE SHIELD- TRADITIONAL
- COFINITY
- DEFINITY HEALTH
- FIRST HEALTH
- GOLDEN RULE
- INSIGHT
- MPN-EMPIRE PLAN
- MEDICARE OF MICHIGAN PART B (Red, white, & Blue Card)
- MEDICARE PLUS BLUE PPO
- OXFORD HEALTH
- RAILROAD MEDICARE
- STRAIGHT MEDICAID
- UHC STUDENT RECOURCES
- UNITEDHEALTHCARE OF MICHIGAN (UHC)
- UNITEDHEALTHCARE COMMUNITY PLAN
- UNITEDHEALTHCARE DUAL COMPLETE (MI) (MEDICARE & MEDICAID)
- UNITED MEDICAL RESOURCES (UMR)
- VETERAN'S AFFAIRS COMMUNITY CARE NETWORK
- WORKER'S COMP
In-network patients do not qualify for the options below.
All other insurance companies not listed above are considered OUT-OF-NETWORK. We signed agreement forms for the following companies but have yet to be accepted into their network:
On Deck (Contracts loading):
- BLUE CARE NETWORK (Commerical-HMO)
- BLUE CARE NETWORK ADVANTAGE (Medicare)
- BLUE CROSS COMPLETE (BCC-Medicaid)
- HUMANA (Commerical and Medicare)
- MERIDIAN
- MOLINA
Closed Networks:
- PRIORITY HEALTH/CIGNA
- HUMANA MILITARY/TRICARE
- HAP HMO
To allow our patients to still access us, we have the following 2 options for OUT-OF-NETWORK services:
OPTION 1: PATIENTS WHO WANT TO TURN IN/SUBMIT THEIR BILLS TO THEIR INSURANCE COMPANY
- Patients pay PTSportsPRO directly using their HSA card or any other form of payment.
- The following charges will apply:
- Physical Therapy Evaluation 45-minute session: up to $200 ($100 evaluation charge; up to 2 units of treatment at $50 per unit)
- Physical Therapy Re-Visit 45-minute session: up to $150 (up to 3 units of treatment at $50 per unit)
- Claims can be submitted by PTSportsPRO or the patient. The insurance will pay the patient directly for services received based on their plan coverage.
We are NOT ALLOWED to bill out-of-network services for the following insurance companies, but these patients can take advantage of our SELF-PAY option (OPTION 2):
- Any HMO or EPO plans
- Any narrow plans
OPTION 2: PATIENTS WHO WANT TO PAY CASH/SELF-PAY
- Patients pay PTSportsPRO directly using their HSA card or any other form of payment.
- The following charges will apply:
- Physical Therapy Evaluation 45-minute session: $150
- Physical Therapy Re-Visit 45-minute session: $125
- The is a flat-rate discounted fee
- This option is for patients who do not want to submit their therapy claims to their insurance.
