Answers to commonly asked questions on insurance, pilates, and physical therapy.
FAQs
I'm not in very good shape. Can I do Pilates? YES! The Pilates equipment utilizes springs as assistance (or resistance) for the exercise repertoire, making it adaptable to anyone from beginner to streamlined athlete.
What should I wear? Wear comfortable, stretchy clothes that allow you to bend and move. Form-fitting clothing is best, because it makes it easier for me to identify postural and alignment positions and ensure proper form. However, your comfort is most important, so wear what feels best to you. Pilates is practiced barefoot or with special grippy socks.
Do I need a referral/ prescription? No referral is needed. However, please keep in mind that if you plan to file with your insurance company, some require a referral and/or pre-authorization before the evaluation is performed. It is up to you to check on the requirements for your insurance company.
Do you accept insurance? Therapeutic Pilates is a fee-for-service clinic and payment is required at the time service is provided.
If you are being seen for skilled Physical Therapy services, I will provide you with an itemized bill and coding information upon request. You can then file a claim with your insurance company and possibly be reimbursed under your out-of-network benefits.
Why do you not file insurance? In order to provide you with the highest quality of care, Therapeutic Pilates has elected to be a fee-for-service clinic. Patients receive one-on-one treatment by a licensed Physical Therapist/Pilates teacher for 55 minutes. You and I will determine your course of treatment, NOT your insurance company. You will receive treatment that's tailored to your specific needs, and not dictated by the insurance company. Being a private-pay provider allows me to decrease my administrative costs and spend more time treating you.
How do I find out what my out-of-network Physical Therapy benefits are? Please download "How to Determine Your Insurance Benefits for Physical Therapy" for step-by-step instructions on contacting your insurance company regarding your out-of-network benefits.
Would it be a smart investment to see an out-of-network provider for Physical Therapy?
When deciding on a Physical Therapy provider, you have the choice to see whomever you desire. There are several things you should consider when making a decision: length of appointment time, amount of individualized time you're being treated by a licensed Physical Therapist (not support staff), accessibility of your Physical Therapist, amount of your yearly deductible/copay/what the Physical Therapy clinic is charging you (or your insurance company). When all these factors are taken into account, Therapeutic Pilates, LLC, offers a higher VALUE for your money because you receive more time, care, and personal attention from an experienced Physical Therapist.
What if I have Medicare, Medicaid, Motor Vehicle, or Worker's Compensation? I offer Wellness/Fitness, Injury Reduction, and Post-Rehab Pilates to Medicare, Medicaid, Motor Vehicle Accident Insurance, and Worker's Compensation beneficiaries.
Unfortunately, at this time I am NOT able to provide skilled Physical Therapy services to Medicare or Medicaid beneficiaries, regardless of whether this is your primary, secondary, or tertiary provider. This restriction is due to changes in the Affordable Care Act, which make it unlawful for non-enrolled providers to receive direct payment from Medicaid or Medicare members for skilled Physical Therapy. I also do not file claims directly with your Motor Vehicle Accident Insurance or Workman's Compensation Insurance. If you have Medicare, Medicaid, or Workman’s Comp, and are in need of skilled PT, I am happy to refer you to another Physical Therapy clinic.
Can I use my HSA/FSA account to pay for Physical Therapy? Yes! Physical Therapy Rehabilitation services are HSA/FSA-eligible medical expenses and can help decrease your cost by paying with pre-tax dollars. I can provide you with a receipt for reimbursement if needed. Please check with your provider to determine if Pilates Wellness/Fitness, Injury Prevention, and Post-Rehab sessions are eligible.
Still have questions? Please don't hesitate to call me at 919-619-7167 or email at katie@therapilatesstudio.com, and I will do my best to answer any questions that you might have.
