FAQ - estimated payment per visit

Alpine PT believes that our services and Physical Therapy in general are a very worthwhile investment in your health.  But we understand that costs can be a burden and that insurance benefits can be confusing.  It is with this understanding that we have decided to transition toward a deposit due at the time of service.  We encourage people to check into their Physical Therapy benefits prior to beginning a course of PT.  We believe that understanding the estimated cost of each visit will prevent surprise bills after your treatment is over.  As always we feel communication is key!  We pride ourselves on trying to work with and understand where our clients are coming from, both in their physical health and their financial health.  So please feel free to ask questions and discuss with your PT any concerns you may have about your treatment.  As we describe below, there are lots of ways to help you reach your goals.  

Why do I have to pay if I have insurance?  
A: Your insurance benefits are dependent on your plan and may include a deductible that has not been met, a coinsurance, or a co-pay that is the patient's responsibility to pay. You are responsible to pay some amount at each visit. By paying toward the total balance at each visit, your final bill will be much lower. 
More info: Until your deductible is met, you will be responsible for the full amount of each visit. Ultimately this amount is determined by your insurance company. Once the deductible is met, the amount you pay at each visit will decrease significantly. With some insurances, once the deductible is met you pay nothing, for other insurances you will have a coinsurance to pay once your deductible is met. Check your benefits to understand more. 

How do you determine the amount I need to pay toward each visit if I have insurance? 
A: The deposit toward your visit is based on the average amount that gets passed to the patient after insurance processing plus considerations including a) if the deductible has been met and b) your co-pay or coinsurance associated with your plan.
 
What if I can’t afford that amount? Consider other options that currently include:

1. Adjusting frequency and duration of visits - focus on a plan of care with self-efficacy at the center
2. Cash pay plans (although this is not always better if they might meet their deductible this year as we will not bill insurance retroactively)
3. Direct Primary Care plans, such as the one at Cost Care, that include 5 visits/year with only a $40 copay
4. 10 Pack for $1600
5. We will work with people on an individual basis to set up payment plans, only if necessary. Experience has taught us they don’t often get paid. The billing team will work one on one in these cases.
6. Currently PhysioTrekk is $95/standard visit (~40 min), $129/premium visit (~55 min). (works great for something that requires less than a handful of visits, patients that are good managing their own care but not ideal for post-op, conditions that require frequent follow-up or individuals that need more managed care)

What if I end up paying more than I am billed? 
A: Once your PT course of care is complete, and your final claim has been processed through your insurance, any remaining credit on your account will be reimbursed to you from Alpine. 

Why is the cash pay rate lower than the insurance rate? 
A: We offer a discounted rate on our billed charges to patients who opt to self pay at the time of service because we cut out the administrative costs associated with insurance billing. 
More info: Theoretically, this discount is available to insurance companies, but they don’t pay at the time of service. 

Can I find out how much my total PT care will cost? 
A: In some cases we can, but it is only an estimate based on the number of visits we think you will need. 
More info:  It is best to meet with your physical therapist for your initial evaluation first, then they can take all of your health factors into consideration to provide an estimate of the number of visits you will need. If you are cash-pay, this is a bit easier since the cash pay rate is set. If you are using insurance and have a deductible or coinsurance it is trickier and will be less accurate.

Why do you charge so much for a PT visit?
A: In the US healthcare costs are only subsidized if you qualify for Medicare, Medicaid or VA benefits. Instead healthcare is provided by private businesses that have to set prices according to costs of doing business. For Physical Therapy this includes doctorate level providers who are highly trained experts in their field. At Alpine, we provide one-on-one care with your physical therapist for the full treatment session, which typically lasts between 50-60 minutes.
More info: The cost for a PT visit depends on the length of the visit, how much time is spent with the physical therapist rather than with an assistant, and the location of the PT clinic (both geographic location in the US and if it is a hospital vs private clinic). 

If I pay cash can I submit the bill to my insurance on my own? 
A: Typically, yes.  The process to do this is set by your insurance company.