What health insurance providers do you accept?

CHPT currently accepts the following health insurance plans:

• Aetna
• Champ VA
• Cigna
• Fidelis
• Medicare
• Most Excellus BC/BS plans
• MVP
• Pomco
• RMSCO
• Tricare
• Most United Health Care plans
• Univera

WE do NOT accept:

• Medicaid (as primary insurance)
• UHC Empire Plan
• Wellcare

*This list reflects the most common insurance plans in the Rochester area. Your insurance plan may not be listed above; please call our office if you do not see you plan above.

*There are some plans that will charge you a higher copay if you choose to come to our office.

 

What are some common health insurance terms to know?

Pre-authorization: Refers to the process when a health insurance company pre-approves a covered entity to receive medical services prior to treatment. Depending on your insurance company, this may apply to you.

Referral/Prescription: A written instruction by a medical provider (such as an Medical Doctor, Doctor of Osteopathy, Nurse Practitioner or Physician's Assistant) authorizing treatment for a condition.

Deductible: The amount an individual is liable for paying before their insurance company will make any  payment.

Copay: A fixed amount required at the time of  medical visit.

Coinsurance: An agreement between you and your insurance company to share the responsibility in payment of a medical claim.

Direct Access: In New York State, the law allows you to see a physical therapist for up to 10 visits or 30 days, whichever comes first, without a prescription or referral. You may need a referral, however, if your health insurance requires one to cover your treatments.

 

What should I bring to my appointment?

It would be helpful if you have a script from your MD with information on what he/she would like us to be focusing on during your visits.

You should also bring your insurance card/s and if you have more than one, KNOW which is your primary insurance.

You should wear or bring clothes that allow you to move easily and allow the therapist to observe the part of your body being evaluated. For example, wear/bring a tank top for shoulder evaluations and shorts for knee or hip evaluations. We have t-shirts, shorts and gowns for you to borrow while at your appointment if needed. You should also bring appropriate footwear (sneakers or dance shoes) to your appointments as needed.

 

What are the clinic policies on cancellations, insurance, etc?

• If you are running 10 or more minutes late for your appointment, we may have you reschedule to be sure you receive a complete treatment. If you are able to reschedule within 24 hours, you will not be charged for a missed appointment. There may be times when your therapist can accommodate you without putting them behind in their schedule, but it is not usually the case.
• Our practice requires 24-hours notice for all cancellations. If a scheduled appointment is cancelled within 24 hours of the scheduled time, there will be a charge of $40. If you do not show up for your appointment, the $40 fee will also be issued. This is an office policy that your therapist cannot override, so please do not spend your treatment time trying to have it done. While we understand that things come up, we are holding that spot for you, and we could have placed another patient in that time slot.
• Should you miss or cancel three times without 24-hour notice, we will no longer schedule your appointments in advance. You can call on the day you would like to be seen to inquire if there are any available appointments that day.
• If you have a deductible insurance plan, you may choose to pay an amount to be applied toward your total payment per treatment and will be billed the remainder after insurance payments come through. If you have met your deductible, you are responsible for your co-payment or co-insurance, per your health insurance plan, until you have met your out-of-pocket maximum.
• There will be a $5 charge for any bill that needs to be mailed to you. Please stop by the desk and take care of your co-pays at the time of treatment.
• If your insurance requires pre-authorization, our office can get one for you, with a referral from your doctor's office.

 

How do I make my first appointment?

Call our office (585-482-5060), and our receptionist will ask you some initial questions, including your diagnosis and health insurance coverage (if applicable). We would prefer that you have a prescription/referral prior to your appointment, but under the Direct Access law, you can still be seen. Please have an idea of what your insurance allows prior to calling so there are no surprises when it comes to billing. Please arrive in our office 20 minutes prior to your appointment time to complete your initial paperwork. You can find the initial paperwork under the new patient tab, complete it at home and bring it with you, if you prefer.

Make sure you bring your insurance card and prescription/referral with you.

 

What should I expect at my first appointment?

Your initial visit lasts about one hour and consists of a thorough evaluation by your physical therapist. Your therapist may decide to begin your treatment during this time. Follow-up appointments are 30 minutes, or 45 for lymphedema appointments; you and your therapist will make a plan for how often you will need to come.

 

What if I have an emergency when the clinic is closed?

Physical therapists are not emergency responders. If you think you are having an emergency, (ie. extreme pain, fever, red/hot swollen limb, etc.) please contact your physician, or go to your Urgent Care or local hospital Emergency Department.