OPTM will contact your insurance company prior to your initial visit to obtain the following information:
- In network or Out of Network Benefits
- Pre-Authorization Information
- Deductible Information
- Insurance coverage
- Visit or Dollar Limitations
Please be prepared to provide the following when calling the business office:
- Insurance Company Name
- Insurance Company Phone Number
- Subscriber Name
- Subscriber’s date of birth
- Subscriber’s ID Number
Each insurance bases benefits on factors such as medical necessity. Your insurance may not require a referral, but a prescription including diagnosis, frequency and duration is recommended to satisfy medical necessity. Insurance companies determine benefits after receiving and reviewing claims. Your visits will fluctuate depending on the procedures and/or modalities received at each visit. OPTM will collect a payment at each visit either towards your co-pay, co-insurance, or deductible. You will be advised at your evaluation of the exact amounts. After final payment from your insurance company, if there is a credit, you will be issued a refund. If a balance is owing, you will receive a balance due statement. At each visit please sign in, schedule appointments, make co-payment and check in with your therapist. Each insurance company has their own rules and regulations and you are responsible for knowing them. If you have any questions regarding your benefits, limitations, or denials please call your insurance company.
You understand, agree and accept the following:
- I authorize release of information to my insurance company.
- I am fully responsible for my bill, including any charges denied by my insurance carrier as non-covered, not authorized or not medically necessary.
- All bills are due and payable in full within 30 days from discharge at OPTM’s request. Collection proceedings will begin if payment is not received.
- I will pay my insurance co-payment and /or deductible as listed above at each appointment.
- A 24 hour cancellation notice is required. Failure will result in a $50.00 fee, non payable by my insurance company.
- The referring physician will not write a referral retroactively to cover any visits beyond those originally ordered.
- I am ultimately responsible for monitoring the number of visits attended and am fully financially responsible for any visits which go beyond those ordered.
- ALL billing issues should be addressed to the billing department only.