Q: My orthopedic surgeon wrote a prescription for physical therapy to strengthen my muscles before a total knee replacement. Can I choose the place I would like to have my therapy?
A: You sure can. You choose where to get your hair cut, oil changed and eyes examined. The same is true for your therapy. Patients always have a choice of where to receive their therapy. The patient makes the ultimate decision.
Q: How do I know if a provider is in network with my insurance plan?
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A: We encourage our patients to call the number on the back of their insurance card to ask who is in network and if their benefit includes outpatient physical, occupational and/or speech therapy services. Occasionally, insurance plans provide services only before and after surgery while others have no therapy benefits. When talking with your insurance company, ask for a reference number for the call and the name of the person you spoke with. This refers to the record of the call and the associated notes related to the conversation. If after the paperwork is processed through your insurance company, it is discovered that what you were told is not what happens, you can use this reference number to ask for a correction. This is not guaranteed to fix the problem but it will certainly help your chances.
Q: What should I consider when selecting a provider for my therapy services?
A: Consider a provider who is in network, has a good reputation in the community, convenient hours and location, ample parking, handicapped accessible and a quality staff. Ask about patient satisfaction rates. We are happy to provide tours of our facility and answer questions before a potential patient decides where to seek therapy services.
Q: If I don't have a doctor, can I get therapy?
A: If the patient is seeking physical therapy, the answer is maybe. There are two options. The first option is that some insurance plans offer "Direct Access for Physical Therapy" as a feature of their particular plan. This simply means there is no prescription needed from a physician to receive physical therapy services. However, the patient does have the ability to use their insurance benefit. Co-pays, deductibles and co-insurances would apply. This is not approved for a trauma, as one should seek services from a physician to rule out a serious injury like a fracture. Medicare does not participate in Direct Access.
One more thing to know about the "Direct Access" program is the reason a person is seeking treatment (i.e., back pain, knee pain, etc.) allows either 10 visits or 30 days, whichever comes first. No additional services for the same condition can be delivered again without a prescription from a physician.
The second involves seeking a prescription for therapy from an urgent care center. The new urgent care facility called Five Star Urgent Care in the Riverwalk Center is open seven days a week and will see patients for all concerns that are not life threatening.
We all know that maneuvering through the healthcare system can be a challenge. We welcome your calls or stop in to meet us and we will be happy to do our best to help get you the services you need to feel better.
As a premier provider of physical and occupational therapy in our community for more than 10 years, we have helped thousands of patients improve function and relieve pain through individualized treatment programs. Physical and occupational therapists evaluate and address the underlying cause of a patient's pain or dysfunction using a diagnostic approach. We offer free consultations, have convenient hours and accept most insurance plans.
Chautauqua Physical & Occupational Therapy is located in the Riverwalk Center, 15 S. Main St., Suite 220, Jamestown, NY 14701. For more information, call 488-2322, email cpt@stny.rr.com or visit www.chautauquapt.com.