In-Network Insurance
As part of our service to you, we will contact your insurance company on your behalf to obtain your in network insurance benefits information. Kinetic Energy Physical Therapy is NOT responsible for the accuracy or completeness of the information provided to us by your insurance company. Insurance companies do provide inaccurate information from time to time and you are ultimately responsible for the accuracy and completeness of your insurance verification information.
If we are in network with your insurance plan, we will collect from you your cost share (deductible, co-pay, co-insurance) upon arrival at each visit. If the exact amount of your cost share cannot be known at the time of service, we will collect from you an estimated cost share based on history with your insurance company. Any overpayments collected or underpayments determined by your Explanation of Benefits (“EOB”) will be settled with you once we have received the EOB for your last date of service. As a condition of participation with your insurance company we are required to collect your cost share from you for all services provided by Kinetic Energy Physical Therapy. Because of federal regulations, we are unable to extend courtesy or professional discounts to anyone who does not meet federal financial hardship conditions. If you think you are eligible for consideration under federal financial hardship conditions, let us know and we can perform the required financial hardship assessment.
Your deductible amount resets every year on January 1st. You can assume that 100% of the allowed amount for your physical therapy visits will be applied to your deductible by your insurance company for visits you receive early in the year. We will collect 100% of the expected allowed amount from you at the time of service until we have received proof from your insurance company through their EOB process that your deductible has been met. It is always possible that part of your deductible has not been met at any time throughout the year. We will rely upon the verification of benefits process information obtained from your insurance company to establish the status of your deductible and collect a cost share amount from you based on this information. We cannot know that your deductible has been met until we obtain an EOB from your insurance company for submitted claims telling us this is the case.
We will provide you with a receipt for all amounts collected from you at the time of service which will serve as your proof of payment for your cost share responsibilities.
The EOB from your insurance company is the definitive indication of what they have allowed for your therapy visits and what they have determined your financial responsibility to be. All actions we take in regard to determining what you owe for physical therapy services are determined by the EOB. If you have a concern with what your insurance company decided based on the EOB, please contact your insurance company.
All payments made by you are posted into the billing software as unapplied payments in your account until we have an EOB from your insurance company to apply payments to. We apply all payments made by you according to the information on the EOB starting with the oldest date of service. If after closing all dates of service we continue to have an unapplied payment balance we will either refund the excess payment by mailing you a check or you can elect to hold your credit balance to be applied to future services you may receive from us.
Upon intake we collect and store your payment card information in an electronically secure location. If it is determined that you have a balance due for services provided and we do not have unapplied payments to apply to this open balance, we will charge the balance due to the card we have on file to settle your unpaid account balance. We will issue you a receipt once any charges have been made to your payment card. If you do not have a payment card, any balances due will be processed according to the patient statement policy below. This policy applies to Credit Cards, Debit Cards and HSA Cards - any form of payment to be kept on file.
A patient statement is provided when we have determined that you owe a balance on services provided and we do not have unapplied payments to apply or credit card on file to automatically collect payment for unpaid balances as determined by your insurance company. Payment is due upon receipt. If payment is not received after 30 days, we will send a second duplicate billing statement. If payment is not received after 60 days, your account will be given to a collection agency.
We use an outside revenue cycle management company to process your claims with your insurance company. This company is Revenue Cycle Solutions, LLC (“RCS”). Their contact information is 800-230-8333 and CallCenter@certifiedrsllc.com. Contact RCS if you have questions about your insurance company’s handling of your claims, balances you owe, amounts you have paid, statements you have received or anything else related to the processing of your insurance claims for your physical therapy appointments. Our in office staff are not able to address claims processing issues. When contacting RCS please be sure to leave all required information on their answering machine if they do not answer your call. Keep in mind that they operate in the eastern time zone.
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