Out-Of-Network Insurance
As part of our service to you, we will contact your insurance company on your behalf to obtain your out of 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.
As an out of network client, you are responsible for payment of 100% of our appointment fee at the time of service.
Being out of network with your insurance company, we are unable to collect payment from them for your physical therapy services. We use an outside revenue cycle management company to submit claims on your behalf. This company is Revenue Cycle Solutions, LLC (“RCS”). We will provide the claim coding information needed to submit claims on your behalf to RCS. As part of our service to you, we pay RCS to submit claims and perform follow up services on claims related to your physical therapy visits to facilitate you receiving reimbursement from your insurance company for the services we have provided to you. Neither Kinetic Energy Physical Therapy or RCS can guarantee payment by your insurance company. We will coordinate with RCS to provide the best chance of you receiving reimbursement from your insurance company. Once you receive payment, you are entitled to keep payment up to the amount you have paid us for each date of service. If your insurance company pays more than the per visit rate you have paid us, RCS will collect the excess payment amount from you by charging the credit card you have with us on file. RCS 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. If you do not wish us to have RCS submit claims on your behalf, let us know and we will consider you a Cash-Pay Client.
Your deductible amount resets every year on January 1st. You can assume that 100% of the amount you paid us for your physical therapy visits will be applied to your deductible by your insurance company for visits you receive early in the year. Even if you have a high deductible plan, the amounts you pay per visit under out of network benefits will be applied by your insurance company toward your deductible and benefit you later in the year for future medical expenses incurred after your deductible has been met. It is important you keep the receipts we provide you as proof of payment which will allow your insurance company to apply those payments to your deductible. The process performed by RCS will also facilitate you receiving credit for your out of pocket expenses.
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 use with your insurance company in the process of reimbursing you for your out of pocket expenses.
You are a cash pay client if: 1) you are receiving physical therapy services that are considered physical therapy benefits and those services are not being submitted to an insurance company under either in network or out-of-network benefits available to you or 2) you are receiving services that are not considered to be payable physical therapy benefits either alone or in combination with payable physical therapy benefits services that are being submitted to an insurance company under either in network or out-of-network benefits available to you. Refer to our cash pay fee schedule available at our front desk. We accept payment by check, HSA card, MasterCard, VISA, American Express and Discover.
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