FAQS

Insurance

Q: What is Fee for Service?

A: Payment is made by the patient in full at the appointment time.  

Q: Why Fee for Service?

A: Insurance-based health care allows for treatment of a body part expressing a symptom. Frequently this body part is the result of a larger more widespread problem.  This requires advanced training and time to understand the big picture and what is truly causing the pain. 

As fee for service providers, we treat patients for 1 hour for every visit in a private treatment room and use the Integrated Systems Model (ISM) to diagnose the pain source.  In contrast, in-network facilities offer shorter visits (possibly several in one week) and treatment is limited to what the insurance is willing to pay for.

Fee for service allows you as the patient the freedom of choice when it comes to your healthcare.  You may choose to see providers outside of the network for quality care.

Q:Will my insurance reimburse me?

A: As a courtesy, we will call and check your out of network benefits.  

If you are curious about your insurance out of network benefits, give us a call!  We'll get the information for you from your insurance company!

Q:What can I expect to pay for each appointment?

A: Fees are based on time spent with you and the treatments performed during your appointment.  The fee ranges are as follows:

$183 - 201 for Initial Evaluation

$156 - 160 for 60 minute appointments

$50.00 or the cost of the visit for cancellations with less than 48 hours notice (therapist's discretion)

 

We do make exceptions for inclement weather and illness.

 

The Insurance Worksheet can help to call your insurance company and ask the right questions.

Pediatric Urinary Incontinence FAQs

Q: How long do we need to come to therapy?

A: Most children require 6-8 visits in therapy to accomplish daytime dryness.  If your child has daytime, as well as night time wetting, this may be longer.  Patients are usually seen once every two weeks, then 3-4 weeks as progress is attained.

Q: How long does each session last?

A: Sessions last 30-60 minutes.

Q: Will you do a vaginal or rectal exam on my child?

A: No.  Vaginal or rectal exams are NOT done by physical therapists in the pediatric population. Visual inspection of the perineum will be conducted to observe the following:

  • skin irritation or redness from soiled underclothing

  • pelvic floor muscle contraction to see if the child understands how to use the muscles correctly

  • normal sensation and reflexes of the anus with a light touch

Q: What is biofeedback?

A: Biofeedback, also called Surface Electromyography (SEMG), is a learning technique that utilizes specialized equipment to assist a person in gaining control of their natural body functions.  It involves the monitoring of a life process (bio) and the return of that information to the patient and therapist in a meaningful form (feedback).

Biofeedback training uses sensitive equipment that enables you to see or hear how your muscles are responding to your instructions on a computer.  The computer shows animated pictures (dolphin, space shuttle) to encourage proper muscle function.  Becoming aware of these responses is the first step in learning to control them.  By combining this information with special exercises, you can learn to relax tense muscles or strengthen weak muscles.

Q: Who uses biofeedback and why?

A: Your health care provider may recommended biofeedback evaluation and treatment for the muscles of your pelvic floor.  These muscles are responsible to assist in bladder and bowel control. Anyone interested in learning how to relax tense muscles, strengthen weak ones, or to control and coordinate use of muscles may benefit from biofeedback.

Q: What does biofeedback involve?

A: For the evaluation, you will use external stick-on sensors placed near the rectal opening. These sensors are used to monitor the muscle activity of your pelvic floor. This enables you and your therapist to see and evaluate resting muscle activity as well as evaluate your muscle strength and endurance. The results of your evaluation will help your therapist design a specific treatment plan for your needs. We use "magic" lotion to remove the sticky part so it is virtually pain free!

Q: What is required after the evaluation?

A: Your exercise program will depend upon the results of your evaluation. Almost everyone is asked to carry out a home exercise program utilizing the skills and exercises they learn in the clinic. Occasionally people need special home biofeedback equipment to help them monitor their exercise program. If this is necessary for you, the equipment can be either rented or purchased.

Q: Will I get reimbursed for therapy?

A: Insurance plans that do not require you to go to an "in network" provider, such as a HMO, will reimburse you according your plan.  If you have a Preferred Provider network (PPO), you will be reimbursed according to your plans’ "out of network" benefit. You most likely will have to satisfy your deductible first.

If your child is seeing us for Dysfunctional Elimination Syndrome, Dysfunctional Voiding, daytime or night time incontinence, and you do not have a physical therapist specializing in this in your network, you can request "in network" reimbursement. If your plan cannot provide you with an "in network" provider they may allow you to have an "in network" benefit for an "out of network" provider. You should get pre-authorization from your PCP if you belong to a HMO or a plan that requires referrals.

Pediatric Kaiser Permanente patients have been successful in getting prior authorization and coverage for treatment.  You must start with a pediatrician's referral for pelvic floor physical therapy.  Give us a call to find out the process.  

Pelvic Pain and Urinary Incontinence FAQs

Q: How often should I expect to come to therapy?

A: Stress/Urge and Mixed Incontinence usually can be treated in 6-8 visits lasting 45-60 minutes each.

Your first 2-4 visits will be weekly, and then you will be given exercises to do at home on your own and return every 2-3 weeks for progressions to your home exercise program.

If you are experiencing pelvic pain, you will likely require more visits depending on the severity of the pain and how long you’ve experienced the pain. These visits are weekly.

Q: Is it necessary to do an internal vaginal and/or rectal exam?

A: Evaluation of the pelvic floor muscles is done via an internal vaginal (female) or rectal (male). Not all patients receive an internal exam, it is done based on your condition and consent. This exam is performed to assess the strength, muscle symmetry and tone, trigger points and specific ability of your pelvic floor muscles to contract and relax. Just like in a neck injury, the muscles need to be treated to promote relaxation and re-gain normal strength. If at any time this causes discomfort for you, please let us know so we can discuss your feelings and perhaps find alternatives for treatment.

Q: What is biofeedback?

A: Biofeedback, also called Surface Electromyography (SEMG), is a learning technique that utilizes specialized equipment to assist a person in gaining control of their natural body functions. It involves the monitoring of a life process (bio) and the return of that information to the patient and therapist in a meaningful form (feedback).

Biofeedback training uses sensitive equipment that enables you to see or hear how your muscles are responding to your instructions. Becoming aware of these responses is the first step in learning to control them. By combining this information with special exercises, you can learn to relax tense muscles or strengthen weak muscles.

Q: Who uses biofeedback and why?

A: Your health care provider may recommended biofeedback evaluation and treatment for the muscles of your pelvic floor.  These muscles are responsible to assist in bladder and bowel control. Anyone interested in learning how to relax tense muscles, strengthen weak ones, or to control and coordinate use of muscles may benefit from biofeedback.

Q: What does biofeedback involve?

A: For the evaluation you will use either an internal sensor, placed into the vagina or rectum, or external stick-on sensors placed around the rectal opening. These sensors are used to monitor the muscle activity of your pelvic floor. This enables you and your therapist to see and evaluate resting muscle activity as well as evaluate your muscle strength and endurance. The results of your evaluation will help your therapist design a specific treatment plan for your needs.

Q: What is required after the evaluation?

A: Your exercise program will depend upon the results of your evaluation. Almost everyone is asked to carry out a home exercise program utilizing the skills and exercises they learn in the clinic. Occasionally people need special home biofeedback equipment to help them monitor their exercise program. If this is necessary for you, the equipment can be either rented or purchased.

Q: Will I get reimbursed for therapy?

A:  Insurance plans that do not require you to go to an "in network" provider will reimburse you according to the plan you have purchased. If you have a Preferred Provider network (PPO) you will be reimbursed according to your plans’ "out of network" benefit. You most likely will have to satisfy your deductible first.

If you have any questions, please feel free to contact us at 303-740-2026 or staff@ptspecialist.com.

© 2019 by Physical Therapy Specialists. Site Map/Privacy Policy

Site Design by Kott Kreative

Follow Us
  • Facebook - White Circle
Contact Us

3989 E Arapahoe Road Suite 120
Centennial, CO  80122     

303.740.2026

303.770.5459 (fax)