Insurance & Billing
We’ve taken the headache out of billing.
Everything about your visit to TexPTS is made as easy as can be by our team–and that includes billing. Your road to recovery can be complicated enough, so we’ve worked hard to make our processes easy for you.
When it comes to billing, it’s as simple as this:
- First, we verify your benefits so that we know how much your copay for physical therapy will be.
- When you visit, we collect the copay and apply it to your account with us.
- We take care of submitting a claim to your insurance company so they are aware of your appointment. It can take the insurance company up to 45 days to process a claim.
- Once it has been processed, we review the claim and let you know if you have a balance or a refund coming your way.
Billing & Insurance
TexPTS works with the majority of insurance carriers, as well as out-of-pocket- benefits for most plans, including:
- AARP Medicare Complete
- Aetna
- Ambetter
- Amerigroup Medicaid (Limited)
- Amerigroup RealSolutions (Only Medicare replacement NOT Medicaid)
- Amerivantage Wellmed Aria
- Ascension Personalized Care
- Assurant Health
- BCBS
- BCBS Blue Advantage HMO
- BCBS CHIP & STAR (Limited)
- BCBS Health Select
- Champ VA
- CHIP
- Christus US Family Health Plan
- Cigna/ASH (HMO, Network, Open Access, Open Access Plus, POS & PPO; Benefit Plan)
- Community Care Collaborative (CCC or MAP) – Austin clinics only
- Community First
(Only Medicaid approved) - Community First Star Kids (Only Medicaid approved)
- Connected Senior Care Advantage
- Coventry/First Health (Limited)
- Dell Childrens Health Plan
- First Health Texas HCN (Limited)
- GEHA
- Global Sports Services GreatWest
- Health Texas
- Health West Humana Humana Gold Plus Humana
- HMO Premier
- Humana POS
- Liberty Mutual (Limited)
- Mail Handlers Benefit Plan
- Maxor
- Medicaid Traditional
- Medicare
- Medicare Railroad
- Medport
- Molina (Limited)
- Molina Star Kids (Limited)
- Multiplan
- National Choice Care
- Orchid Medical
- PHCS/MultiPlan
- Point Comfort Underwriters
- Scott & White (Only Austin & San Marcos clinics)
- Sendero IdealCare (Austin Only)
- Seton Employee Health Plan
- SmartHealth Ascension
- Superior Medicaid and CHIP, Medicare, Commercial Exchange
- SyndeoCare
- Texas Independence Health Plan
- Texas True Choice
- The Reny Group
- Tricare for Life (Secondary to Medicare)
- Tricare Prime
- Tricare Standard
- TriWest VA
- UHA Managed Care Unicare
- UHC Golden Rule
- UHC Compass EPO
- United Healthcare Chronic Complete
- United Healthcare
- Dual Complete Focus
- UT Health Austin
- WellCare
- WellMed
Worker's Comp Networks
- ACS/DOL
- Adams Resource
- Align (now called OneCall)
- Beech Street
- Bill Miller
- Broadspire W/C
- Care IQ
- Corporate Remedies
- Corvel CoreCare
- Coventry/First Health (Limited Therapists)
- Custom Design Benefits
- First Health Texas HCN (Limited)
- Focus/Concentra
- Gallagher Bassett
- IMO
- Liberty Mutual (Limited)
- MedRisk
- Network Synergy
- Occunet
- OneCall
- Political Subdivision of Workers Comp Alliance (TML, TASB, Texas Association of Counties, TCRMF, TWCA, Risk Management Fund)
- Rockport Sedgwick Claims
- Management Services
- TechHealth
- Texas Healthcare Fund
- Texas Mutual (uses WorkWell)
- Texas Star (now called WorkWell)
- The Boon Group
- Therapy Direct
- Travelers
- WorkWell
We know that insurance can seem complicated, so if you have any questions about your insurance or about how billing works, we encourage you to contact our helpful billing department at any time at [email protected].
Don’t let the headaches associated with billing and insurance stand in the way of getting the pain relief that you deserve.
Do you have a High Deductible Health Plan?
If you’re wanting to seek care but you’re worried about the cost and not sure how your health plan works, you’re not alone.
Navigating the healthcare system can be stressful – financially, emotionally, and physically. But as we know, putting off care now leads to needing more care later… and spending more later, as well. This is especially true of musculoskeletal injuries and conditions. It’s a fact that getting the right PT early results in less imaging, opioid medication, injections, and surgery.
Let us help you get the care you need – without breaking the bank. We’re well versed in High Deductible Health Plans and have a variety of options at our disposal to ensure that you’re not putting off feeling better due to cost concerns.
Here’s what you need to know:
What is a High Deductible Health Plan?
A High Deductible Health Plan (HDHP) is an insurance plan that requires patients to pay a large amount of their healthcare costs out of pocket before their insurance kicks in to help lighten the load. According to the IRS, in 2019, a health plan is considered an HDHP if….
- The deductible is $1350 or more, for individuals
- The deductible is $2700 or more, for families
Additionally, more than 90% of persons enrolled in an Exchange Plan are in High Deductible Health Plans, in which the average deductibles are even higher: $3572 for an individual and $7474 for a family.
So, how can TexPTS help me?
At TexPTS, we’re committed to providing our patients with the highest quality care, and that doesn’t just mean on the treatment table. We’re always searching for options to make physical therapy a reality for each and every one of our patients, regardless of their financial situation. Thus, we offer a variety of affordable payment and financing options, including:
CARECREDIT
TexPTS has partnered with CareCredit to offer flexible payment plans for our patients. CareCredit provides convenient payment options so that you can get the treatment you want and need while paying for it over a period of time, often without incurring interest charges. It’s ideal for co-payments, deductibles, and treatments not covered by insurance. Search for your local clinic here and complete the CareCredit Application to find out what monthly payment options are available for you.
FLEXIBLE SPENDING ACCOUNTS & HEALTH SAVINGS ACCOUNTS
Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) are a great option for those looking to use pre-tax dollars to pay for physical therapy.
Flexible Spending Accounts are set up through your employer and must be used by the end of each enrollment year. Health Savings Accounts allow you to spend money on qualified health expenses or medical costs not covered by your insurance. There is no deadline for withdrawing funds from an HSA, and unlike FSAs, anyone can set one up. All plans are different – it’s best to contact your insurance provider for details on eligibility and benefits.
ACCEPTED INSURANCE PLANS
We accept a variety of health insurance plans for patients needing musculoskeletal care. We’ll work with you and your health plan to make the payment process as easy and hassle-free as possible. For more information or questions on coverage, please contact your insurance agent or give your local clinic a call.
Another Bonus?
The therapists at TexPTS are specialists, not generalists, which means you get results in fewer visits, saving you time and money.
The Bottom Line:
Don’t delay or avoid physical therapy due to your high deductible plan. If you have questions about your specific plan, payment options, or the Care Credit process, let’s discuss it! Our expert billing team can help. Email [email protected].