Frequently Asked Questions – Insurance/Billing
Advance Physical Therapy participates with several insurance providers including Medicare, Tricare, Blue Cross Blue Shield*, and Medicaid (for children 21 and younger). We also offer a discounted self-pay rate and accept CareCredit. Not all insurance policies include benefits for Out-of-Network providers. It is the patient’s responsibility to verify specific policy coverage provided by your insurance company for physical therapy and any patient responsibility costs for services provided. When calling your insurance company to verify benefits/coverage for your policy, please specify the request is for physical therapy in a private, outpatient office setting. Your insurance provider will determine your coverage.
IN-NETWORK INSURANCE COVERAGE
Advance Physical Therapy will bill your insurance company for the services provided, upon request. Your insurance policy is a contract between you and your specific insurance company. Your coverage and benefits are determined by your insurance company. Your insurance company reserves the right to decide what services are medically necessary for you and which health related services they will cover. Advance Physical Therapy will verify your eligibility for coverage.
OUT-OF-NETWORK INSURANCE COVERAGE
If Advance Physical Therapy is considered an out-of-network provider with your insurance network, we may bill your insurance as a courtesy, upon request. However, payment is due at the time of service. Payment by out-of-network insurance companies will be paid directly to the insured party.
DISCOUNTED SELF-PAY RATE
Advance Physical Therapy also offers a self-pay rate. Please call our office to inquire about our discounted Self-Pay rates.
BLUE CROSS BLUE SHIELD POLICIES
BCBS of NC’s BlueValue Plan was created in 2013 and only included specific providers as participating, after which the network was closed to additional providers. Advance Physical Therapy is not a participating provider for the BlueValue network. Please review the following notice from BCBS for additional information: www.bluecrossnc.com/document/closed-counties
BlueLocal only includes providers within Wake Forest Baptist Health System.
DO I NEED A REFERRAL FOR PHYSICAL THERAPY? Advance Physical Therapy does not require that you have a referral. Some insurance companies require that you obtain a referral for physical therapy, including Medicare, Medicaid, TRICARE PRIME and some
BCBS policies. Please contact your insurance company to verify if your specific policy requires a referral.