Insurance Plans We Accept

Insurance Terms

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Deductible – The portion of any claim that is not covered by the insurance provider. It is the amount of expenses that must be paid out of pocket before the insurer will cover any expenses. It is normally quoted as a fixed amount and must be paid in full by the insured before the policy benefits can be applied. This amount starts over at the beginning of the plan year.

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Co-payment – A payment defined in the insurance policy and paid by the insured person each time a medical service is provided. This amount is set by the insurance policy and must be paid before any policy benefit is payable by the insurance company.

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Co-insurance – The percentage paid by the insured after the deductible amount has been met up to the policy’s stop loss. It is expressed as a pair of percentages with the insurer’s portion stated first. 70/30, 80/20, and 90/10 are all common co-insurance percentages with the insurance company covering, for example 70% and the patient being responsible for the remaining 30%. Once the patient has met their out of pocket expense maximum the insurance company will assume responsibility for 100% of the costs.

Workers Compensation

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* We do not accept auto-accidents and legal cases unless it is worker's compensation.

Medicare Physical Therapy Cap

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Medicare currently has a set limit on the dollar amount of physical therapy services a patient can receive in a year. This initial cap is $1,900 and includes outpatient, home health and inpatient rehab physical therapy settings. Some patients may be eligible for additional services beyond the initial cap. Your therapist can determine if you qualify. OSPT tracks this dollar amount in house. However, if you received therapy services elsewhere during the year we may not be aware of those charges. This cap resets each year on January 1.