OT Physical therapy billing

I've spent my fair share of time in physical therapy, but this recent one was for my daughter. She dislocated her shoulder, and the doctor said she should get physical therapy to strengthen it up.

So we make an appointment for the initial consult. We go in and they take our insurance, and say "ok your co-pay is $20/visit with your insurance". I say that's fine, and pay the bill. The therapist says we can come 1-2x a week, and have daily exercises to do at home. I say we can come twice a week, $20 isn't bad.

That was in october-november. 2 months of physical therapy. Last week I get a bill saying it's $100/visit with my insurance, and they'd like the remainder, another $1200. I said that's not what you told me. I paid the $20 every visit, now two months later you tell me it's going to be that expensive? I was furious. I would not have opted to go twice a week had I known ahead of time how much it would cost.

Do I have a leg to stand on? This seems like a real racket when they tell me one thing, then two months later turn around and send me this huge bill.

When they told you $20 did you have a witness?
Every time you paid did you get a receipt?
if so did it say paid in full?

Maybe not in response to your post exactly but I had a knee replacement in October and our health system up here (which paid for the
replacment) gives a guy seven paid-for visits to a private physio place after surgery. The system schools you on after-surgery exercises to
get your range of motion back along with a valuable exercise booklet and recovery program. After that, we have a bit of extra physio
insurance, for every $80 visit (regular fee) I paid $45. During the freebie sessions, I realized that I was pretty much doing at the physio
clinic as what I did at home on my own. OK, a few different exercises added on here and there, but for knee recovery there are only two
basic exercises to do .... flexion and extension. Each one has hundreds of possibilities for the same basic exercise. I saw untold numbers
of good exercises on the internet and a lot of good videos as well. After one visit where I was paying $45 I stopped going. Is physio a
rip off? Hmmm, good question. Exercises are necessary for sure, but does the system (or myself) have to pay someone else to monitor my
exercise program? Even the flexion and extension measurements themselves (degree values) ...... I made my own measuring device and still
do that on my own (along with my exercises every day). Great if someone else is paying the full freight, maybe not so great when you're on
your own. Good luck with the situation you are in.

Same thing happened to us with that "Free Annual Physical" that everybody's entitled to now. The wife wanted the whole battery of tests including a colonoscopy. The insurance company said sure,no problem,it's covered and it's free.
We got a bill for $1650. She called the insurance company. They said if it had been done in the doctors office it would have been free,but since it was done in the hospital,where you have to go for a colonoscopy,it was only covered 70% since we have a 70/30 until we meet the deductible. Merry Christmas.

I was in the hospital for fluid on my lungs back in October. Was treated with drugs. No incisions of any kind. Insurance paid $28,639.07 for the stay. They refused to pay a charge for $224. Now I have received a bill from the hospital as follows- Physical Therapy $446.91, Occupational Therapy $445.00,Other $262.05.

During my stay the Physical Therapy lady came to my room and asked if I could walk to which I replied that I could do it and had just walked down the hall and back. She asked to see me walk and then told me there was nothing they could do for me. The next day the Occupational Therapy lady came to the room and asked if I could walk. Told her that the Physical Therapy person checked me out the day before and everything was fine. She left without further comment.
My daughter, who used to work in the billing dept. of the hospital is trying to check things out.

Now if they insist that I pay this bill they will be waiting for a long time. I don't pay for thins I didn't order or receive. If they tell me that my credit rating will take a hit I'll tell them the same thing I told the Visa people. At the ripe old age of 80 and not having used credit, other than the Visa card which is paid in full every month, for the last 30 years go ahead and do your thing. And I'll see you in court.

Every little thing now seems like it goes towards your deductible until that is met.

Health care REFORM should start with paperwork standardization I say.

The physical therapy department exists mainly as a cash cow for the hospital. Yes, in some cases a patient will benefit greatly, but if it wasn't for insurance, most of the physical therapy departments would not exist.

Sounds like what happened to me back about 38 years ago. I slipped and my hand went down between the moldboard and coverboard of the plow and I sliced my hand to the bone,severing the tendons to my right thumb. I had to go in to the outpatient department every other day or so and have the bandage changed and have it checked. The doctor told me that the next time in,he'd take out the stitches. I was down to just a band aid on it. Before I went in,I changed the band aid. I got there,the nurse pulled off the new one and immediately stuck another new one on. I said "I thought he was taking the stitches out today?". She said "The doctor has already gone to his office.". I had to pay to have her rip off a new band aid and put another new one on. Why couldn't she just tell me before hand that the doctor had already gone? One of them things that makes your head want to explode.

Most insurance has a co-pay and a deductible. The $20 per visit is your co-pay. Does your insurance also have a deductible or a 70/30 payment policy until the deductible is met? The $100 per visit could easily be your requirement under the deductible.

My first thought was what drussel said.

My insurance is deductible of $600, co-insurance of x%, and maximum out of pocket of $3000.

I am getting PT for my knee twice a week so I met my deductible the first week, all on me.

I am wondering if they neglected to tell you about the deductible.

Paul

As we used to say in the service. Didn't get done because it would make too much sense.

I didn't see any of the replies says this--My doctor told me I could do the therapy myself and didn't need to come in. Told me to hold a 5 lb weight and do the following exercises and handed me a sheet of exercises. I start doing them every time the torn rotator cuff starts hurting. Just need to strengthen the muscles around the cuff.
Now the doctor bill--yes their trying to rip you off! You have 2 options 1) call and try to get them to back off or 2) Call the insurance company and let them deal with it. Most likely the insurance has a agreement whereby the hospital agrees to accept what they are given and not ask for more.

Read over your insurance policy or check with your insurer directly. There is no "normal" in health insurance, so it's difficult for clinics and doctors to estimate your costs or deductibles.

I have a receipt for every visit, says copay paid in full. THe insurance company did hteir magical adjustments, but everything goes to the normal deductable($11,000/yr for hte family). HOwever the lady specifically told me that the insurance was $20 copay. The only witness would have been my 14 year old daughter. However I have all my paperwork.

The insurance didn't change hteir policy, the people just informed me incorrectly, portrayed it like a bargain seemingly to get me to come in more often than really necessary.