BILLING & PRICING

CLIENT -CENTERED AND TRANSPARENT APPROACH

OUR CLINIC PRINCIPLES

✓ COST EFFECTIVE TREATMENT
✓ STRONG COMMUNICATION & PATIENT SUPPORT
✓ STANDARDIZED POLICIES
✓ TRAINED BILLING STAFF
✓ ACCOUNTABILITY & TEAM APPROACH

ADAPT COMMITS TO A CLIENT-CENTERED APPROACH IN OUR BILLING PRACTICE. INDIVIDUAL PRICING STRUCTURE WILL BE DISCUSSED AT YOUR INITIAL VISIT. OUR TOP PRIORITY IS TO PROVIDE YOU THE MOST COST EFFECTIVE SERVICE WITH THE UTMOST TRANSPARENCY.

BELOW IS GENERAL INFORMATION ON PRICING.

BILLING & INSURANCE

ADAPT PHYSICAL THERAPY WILL SUBMIT INSURANCE CLAIMS ON YOUR BEHALF. DEPENDING ON YOUR INDIVIDUAL HEALTH INSURANCE BENEFITS, CERTAIN OUT-OF-POCKET COSTS MAY APPLY. WE ALSO OFFER SELF-PAY (CASH) OPTIONS FOR THOSE WITHOUT INSURANCE COVERAGE OR WHO PREFER TO PAY DIRECTLY.

FOR INSURANCE PLANS WITH A DEDUCTIBLE, WE TYPICALLY COLLECT A SET AMOUNT UP FRONT TO BE APPLIED TOWARD YOUR TOTAL BALANCE. THIS IS NOT A ONE-TIME VISIT FEE, BUT A PAYMENT THAT IS CREDITED TOWARD YOUR OVERALL PLAN OF CARE COST. THESE PAYMENTS HELP MINIMIZE LARGER BALANCES AT THE COMPLETION OF YOUR TREATMENT.

CANCELLATION POLICY

A $50 FEE WILL BE CHARGED TO YOUR ACCOUNT FOR A NO-SHOW OR CANCELLATION MADE LESS THAN 24 HOURS BEFORE YOUR SCHEDULED APPOINTMENT.

PHYSICAL THERAPY

✓ QUALIFIES FOR MEDICAL INSURANCE COVERAGE
✓ CASH PAY OPTIONS AVAILABLE
✓ CREDIT / DEBIT CARDS ACCEPTED
✓ ABLE TO USE HSA/FSA CARDS

    • BCBS

    • Aetna

    • Tricare

    • Cigna

    • United Healthcare

    • Medrisk

    • Oscar

    • GEHA

    • EK Health / Berkley Entertainment

    • Chubb

    • Allied Benefits

    • Secondary insurance plans, including but not limited to:

      • BMI (Bob McCloskey Insurance)

      • AG Administrators

      • HSR (Health Special Risk)

  • The cost of your session will strictly depend on your individual plan coverage & benefits. In some cases, we may not know the exact amount until we send the bill to your insurance company, post-visit. Should you have a deductible or copay associated with your insurance plan, we will take payment at the time of the session and then complete payment once your insurance company returns claims to us after processing.

    To verify your insurance prior to coming in, please send an email to info@adaptathlete.com with your first & last name, and a photo (front and back) of your insurance card.

  • Please call us at (404) 400-6242 to discuss your needs for cash pay physical therapy and we can assist you further.

STEP-BY-STEP BILLING

YOUR INSURANCE PLAN DETERMINES WHAT IS COVERED, COST OF COVERED SERVICES, AND HOW MUCH YOU ARE RESPONSIBLE FOR PER VISIT.

ONCE YOUR INSURANCE PROCESSES THE CLAIM, YOU AND ADAPT PT WILL RECEIVE AN EXPLANATION OF BENEFITS (EOB) DETAILING WHAT PORTION YOU OWE. THE SAME EOB IS SENT TO YOU AND TO ADAPT.

INITIAL EVALUATIONS

THIS IS YOUR FIRST VISIT WITH US OR IF YOU ARE REVISITING AFTER A LONG PERIOD/WITH A NEW INJURY. $55 - $180 PER SESSION FOR PLANS WHERE DEDUCTIBLES HAVE NOT BEEN MET.

FOLLOW-UP APPOINTMENTS

THIS IS EVERY SUBSEQUENT VISIT AFTER YOUR INITIAL EVAL. COSTS ARE BETWEEN $55 - $120 FOR PLANS WITH DEDUCTIBLES THAT HAVE NOT BEEN MET.

CO-INSURANCE

90/10 (PATIENT RESPONSIBLE FOR 10%): $5–$15 PER VISIT, 80/20 (PATIENT RESPONSIBLE FOR 20%): $10–$25 PER VISIT

SELF-PAY

PLEASE CALL (404) 400-6242 TO DISCUSS YOUR INDIVIDUAL NEEDS FOR CASH PAY PHYSICAL THERAPY.

CASH + SPECIALIZED PRICING

OUTSIDE OF REGULAR SESSIONS, WE OFFER ANCILLARY SERVICES, INCLUDING BUT NOT LIMITED TO STRENGTH TRAINING, DRY NEEDLING, CUPPING, NORMATEC BOOTS, GRASTON, AND MORE. THESE SESSIONS CAN BE PERFORMED SEPARATELY OR PRE/POST PHYSICAL THERAPY SESSION.

✓ NO HIDDEN FEES
✓ CREDIT/DEBIT CARD ACCEPTED
✓ PACKAGE OPTIONS AVAILABLE

❌ Qualifies for insurance coverage

DISCLAIMERS & EXPLANATIONS

  • WHEN YOU CALL TO SCHEDULE YOUR FIRST APPOINTMENT OR AT YOUR FIRST APPOINTMENT, WE WILL ASK FOR YOUR INSURANCE INFORMATION. AS A COURTESY, OUR TEAM WILL CONTACT YOUR INSURANCE COMPANY TO VERIFY YOUR BENEFITS AND REVIEW YOUR COVERAGE DETAILS WITH YOU BEFORE YOUR INITIAL VISIT.

    WE ALSO RECOMMEND THAT YOU CONTACT YOUR INSURANCE PROVIDER DIRECTLY TO CONFIRM YOUR PHYSICAL THERAPY BENEFITS PRIOR TO YOUR FIRST SESSION.

    ONCE YOU BEGIN CARE, WE WILL SUBMIT ALL INSURANCE CLAIMS ON YOUR BEHALF SO YOU DON’T HAVE TO WORRY ABOUT ADDITIONAL PAPERWORK OR FORMS.

    BILLING FOR PHYSICAL THERAPY SERVICES WORKS SIMILARLY TO A DOCTOR’S OFFICE. WHEN YOU ARE SEEN FOR TREATMENT:

    1. YOUR THERAPIST BILLS YOUR INSURANCE COMPANY, WORKERS’ COMP, OR SELF-PAY ACCOUNT USING STANDARD CPT CODES BASED ON THE SERVICES PROVIDED.

    2. THESE CODES ARE ENTERED INTO A BILLING SYSTEM AND SUBMITTED ELECTRONICALLY OR BY MAIL TO YOUR INSURANCE PROVIDER.

    3. THE INSURANCE COMPANY PROCESSES THE CLAIM AND MAKES PAYMENT ACCORDING TO YOUR PLAN’S AGREED-UPON RATES.

    4. AN EXPLANATION OF BENEFITS (EOB) IS THEN SENT TO BOTH YOU AND THE CLINIC, DETAILING PAYMENT INFORMATION AND ANY BALANCE DUE.

    5. ANY REMAINING BALANCE NOT COVERED BY INSURANCE IS THE PATIENT’S RESPONSIBILITY AND WILL BE BILLED ACCORDINGLY.

  • ALL ACCOUNTS ARE REGULARLY REVIEWED. PATIENT ACCOUNTS WITH BALANCES OUTSTANDING FOR MORE THAN 90 DAYS, AND WITH NO ACTIVE INSURANCE CLAIMS PENDING, MAY BE REFERRED TO A THIRD-PARTY COLLECTIONS AGENCY IF WE HAVE BEEN UNSUCCESSFUL IN COLLECTING THE REMAINING BALANCE FROM YOU.

    COURTESY CALLS AND EMAIL REMINDERS WILL BE MADE PRIOR TO ANY ACCOUNT BEING SENT TO COLLECTIONS.

  • DEDUCTIBLE: THE AMOUNT YOU PAY OUT OF POCKET BEFORE INSURANCE STARTS TO PAY TOWARDS THE COST OF YOUR CARE.

    COINSURANCE: USUALLY DISPLAYED AS A % OF COINSURANCE. FOR EXAMPLE - A 20% COINSURANCE MEANS THAT YOU WILL PAY 20% OF THE COST OF CARE AND INSURANCE WILL PAY FOR 80% OF THE COST OF CARE AFTER YOUR DEDUCTIBLE IS MET.

    COPAY: THE COST OF EACH SESSION YOU WILL PAY AS LONG AS YOUR OUT OF POCKET AMOUNT IS NOT MET.

    OUT OF POCKET AMOUNT: THE AMOUNT YOU WILL HAVE HAD TO PAY OUT OF POCKET TO GET INSURANCE TO COVER 100% OF YOUR PHYSICAL THERAPY BILL.