In the state of Georgia, you are allowed to see a physical therapist without seeing a physician first.
- Arrive at your appointment with your paperwork completed (you can download it from here – see the paperwork or forms link).
- You will provide us with your prescription for physical therapy.
- We will copy your insurance card and picture identification.
- You will be seen for the initial evaluation by a licensed clinician.
- The clinician will discuss the following:
- Your medical history.
- Your current problems/complaints.
- Pain intensity, what aggravates and eases the problem.
- How this is impacting your daily activities or your functional limitations.
- Your goals with physical therapy.
- Medications, tests, and procedures related to your health.
- The therapist will then perform the objective evaluation which may include some of the following:
- Palpation – touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
- Range of Motion (ROM) – the therapist will move the joint(s) to check for the quality of movement and any restrictions.
- Muscle Testing – the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
- Neurological Screening – the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
- Special Tests – the therapist may perform special tests to confirm/rule out the presence of additional problems.
- Posture Assessment – the positions of joints relative to ideal and each other may be assessed.
The clinician will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient’s input. This includes how many times you should see the clinician per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created with input from you, your clinician, and your doctor.
Make sure you bring your referral (provided to you by your doctor) and your payment information. If your insurance is covering the cost of physical therapy, bring your insurance card. If you are covered by Workers’ Compensation, bring your claim number and your case manager’s contact information. If you are covered by auto insurance or an attorney lien, make sure you bring this information.
You should wear loose fitting clothing so you can expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination.
This is highly variable. You may need one visit or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc. You will be re-evaluated on a regular or daily basis and when you see your doctor, we will provide you with a progress report with our recommendations. However, Most patients are seen 2-3 times weekly until you are Beyond Better is common with scheduling. Your clinician will work with you to determine the best schedule to meet your needs.
You have probably heard of the profession of physical therapy. Maybe you have had a conversation with a friend about how physical therapy helped get rid of his or her back pain, or you might know someone who needed physical therapy after an injury. You might even have been treated by a physical therapist yourself. But have you ever wondered about physical therapists–who they are and what they do? Many people are familiar with physical therapists’ work helping patients with orthopedic problems, such as low back pain or knee surgeries, to reduce pain and regain function. Others may be aware of the treatment that physical therapists provide to assist patients recovering from a stroke (e.g., assisting them with recovering use of their limbs and walking again).
The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we are able to continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.
Because physical therapists are experts in movement and function, they do not confine their talents to treating people who are ill. A large part of a physical therapist’s program is directed at preventing injury, loss of movement, and even surgery. Physical therapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide services to athletes at all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, a number of physical therapists are engaged in consulting with recreational golfers and fitness clubs to develop workouts that are safe and effective, especially for people who already know that they have a problem with their joints or their backs.
The cornerstones of physical therapy treatment are therapeutic exercise , manual therapy, and functional training. In addition to “hands-on” care, physical therapists also educate patients to take care of themselves and to perform certain exercises on their own. Depending on the particular needs of a patient, physical therapists use manual therapy on joints and muscles to promote proper movement and function. Physical therapists also use modalities as needed to help with relief. Although other kinds of practitioners will offer some of these treatments as “physical therapy,” it’s important for you to know that physical therapy can only be provided by qualified physical therapists or by physical therapist assistants.
Most forms of physical therapy treatment are covered by your insurance, but the coverage will vary with each plan. Direct access, without seeing a physician is available as well. Most of the time all you have to do is ask your doctor if physical therapy is right for you.
Reference: APTA
Athletic trainers are health care professionals who collaborate with physicians to optimize patient and client activity and participation in athletics, work and life. The practice of athletic training encompasses the prevention, examination and diagnosis, treatment, and rehabilitation of emergent, acute, subacute, and chronic neuromusculoskeletal conditions and certain medical conditions in order to minimize subsequent impairments, functional limitations, disability, and societal limitations.
The Athletic Training Scope of Practice is defined within two professional publications: the Athletic Training Educational Competencies (Competencies) published by the National Athletic Trainers’ Association (NATA) and the RoleDelineation Study (RDS) conducted and published by the Board of Certification, Inc. (BOC). Eligibility for the BOC exam is contingent upon completion of a program accredited by the Commission on Accreditation of Athletic Training Education (CAATE) that must instruct the Competencies within the curriculum.
Passage of the certifying examination is a requirement for licensure in most states. Athletic trainers’ work settings can include high schools, colleges, universities, professional sports teams, hospitals, rehabilitation clinics, physicians’ offices, corporate and industrial institutions, the military, and the performing arts.
Regardless of their practice setting, athletic trainers practice athletic training (or provide athletic training services) according to their education and state practice act.
Reference: NATA
Who is better to see, a PT that works for a physician or a PT that owns a private practice? We leave it up to you to draw your own conclusions but here are some facts. The studies indicate there were more treatments (visits per patient were 39% to 45% higher in physician owned clinics) and the cost was greater for those patients that attended a physician owned physical therapy practice (both gross and net revenue per patient were 30% to 40% higher)
1 Another study indicated that licensed and non-licensed therapy providers spent less time with each patient in physician owned clinics and physical therapy assistants were substituted for physical therapists.
2 We believe that we can provide you with the highest quality of care available and do it in a cost-effective manner.
3 You will work closely with your physical therapist and in most instances, your case will be managed by the same physical therapist from the beginning to the end of your experience with us.
- Mitchell, J., Scott, E., Physician Ownership of Physical Therapy Services: Effects on Charges, Utilization, Profits, and Service Characteristics, Journal of the American Medical Association, 1992.
- “Joint Ventures Among Health Care Providers in Florida,” State of Florida Health Care Cost Containment Board, 1991.
- Federal Office of the Inspector General May 1, 2006 – This report calls into question billing processes done by non-physical therapist owned practices.
In most cases, health insurance will cover your treatment. Click here for a summary of insurances we accept and make sure you talk to our receptionist so we can help you clarify your insurance coverage.
Ultimately it is your responsibility to understand your insurance coverage. We will verify your benefits prior to your arrival however quoted rates are never a guarantee of payment. If you have a deductible, copay, or coinsurance we will require payment prior to each visit. We can also offer interest free payment plans.
Flare ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.
In most cases, you have the right to choose any physical therapy clinic. Our practice is a provider for many different insurance plans.
The best thing to do is give us a call and we will attempt to answer all of your questions.
Billing for physical therapy services is similar to what happens at your doctor’s office. When you are seen for treatment, the following occurs:
- The physical therapist bills your insurance company, Workers’ Comp, or charges you based on Common Procedure Terminology (CPT) codes.
- Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
- The payer processes this information and makes payments according to an agreed upon fee schedule.
- An Explanation of Benefits (EOB) is generated and sent to the patient and our clinic with a check for payment and a balance due by the patient.
- The patient is expected to make the payment on the balance if any.
It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, poorly communication, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.
Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you. Physical Therapists can be your guide for rehabilitation and wellness.
In most cases, health insurance will cover your treatment. Feel free to call our office so we can help you clarify your insurance coverage.
Ultimately it is your responsibility to understand your insurance coverage. We will verify your benefits prior to your arrival however quoted rates are never a guarantee of payment. If you have a deductible, copay, or coinsurance we will require payment prior to each visit. We can also offer interest free payment plans.
All Atlanta Rehabilitation & Performance Center locations participate in the following insurance plans:
- Aetna PPO/HMO/POS
- Beechstreet PPO & Workers Compensation Network
- Blue Choice POS
- Blue Choice PPO & Blue Cross Blue Shield of Georgia (Includes Federal Plan)
- Cigna PPO & POS
- Community Care Network (CCN) PPO & Workers Compensation
- Companion Workplace Health MCO
- Corvel PPO & Workers Compensation Network
- Coventry
- First Health PPO & Workers Compensation Network
- Focus Healthcare Management PPO
- Focus Healthcare Workers Compensation Network
- Gaston-Loughlin MCO Workers Compensation Network
- Georgia 1st (State Health Benefit Plan)
- Golden Rule Insurance (This is a division of UHC)
- Great West Healthcare / One Health Plan
- Gwinnett County Schools Workers Compensation Network
- Health Payors Organization
- Humana Choice Care Network PPO
- Humana Military (Champus / Tricare Standard)
- Integrated Health Plan
- Medicare
- Multiplan PPO Network
- NovaNet PPO Network
- Oxford Health Plans (First Health)
- Plan Vista Solutions (NovaNet)
- PPONext PPO & Workers Compensation Network
- Preferred Plan of Georgia (Part of Multiplan Network)
- Private Healthcare Systems (PHCS)
- Railroad Medicare
- Southcare
- Unicare PPO
- United Healthcare (All Plans)