Thank you for choosing Brewer Physical Therapy as your health care provider. We are committed to your treatment being successful.
Please understand that payment of your bill is considered part of your treatment. The following is a statement of our Financial Policy which we require you read and sign prior to any treatment.
All patients must complete our Information and Insurance form before seeing the therapist.
- The part of the bill that you owe is always required at the time of service. We do not bill our co-pays, deductibles, or the part your insurance does not pay. FULL PAYMENT IS DUE AT TIME OF SERVICE.
- We make it easy to collect payment at the time of service. You may choose to pay with cash, check or credit card. A convenient option is Our EASY-PAY program which allows us to capture your credit card/ debit card on file.
- If you are uninsured, all fees are required at the time of service.
Regarding Insurance, HMO/PPO plans, Indemnit Insurance, and Other Third Party Liability Claims:
As a service to you, we will call your insurance company or other third party payer in an attempt to determine your benefits prior to: your first therapy visit and prior to purchasing any medical equipment/ supplies. Keep in mind that what we are quoted is not a guarantee of payment, and you are ultimately responsible for any expenses incurred if your insurance does not pay what you expected. It is best if you know what your therapy benefits are before your first visit. Your insurance policy is a contract between you and your insurance company. We are not a party to that contract. Sometimes we are quoted differently than your claim is processed, when this occurs you will be notified. Keep in mind that some claims require 30-45 days to process after the time of service has occurred.
**If at anytime during your treatment it is determined that your injury was dur to an accident and the insurance refuses payment, you will be held 100% responsible for any/all monies due to Brewer Physical Therapy.
Notification of Insurance Changes
We will submit claims to your insurance company or other liabilit plan if you provide us with the current insurance information. Please notify Brewer PT of any changes to your insurance during time of treatment.
Usual and Customary Rates
Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area.
It is your responsibility to notify us if you have attended therapy elsewhere or received HOME HEALTH in the past year as this may affect your patient balance.
Adult patients are responsible for full payment at time of service.
The adult accompanying a minor and the parents (or guardians of the minor) are responsible for full payment. For unaccompanied minors, non-emergency treatment will be denied unless charges have been pre-authorized to an approved credit plan, Visa/MasterCard, or payment by cash or check at time of service.
Unless canceled at least 24 hours in advance, our policy is to charge for missed appointments at the rate of $25. Please help us serve you better by keeping scheduled appointments.
We reserve the right to charge interest in the amount of 12% as provided by state law for a rebilling fee.
Thank you for understanding our Financial Policy. Please let us know if you have any questions or concerns.
I have read the Financial Policy. I understand and agree to this Financial Policy: