Thank you for choosing Lisenby Physical Therapy for Women, Inc. and/or Lisenby Physical Therapy for All for your physical therapy needs. Please review the following policy regarding financial responsibilities for your care.
All co-pays, co-insurance, deductibles, and self-pay balances are due at the time of service.
We require a valid credit card to be retained on file for payment. If you do not wish your credit card to be charged at the time of service, please provide an alternate form of payment at each time of service and make arrangements with us for any outstanding balances that may remain following your discharge from care. A $35 fee will be charged for any returned check unpaid by your financial institution. Please be advised any billing related statements, receipts, or outstanding balances will come via email from Kareo Patient Portal, our secure billing software platform. You may pay any outstanding balance through this secure portal as well. If you have not provided us an email, you will receive all billing related material via mail.
Insurance and personal information provided must be accurate and up to date. Failure to notify us of changes to your insurance may result in delays in processing or denials to your claims for which you will be responsible.
Your progress in therapy is directly tied to your adherence to your prescribed treatment plan. It is our top priority to help you attain your goals. To do this, we book a one-on-one session for you with your therapist for every visit. If you do not show for your appointment, we do charge a $100 no show fee as we are then unable to fill your reserved spot with another patient. If you cancel with less than 24 hours notice, we charge a $50 fee. If you need to cancel or re-schedule, please give us greater than 24 hours notice to eliminate incurring any fees.
Past due accounts will be charged a delinquency fee of 1.5% per month if left unpaid after 60 days beyond the initial billing period. Lisenby Physical Therapy for Women, Inc. and/or Lisenby Physical Therapy for All reserves the right to submit all necessary information to a collections agency for failure to pay 90 days beyond the initial billing period. You will be responsible for the balance defaulted and all charges including collection agency fees, which are typically 33% to 50% of the unpaid balance, recorder's fees for depositions and at trial expenses we incur in enforcing our rights under this policy.
We participate in several insurance plans. If you have provided your insurance information, as a courtesy we have verified your physical therapy benefits to the best of our ability at the time requested. This is, however, not a guarantee of coverage. It is your responsibility to be aware of your individual benefits, including all deductible amounts, copays, and coinsurances and whether you are in-network or out-of-network. You will be responsible for all balances due not covered by your insurance company. Please be aware that some, and perhaps all, of the services provided may not be completely covered by your insurance company. Please notify us immediately of any changes to your insurance policy.
If you do not carry health insurance, or wish to not bill your insurance, our self-pay rate for a physical therapy evaluation is $150 and for physical therapy treatments are $125 per visit.