Insurances We Are Out of Network Providers
We are Out of Network Provider (OON) for Medicare Advantage (Part C) PPO plans including but not limited to:
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United
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Aetna
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Cigna
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Humana
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And more…
We are also OON providers for Tricare!
Questions?
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FAQ
What does being an Out of Network Provider mean?
Being out of network providers means that our practice isn’t in contract with an insurance provider to become In-Network Provider. It is important to note that insurances often still have out of network benefits. This means if you seek care from an out of network provider, you may still only pay a coinsurance or copay. If you have any questions on what your out of network benefits for physical therapy are, please give us a call at 903-492-5215, fill out a contact us form, or reach out to us on the live chat feature.
What is a copay and what is a coninsurance?
Copay is the amount you pay per visit. Coinsurance is the amount you pay which is a percentage of the cost of billed services for that visit. For example if your coinsurance is 30% and the total cost for that visit is $100 then you owe $30 for that visit.
The difference: Copay is the same regardless if you have met your deductible. Coinsurance only kicks when you meet your deductible. Until you meet your deductible, you pay 100% for each visit if you have a coinsuranc benefit. In regards to payment, copays is the same every visit so it can be charged at the visit. Coinsurances will need to be billed first to the insurance because your insurance needs to determine the cost of services for your visit. That way your consinurance that you are responsible for paying can be calculated. Once your insurance calculates everything, you will be sent a bill for the portion of services you are financially responsible for.
Are all of your services covered by insurance?
Physical therapy is covered by your insurance as long as we are in-network with your insurance or you have out of network physical therapy benefit.
More specialized treatments such as dry needling, shockwave therapy, and subzero cryotherapy are not covered by insurance or Medicare.