By Kandy

There are some insurance companies that cover CPT therapy on an out of network basis although you may feel more comfortable calling your insurance company to verify your benefits prior to receiving services from Clear Passage therapies. Since CPT does not participate with any insurance providers we are considered out of network for all insurance plans.

In today’s society we all need to lead a pro-active approach to not only our health but also to being informed and up to date on our insurance benefits. There are many different types of insurance companies and multiple different plans within each company. To help reduce the stress of whether or not your particular insurance provider will cover treatment with Clear Passage therapies please consider the below suggestions when contacting your insurance company.

Inquire to what type of out-of-network benefits are available to you for out-patient physical therapy as you are coming to CPT for treatment of pain and/or adhesions to be performed by licensed therapists. Specifically explain to your insurance provider that you are going to be receiving several hours of therapy per day (usually 4 hours a day over the course of a 5 day week for a total of 20 hours).  The insurer may want to know why you are receiving more than one hour of therapy a day, please explain that you are attending an accelerated program for treatment of pelvic adhesions or physical therapy for pelvic or other related pain.

Educate the insurance company by letting them know that the reason you are going out of network for this service is because there are no clinics within your network that perform this particular specialized service, therefore your only option is to seek services outside the network. Also remind them that repeated diagnostic tests, hospital claims, and/or surgical interventions will in the long run cost the insurance company more money in paid claims than 20 hours of this accelerated therapy.

Another question that may arise by the insurance company is what procedural codes are going to be billed during your treatment with Clear Passage therapies. Please let them know that all of the codes being used are approved by the American Medical Association and include common physical therapy codes such as the following:

• 97001- Physical therapy Initial evaluation
• 97110- Therapeutic procedure
• 97112- neuromuscular reeducation
• 97140- manual therapy
• 97530- therapeutic activities to increase function
• 97535- self care education

Finally, find out at what level of reimbursement you can expect to receive from your insurance once you submit your claim. This way you will know what to expect beforehand.

By Kandy

One of the frequently asked questions I receive during a phone conversation with someone inquiring into Clear Passage is, “Why do I need to submit a health questionnaire before I can schedule services?” I hope the brief summary below will give you a better understanding as to the relevance of the health questionnaire.

The health questionnaire plays an important part in Clear Passage as it allows our therapists to review your past medical history which aids them in determining whether our services are appropriate for you.

Each individual has his/her own personal experiences in which you have lived through and the questionnaire is a tool used to help our therapists understand your individual needs and goals. For example, let’s say that you have a history of ovarian cysts, which you indicated on your questionnaire. However, if you did not completely fill in the section specially designed for cysts, that would then impair the review process as we would need additional information supporting any past actions taken regarding your ovarian cysts. In the end, we would request that you send us additional information to aid in a final determination as to whether our treatment is appropriate for you.

The questionnaire also assists our Therapist Director at the time of your phone consultation, as it gives her an opportunity to have a look at your past medical history which aids her during the question and answer process of the phone consultation.

I hope that this short summary has given you a better understanding of the relevance of the health questionnaire.  I look forward to having the opportunity to speak with you!

By Kandy

One of the frequently asked questions I receive during a phone conversation with someone inquiring into Clear Passage is, “Why do I need to submit a health questionnaire before I can schedule services?” I hope the brief summary below will give you a better understanding as to the relevance of the health questionnaire.

The health questionnaire plays an important part in Clear Passage as it allows our therapists to review your past medical history which aids them in determining whether our services are appropriate for you.

Each individual has his/her own personal experiences in which you have lived through and the questionnaire is a tool used to help our therapists understand your individual needs and goals. For example, let’s say that you have a history of ovarian cysts, which you indicated on your questionnaire. However, if you did not completely fill in the section specially designed for cysts, that would then impair the review process as we would need additional information supporting any past actions taken regarding your ovarian cysts. In the end, we would request that you send us additional information to aid in a final determination as to whether our treatment is appropriate for you.

The questionnaire also assists our Therapist Director at the time of your phone consultation, as it gives her an opportunity to have a look at your past medical history which aids her during the question and answer process of the phone consultation.

I hope that this short summary has given you a better understanding of the relevance of the health questionnaire.  I look forward to having the opportunity to speak with you!