At Seacoast Hand Therapy
We have prepared this information for you so that you can feel confident in your search for the right specialized therapy.
Due to the ever changing world of medical insurance policies, we strongly suggest that each patient become knowledgeable and informed regarding your individual insurance policy coverage for Physical and/or Occupational Therapy.
Please contact your insurer to determine if the service being prescribed is reimbursable. All managed care plans require authorization. Patients with managed care plans need to contact their Primary Care Physician for the initial referral /authorization. Some insurers are contracting out with “managed care networks” for benefit specialties such as Physical and Occupational therapies. This often involves additional prior authorization not only from your insurer but also from the managed care network.
Sample Questions to ask your provider
Listed below are some sample questions to ask when inquiring with your medical insurance company regarding benefits available to you for Physical and/or Occupational Therapy & Durable Medical Equipment.
Do I need a PCP referral?
Even though my (i.e., orthopedic physician) referred me to Seacoast Hand Therapy?
Do I need prior authorization for Physical and/or Occupational Therapy?
Do I have a Separate Deductible for Physical and/or Occupational Therapy?
Do I have a Maximum Therapy Benefit?
Number of office visits / or a limited time period.
Is there a maximum dollar benefit?
Do I have a Coinsurance responsibility and /or Co-Pay per visit responsibility?
(this is often different than a physician office visit)
Do I have DME (durable medical equipment – i.e. splinting/orthosis) Coverage?
Sometimes this type of coverage has a separate deductible and/or coinsurance.
Sometimes a “Pre-cert Authorization” is required
The Seacoast Hand Therapy professional team strives to provide the highest standard of individualized care for each patient. We hope that this “outline” will assist you in becoming familiar with the optimal benefits available to you.