Navigating this system is confusing and time consuming—after all, you're a patient, not an insurance expert.
In recent years, insurance policies and billing requirements have become more complex. Insurance companies are requiring more and more documentation, and even PPOs may require pre-authorization for PT services.
That's why Sarton PT goes above and beyond to help you get the best possible benefits from your insurance company and will advocate on your behalf to get the coverage you pay for and deserve.
Sarton Physical Therapy routinely surveys other PT clinics to ensure that the claims submitted to your insurance are on par with the other providers in our area and specialty, and to put you in the best position to meet your deductible quickly, without any additonal out-of-pocket expense. We will not only submit your claim, but also assist you in obtaining the required authorizations. Patients who self-submit claims or authorization requests are more likely to be denied for benefits, especially out of network. This could result in an appeals process which is complex and often lengthy with no guarantees.
When you choose to receive treatment from us, we provide all of these services at no cost to you to make your experience as hassle- and stress-free as possible, so that your focus is solely on healing.
We offer courtesy insurance billing through our billing specialist Donna Mancini. She can be reached at Donna@pelvichealing.com or by calling 949-298-4188. She is available to you for answers to any further questions regarding Sarton Physical Therapy’s billing and insurance policies.
- We are an out of network provider for all insurance companies. There is great variety in out-of-network physical therapy benefits. When verifying insurance benefits - it will help to specify that you will be receiving “outpatient physical therapy services” and that Sarton Physical Therapy is “out-of-network.”
- All out-of-network insurance benefits will be dealt with on a case-by-case basis.
- Once your deductible is met - we will work to have your out of pocket costs be as close to your in-network copayment as possible.
- Patients are fully responsible for knowing their individual insurance plans and coverage for Sarton Physical Therapy services.
- We are not a contracted Medicare provider. Unfortunately federal law prohibits physical therapists that do not contract with medicare from treating Medicare Part B recipients, regardless of payment method.