Insurance

Essential Foundations Pelvic PT is an "Out of Network" Provider and does not contract with any insurance companies. This means fees for services are collected at time of service and that you are responsible for submitting any claims to your insurance if you wish to seek reimbursement. We are not at this time eligible to treat patients with Medicare. So if you are a Medicare patient please contact us so we can make you a proper referral.

By providing physical therapy on a "fee for service" basis, we do not have to limit the time or the quality of treatment we provide because of insurance company restrictions.

Physical Therapy clinics under contract with insurance companies are forced to allow the insurance company to dictate what treatment may be received and for how many visits and patients are often double and triple booked.

Our mission is to help you achieve your goals for your quality life quickly with personalized one on one care without limitations. We work for you not your insurance company.

REFERRALS

In New Jersey patients have "direct access" to physical therapy without needing a referral from a physician, midwife, or other health care provider. Occasionally, an insurance provider will require a referral in order for you to be reimbursed for physical therapy services so it is suggested that each patient verify with their insurance provider whether pre-authorization is required to be reimbursed for out-of-network physical therapy services.

After the first 10 visits or 30 calendar days, we will send a report to your prefered medical provider to review our therapy plan of care in order to be in open communication. If at any point that physical therapy is no long longer appropriate for you or you would benefit from another medically specialized professional you will be informed and assisted in finding the appropriate care.

REIMBURSEMENT

For those interested in the potential reimbursement for Physical Therapy services, please contact your insurance company to inquire about the specifics of your benefits. Upon booking your evaluation, you will receive an Insurance Benefits Worksheet which will serve as a will guide with questions to ask your insurance company about their coverage of "out of network physical therapy".

A receipt for services will be provided at the end of your sessions. It is your responsibility to submit to your insurance company. The amount of reimbursement you receive will vary according to the terms of your insurance policy. Some companies may reimburse you at 80%, some at 60%, some at 40%, and some may not reimburse you at all. We cannot make guarantees or estimates regarding what reimbursement your plan allows.

* Workshops, Events, and Pregnancy Care Services are considered informational and education; therefore wellness services are out of pocket fees and are not subject to reimbursement by insurance.

CANCELLATION POLICY

Cancellations that occur less than 12 hours before appointment will be charged a fee of $50 dollars per incident.