Balance Physical Therapy
Should I come early to fill out paperwork?
Please arrive 15-20 minutes early for your first appointment to check in and complete your paperwork. This allows your treating therapist to do a complete chart review, obtain imaging records if necessary, and it helps us start your evaluation on time. You also have the option of downloading the forms in advance from our website. Click on the “Patient Center” tab, then click on “Patient Forms”.
What should I bring to my first appointment?
Please bring your Doctor’s prescription, or “referral” for physical therapy (if you have one) along with your insurance card(s) and a photo ID. If you have any reports from a surgery (operative report) or diagnostic images (x-rays, MRI’s, CT Scans, etc.) please bring those as well.
How long is my appointment?
Each evaluation is one (1) hour in length and is spent entirely with your physical therapist. Return visits can range from 45-90 minutes depending on the severity of your condition and the intensity of your rehabilitation program.
What can I expect on my first visit?
On your first visit, your physical therapist will perform a thorough evaluation of your posture, strength, range of motion, and a functional biomechanical analysis of the involved region. Expect to be educated, have your questions answered, and to develop an understanding of exactly what is necessary for you to regain your prior level of function. You will be working together to develop a comprehensive treatment program to address your needs.
What should I wear?
Please wear comfortable clothing (shorts or workout pants, and a tank top or t-shirt) that allows the therapist access to the body region to be evaluated. For example, for women with shoulder and neck issues, wearing a tank top, camisole, or sports bra will allow your therapist better access to your area of concern. And please don’t worry, all of our evaluations are conducted in private exams rooms for your comfort.
Do you have a changing room?
Yes, we have several private rooms for you to change your clothes before and after your visit. We also offer a secure place in plain view of everyone to store your personal items during your treatment session.
Do you take my insurance?
We take all insurances except for Medi-Cal (Central Coast Alliance). When you call to make your first appointment, we will request your insurance information so that we may call to verify your physical therapy benefits with your particular plan. We will call you prior to your first appointment to review your coverage based on what is quoted to us by your insurance. If we are not contracted with your insurance, we will work with you to establish your out-of-pocket costs as long as your plan has out-of-network benefits. We are contracted providers with Medicare & Aspire/Monterey Bay IPA.
How does Balance PT calculate the portion of patient responsibility paid up front?
This all depends on your plan coverage and whether or not your annual deductible has been satisfied for the current calendar year. If your deductible has not been met, it is your responsibility to pay for all cost until your plan starts to pick up their portion. If this is the case, we will work with you by collecting payments that we apply towards the total deductible balance that is applied to our claims. The payments we collect to apply toward your deductible balance are a minimum of $150 for the evaluation and $125 for each follow up visit. Once our claims are processed, if we have not collected enough to cover what your insurance has applied to your deductible, you will be billed the difference between what we have collected and what your insurance has allowed. If we have over collected, you will receive a credit. You always have the option of paying for your entire deductible at once to eliminate any guesswork as to your out-of-pocket costs. Please keep in mind that all plan deductibles are different. Some deductibles are the same whether you go in or out of network and some have a separate out of network deductible.
Once your out-of-network deductible has been satisfied, we will determine your set co-pay based on the percentage of your out-of-network co-insurance per your plan. Please note that every health plan has different reasonable and customary rates, which make it difficult for us to accurately predict your exact costs prior to contacting your insurance. We always do our best to satisfy you!
Do I pay at the time of my visit?
Yes. We kindly request that you pay your co-pay at the time of your visit. You may also pay your co-pays in advance if you would rather not bring your wallet/purse in with you at every visit.
How long will it take for Balance PT to know exactly how much I owe?
Our goal is to have all our billing submitted to your insurance within 7 days of your visit. From there, it is in the hands of your insurance company. On average, we see insurance companies’ process claims within thirty (30) to forty-five (45) days.
Can’t you bill my insurance more so they will pay more?
The amount paid by your health plan is based on the health plan’s reasonable and customary rate, or allowed amount. This is often different than the amount we bill to your insurance company. The amount allowed by your insurance company is based on the services rendered and the geographic region of the provider. The allowed amount for each procedural code is not dependent on the amount billed by Balance PT. We are required to submit charges to all health plans based on our set fee schedule.
Why should I come to Balance PT?
Balance PT is one of the few clinics on the Monterey Peninsula and is the Salinas Valley that offers individualized, patient-focused care. All of our team therapists are among the best in the profession. Following a comprehensive evaluation, your therapist will work with you to develop a unique treatment plan tailored to your specific condition. While our rates may be higher, the individualized, focused care approach we believe in at Balance often results in far superior outcomes in fewer visits than other clinics.
Do you have a back/neck/shoulder/knee specialist?
All of our therapists are trained to treat a variety of conditions. Our office staff can help you determine the best therapist for you to work with based on your injury, sport, or schedule. Please visit our staff page for further information on each of our doctors of physical therapy.
Do I need a prescription/referral?
Although the State of California does not require you to have a prescription from a medical doctor to initiate care, most health insurance companies still do require a physician’s prescription/referral in order to cover physical therapy services. We will help you determine if your insurance company requires a physical therapy prescription/referral prior to your first visit. All patients may choose to directly access us and to be “self-pay” patients, if they choose to do so.
What is the cancellation policy?
We would appreciate 24 hours notice if you need to cancel so that we may open your appointment time to other patients. If you cancel with less than 24 hours notice, we will charge you $25.00 for the late notice. If you do not provide any notice (no-show) for your missed appointment you will be charged a $50 No-Show fee. These fees are NOT covered by your insurance. If you cancel or no-show for three (3) visits with less than 24 hours notice, you will be removed from our treatment schedule until you are able to reschedule at a more convenient time that allows you to fully commit to your rehabilitation.