Insurance

FHC - MEDICARE REPLACEMENT
POINT of SERVICE PLAN

• There is no pre-approval necessary from Florida Health Care
• A doctor's referral is required
• A new doctor's referral is required if we treat a different body part
• The patient has a co-pay (some policies $20; some $30; some 20%, etc.)

FHC - TRIPLE OPTION
there are different levels (level I; level II)

• There is a limit to the number of visits per calendar year
• A doctor's referral is required
• A new doctor's referral is required if we treat a different body part
• The patient has a $500 per calendar year deductible
• The patient has a co-pay (some policies $20; some $30; some 20%, etc)

FHC - HMO (a.k.a. Premium Plus)

• The patient is required to get prior approval from Florida Health Care before the appointment with us by asking the doctor to submit an order for physical therapy treatment to Florida Health Care
• A doctor's referral is required; the doctor submits an order for physical therapy treatment to Florida Health Care
• Florida Health Care will contact the patient to inform them if they have or have not been approved
• A new doctor's referral is required if we treat a different body part
• The patient may have a deductible; there are several commercial plans with different options
• The patient may have a co-pay; there are several commercial plans with different options

Notice to VOLUSIA Health Network Patients

Effective January 12, 2012, Thomas Orthopedic & Sports Physical Therapy will no longer have the opportunity to serve you through Volusia Health Network.

Volusia Health Network has chosen not to renew our contract. They have been more than happy with our association and the patient care, but report that this is a business decision that had to be made.

To those patients that have started treatment with us, according to the terms of our contract with Volusia Health Network, we can continue to treat you through completion of your plan of care set at the time of your initial evaluation.

We are disappointed that we can no longer offer you the care we have enjoyed providing for you for the past year. Of course, you may choose to continue your care with us; however, it will have to be payment "out-of-pocket" as we will now be out of network.

If you have any questions or would like to voice an opinion to VHN, we have outlined contact names and numbers below.

Karen Aalbregtse
VHN Operations Manager
386-239-2322

Jean Carroll
VHN Provider Relations Coordinator
3865-4254-4846/option #3/option #1

• Most private insurance policies cover physical therapy fees. Prior to your appointment, we advise that you call your insurance company to see what your benefits are and if you are required to have therapy authorized.
• We ask that you bring payment at the time of service and your insurance will reimburse you.
• We will assist you in getting reimbursement from your health insurance benefits by submitting your claim electronically.

• We bill Medicare directly and the reimbursement goes to you the patient.
• We ask that you bring payment at the time of service. If you find this a hardship, we will be happy to work with you to make special arrangements.
• Most secondary insurance companies are billed by Medicare (called "cross-over"), and again those reimbursements go directly to you.
• Medicare requires that you have a referral from your doctor.

• We bill your automobile insurance directly and are paid directly by the insurance company.
• Please contact your insurance company to see if you are required to have a referral from your doctor.
• We ask that you supply us with the appropriate information to verify your benefits when you schedule your appointment with us:

• We bill your workers' compensation insurance directly and are paid directly by the insurance company.
• Please contact your insurance company to see if you are required to have a referral from your doctor.
• We ask that you supply us with the appropriate information to verify your benefits when you schedule your appointment with us:

As always, if you should have any questions, please feel free to contact us at: Thomas Orthopedic & Sports Physical Therapy (386) 257-2672.