No Referral Needed

Also referred to as Direct Access. It is commonly believed, but untrue, that a referral is needed to see a physical therapist. In Oklahoma you can be seen for 30 days without a physician referral. Medical physicians specialize in medical conditions while physical therapists specialize in biomechanical issues that affect function and respond best to movement and precise manual therapy. Understanding this fact will save you time and money and get you to the right professional to get the care you need. If your condition requires a physician care we will refer you to your primary care provider or appropriate specialist. *Your insurances may require a physician referral as part of your policy agreement. We will check and verify all your benefit coverages prior to your visit.

2nd Opinion

When should I seek a second opinion?
  • When you don’t feel like you are being heard.
  • When you are not being offered options or feel like they might not be comprehensive.
  • When your doctor recommends a serious, but non-emergency surgery.
  • Disappointment with your current treatment results.
  • When you are told there is nothing that can be done for your condition.
  • When your doctor recommends surgery as the ONLY treatment option.
  • When your condition is unresponsive or returns after treatment.
  • When the doctor is unable to give you an accurate diagnosis.

Don’t Give Up! You owe it to yourself to feel better, and at Function Physical Therapy we have been fortunate to help people succeed when they thought there was no hope. It is amazing the type of results you can get when you start treating the causes of your problems, instead of just treating symptoms. If physical therapy is not appropriate for you, we can help you explore and understand your options to help determine the next best step in your care.

Choose PT 1st

Unfortunately, musculoskeletal pain is often untreated, mistreated, and mismanaged in medicine. Costly and unnecessary tests, (like x-rays and MRIs), unneeded surgery, and narcotics (including opioids) are used to treat symptoms instead of the root cause. These treatments lead to higher costs, persistent or recurrent pain, activity limitations, loss of confidence and frustration. Biomechanical causes of your pain are usually over looked but have been proven to be the most cost-effective treatment to you empower you to move better with less pain and limitations.

Insurance & Cost Information for Physical Therapy

Our goal is to provide as much transparency as possible for the costs of your care at Function Physical Therapy. Below is a list to help you better understand your insurance and costs for our services.

  • USING YOUR INSURANCE

    Cost is determined by your insurance policy physical therapy benefits, we do not control the cost.

    • DEDUCTIBLE: Is a set amount you must pay towards your medical bills before your insurance company will pay anything. This amount will vary depending on your insurance company and policy. Until this is met, you will be responsible for cost of services.
    • COINSURANCE: Is the amount you share with your insurance company ONLY after your deductible is met. It is usually a percentage that is shared depending on your insurance carrier and policy. Only applies once the deductible is met.
    • COPAY/COPAYMENT: Is a flat fee you pay every time you have an appointment. The amount is set by your insurance carrier and policy. The insurance carrier usually covers the remaining cost of your visit unless there is also a deductible, each policy will vary.
    • Average Costs
      • Will vary depending on the insurance carrier and policy.
      • First Visit including the evaluation: $65-$165
      • Follow up visits: $65-$125
  • HELPFUL HINTS
    • Some insurance companies have a physical therapy visit limit.
    • Physical therapy is usually a combined benefit with Chiropractic and Speech Therapy.
    • If you are enrolled in Home Health Care, your insurance will NOT pay for concurrent outpatient physical therapy services.
  • Please review your insurance verification form that will be given to you at the initial evaluation, it will have all of your physical therapy benefit details on it.

  • NO INSURANCE/SELF PAY
    • We determine and set the cost of treatment.
    • First Visit including the evaluation: $145
    • Follow up visits
      • 60 Min follow up-$100
      • 30 Min follow up-$75

UNDERSTANDING YOUR EXPLANATION OF BENEFITS (EOB)

DEDUCTIBLE

Is the set amount you pay every year towards your medical bills. This will vary with every insurance plan.

Example

Your insurance plan has a $1500 deductible. You will be responsible for the toal amount of your medical bills up to $1500 for the year. Your insurance coverage begins after this is met. Deductible reset at the beginning of each year.

COINSURANCE

Is a % of our medical bill that your insurance will share with you after your deductible is met.

Example

Your insurance plan has a 70/30 coinsurance. If your bill is $100, the insurance plan will pay $70 and you would be responsible for $30. Only applies if the deductible is met.

PROCEDURE CODE

Is the medical code that we send to the insurance company to bill for our services.

Example

During your treatment we do a hands on technique, we would use the “97140” code which the insurance company labels Manual Therapy.

BILLED AMOUNT

Is our set amounts we use in our fee schedule for each procedure code and to determine the number of procedure codes used.

Example

If the procedure code “97140” was used the billed amount will be $60. If 2 of those codes are used, the billed amount will be $120.

PROVIDER DISCOUNT

Is based on what our contracted rate is with the insurance company. This is the amount the insurance company discounts our charges for service.

Example

If the procedure code “97140” was used the billed amount will be $60. The insurance company may provide a $25 discount so the billed amount becomes $35.

ALLOWABLE AMOUNT

The amount the insurance company will pay for our services.

Example

If the procedure code “97140” was used the billed amount will be $60. The insurance company may provide a $25 discount so the billed amount becomes $35 and they may pay that amount if deductible is met.

Questions?

If you have any further questions, please contact Shelby by phone: (405) 285-9659 or email: billing@FunctionOK.com