1. I understand and agree that I will be financially responsible for any and all charges for services not paid by my insurance for my visits.
2. I understand and agree it is my responsibility, and not the responsibility of PT Professionals, to know if my insurance will pay for medical services provided by this office.
3. I understand and agree it is MY RESPONSIBILITY TO KNOW IF MY INSURANCE HAS A DEDUCTIBLE, OUT OF POCKET EXPENSES, CO-INSURANCE, CO-PAYMENTS, POSSIBLE OUT OF NETWORK EXPENSES, ANY OTHER TYPE OF BENEFIT LIMITATIONS, AND I AGREE TO MAKE FULL PAYMENT WHENEVER REQUIRED!
4. I understand and agree IT IS MY RESPONSIBILITY TO KNOW IF PT PROFESSIONALS IS IN-NETWORK with my insurance. If the office is considered out-of-network, it may result in claims being denied or a higher out of pocket expense to me. I understand this and agree to be financially responsible and make full payment. However, we are a participating provider with local insurance plans, which is considered in-network.
5. I understand it is my responsibility to inquire with my insurance plan on how many visits of outpatient physical therapy I am allowed per year if the office is not able obtain this information.
Precautions - Pregnant women, elderly persons with any heart disease, diabetes, high or low blood pressure should not enter the whirlpool without prior medical consultation and written permission from their Doctor.
No Exceptions - No person may enter the pool or whirlpool if suffering with any of the following; bowel or bladder incontinence, open/bleeding or draining wounds, or any communicable disease.
Observe the 15 minute time limit in the whirlpool. Long exposure may result in nausea, dizziness, or fainting. Enter and exit slowly.
Showering - Prior to entering the pool or whirlpool, each patient must shower and must be attired in appropriate swimwear. Please limit your shower time before and after your appointment as other people need to use the facilities.
Please avoid the use of baby powder and other substances that can spill on the floor and pose a safety risk, as well as unsightly conditions. Please pick up after yourself and place all clothing and other articles in a locker. DO NOT leave them in a changing room, on the floor, in the bathroom stall, or on the bench as other patients will be utilizing those areas.
Physical Therapy Professionals, PC is committed to providing you with the highest quality of care and in order to maintain that level of excellence we ask that you provide at least 24 hours notice of a cancellation.
We do realize that things come up that make it impossible to keep your scheduled appointment. Specifically illness, transportation issues, hazardous driving conditions, or family emergencies. Cancellations without 24 hours notice will be accepted in these circumstances on a one time basis only. Any additional instances will be subject to a $20.00 charge and must be paid at your next scheduled visit.
Not showing for your appointment (no show) is unacceptable and a fee of $20.00 will be charged in every instance. This fee will be expected to be paid at your next scheduled visit.
This fee is not covered by your insurance and it will be your responsibility to pay no matter what type of coverage that you have. If the fee is not paid, you will be billed and this balance is subject to collections.
Please be considerate of other patients and our staff and call as soon as possible if you are unable to attend your scheduled physical therapy visit.