FAQ's

DO YOU ACCEPT INSURANCE?

No, YouFirst Physical Therapy is a cash-based business. In a cash-based treatment model, the physical therapist enters into a contract with the patient to provide physical therapy services in a manner that both parties have determined will help them reach treatment goals most efficiently. The patient pays at the time of service, allowing the therapist to focus attention on providing the best possible service while keeping administrative costs low. You may pay for services using actual cash, a check, Cash-app such as Venmo/paypal or a credit or debit card. Payment is expected in full at the time of services.

Typically, coding for physical therapy services provided (CPT codes) is determined using a complex matrix of "timed codes" and "untimed codes".  This often results in confusing patient bills, as the amount billed to insurance will vary visit to visit based on the exact services provided that day.  Cash-based billing eliminates this confusion and allows for clarity in decision making on the part of the patient and their provider.  Documentation for evaluations, treatment visits, and progress notes are performed just like any physical therapy practice and comply with all legal requirements.

CAN MY INSURANCE BE BILLED FOR CASH-BASED PHYSICAL THERAPY SERVICES?

Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide payment for services received "out of network".  Going out of network means that you can choose to see a physical therapist who is not a participating provider with your insurance company.  Many patients choose to receive services out of network in order to see the physical therapist of their choice.  The end goal of documentation and billing is the same - getting paid - it's just that, in the case of cash-based services, it is the patient who is waiting for reimbursement rather than the provider. 

YOUFIRST IS AN OUT OF NETWORK PROVIDER - WHAT DOES THIS MEAN?

This simply means that the therapist has not entered into a contract with individual insurance companies to receive reimbursement based on their contracted rates.  There are MANY insurance companies, each with their own contracted rates and regulations, and YouFirst Women's  Health and Wellness Physical Therapy’s energy is best spent working with patients.  It is important to note that in network provider status is not currently based on education, experience, skills, or treatment outcomes, but is often determined by the number of providers in a demographic area.  

WILL I END UP PAYING MORE FOR CASH-BASED PHYSICAL THERAPY?

In many cases, the out of pocket expenses for a course of physical therapy will actually be LESS for services provided at YouFirst!  In large part, this is due to the ability to charge less per visit, with these charges being well below the national average charge submitted to insurance in a typical fee for service outpatient practice.  You First Women's Health and Wellness Physical Therapy can charge less because the simplified cash-based fee structure streamlines billing and does not require hiring billing personnel or paying fees to a third party billing service.  This allows  YouFirst staff to focus all energy on patient care, and allows patients to make informed decisions regarding the costs of their health care choices.  

HOW DO I FIND OUT MY INSURANCE BENEFITS FOR OUTPATIENT PHYSICAL THERAPY?

Contact your provider to determine if you can submit claims from Cash-based physical therapy services.

WHAT STEPS ARE INVOLVED IN SUBMITTING A CLAIM TO MY INSURANCE COMPANY?

The process is actually quite simple:  Dr. Jaime Bicknell at YouFirst will provide you with an invoice at the time of service, and you may submit that invoice and receipt to your insurance company for reimbursement. The invoice has all of the necessary  information (business name and address, tax ID, national provider identification, license numbers, etc.) as well as the patient’s ICD-10 (diagnosis) and CPT (billing) codes. You may choose to submit bills following each visit, one time per month, or at any other interval, typically up to one year following your treatment visit.  

MY INSURANCE CARRIER IS MEDICARE - ARE THERE ANY SPECIAL RULES THAT APPLY TO PHYSICAL THERAPY SERVICES?

At this time, YouFirst has chosen not to accept Medicare patients. If you have a supplemental insurance that you plan to submit to, that will be acceptable.

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ADA COMPLIANCE

Dr. Bicknell's home office space is a private room in her home and requires a steps to enter. If you have any disability limiting your ability to enter the home/office, Dr. Bicknell will  make accommodations to either treat via telehealth or at your home.

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NON-DISCRIMINATION POLICY

YouFirst does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.  We are committed to providing an inclusive and welcoming environment for all patient/clients.

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HOW MANY TIMES DO I NEED TO ATTEND THERPY?

Together, we agree on a plan that works for your busy life and your financial needs. Our goal is to give you information and our best professional opinion on what you can expect in terms of healing tissues, strengthening muscles, and improving function without pain. There is never any pressure on you to do more than you can. The individualized home exercise program you receive on your first follow-up visit is a crucial part of your care. We want to work with you for the best results.

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DO I NEED A PRESCRIPTION?

As in nearly all states, here in New York you have direct access to a physical therapist. That means you can come in and be evaluated and treated without a doctor’s prescription or referral. However, if treatment extends beyond 30 days or 10 visits—whichever comes first—you will need a referral for physical therapy. You can get a referral from a physician, physician assistant, or nurse practitioner licensed to treat in New York, often by a phone call!  During your initial evaluation, your physical therapist will ask you several questions about your condition, previous level of function and how is your present condition affecting the way you live. The initial evaluation is necessary for your PT specialist to understand what you are dealing with. Therefore, the specialist can create a better suited treatment plan for you.