How We Handle Insurance & Payment

Why We're Out-of-Network

To provide the level of care our patients need — and the results we're known for — Foundations Physical Therapy does not participate with most commercial insurance plans. All visits are full, one-on-one, hour-long sessions tailored to the individual. An insurance-driven model would require 15-minute visits, handoffs to aides, and visit caps that get in the way of real healing.

By staying out-of-network, we keep clinical decisions between you and your therapist — not your insurance company.

Medicare

We accept Medicare as a non-participating provider, which means:

• Payment is due at time of service
• We submit the claim to Medicare for you
• Medicare submits to your secondary insurance, and you are reimbursed directly

This is different from clinics that "accept" Medicare by collecting only a copay — that model only works for high-volume practices, and it limits how much time you get with your therapist. Because we are not a high-volume clinic, participating in Medicare in this way is the only way we can serve this population properly.

We Submit Your Claims For You — Automatically

Here's the part most patients don't expect: you don't have to file anything. Add your insurance in the Jane patient portal and our billing specialist submits every out-of-network claim on your behalf, automatically, after each visit — reimbursement comes directly to us most of the time from your insurer. Most practices hand you a superbill and wish you luck. We handle the paperwork.

• Free benefits verification before your first visit (an estimate until the first claim processes)
• Every claim submitted for you by our dedicated billing specialist
• Insurer adjustments (deductible met, co-insurance changes) automatically credited toward your next session
• Prefer to verify coverage yourself? We'll provide our TIN and NPI numbers on request

Many of our patients receive substantial reimbursement — sometimes covering 50-80% of their visit fees. We'll help you understand what your specific plan covers.

HSA & FSA

Pelvic floor physical therapy is a qualified medical expense. We accept HSA and FSA cards directly at time of service.

Payment Options

We accept:

• HSA / FSA cards
• All major credit and debit cards
• Cash and check

How to Verify Your Out-of-Network Benefits

Want to know what to expect before booking? Call the member services number on the back of your insurance card and ask:

1. "Do I have out-of-network benefits for outpatient physical therapy?"
2. "What is my deductible, and how much have I met?"
3. "After my deductible is met, what percentage do you reimburse for out-of-network PT?"
4. "Is there an annual visit limit?"
5. "Do I need pre-authorization?"

If that feels like a lot, we'll verify your benefits for you — free, no obligation.