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Do you take insurance at Functionize Health and Physical Therapy?

Functionize Health and Physical Therapy is not a participating provider with any insurance plans. Why not? Simply put, we would not be able to provide the kind of high level care, variety of services and individualized treatment that we do currently when working with an insurance-based model.

In clinics that bill insurance, therapists must see multiple patients at one time to off set insurance reimbursement rates.  On average, insurance companies tend to reimburse about 40% of what a therapist bills out.  Many outpatient clinics are forced to utilize Physical Therapy Assistants or technicians to oversee a patients care. Often a patient may only spend 10-15 minutes with the Physical Therapist and be sent off to complete their exercises independently.  In addition, insurance companies tend to dictate the number of sessions a patient is allowed regardless of the nature and depth of their injury or condition, causing them to stop therapy short and putting them at increased risk of re-injury.

At Functionize Health and Physical Therapy, you spend the full session with your therapist, and will likely require fewer visits overall to meet your goals. Our cost is $195 for the initial evaluation visit and $165 for all subsequent visits. Depending on your plan, your insurance company may reimburse you for part of the cost.

How do I get reimbursed?

We will provide you with any paperwork and the proper codes necessary, but you will need to send the claim into your insurance company. The insurance company will pay you directly any money. They must not pay us as you have already done that, and we don’t need to get paid twice for the same service!

The amount of reimbursement is completely dependent on your insurance plan. If you call your insurance company to inquire, you should ask about reimbursement for “out-of-network, out-patient Physical Therapy” expenses.

I have Medicare. Can I receive treatment?

At this time we are not able to provide physical treatment to Medicare beneficiaries.  However, we can work with Medicare clients for fitness, prevention, and wellness goals.

Why do I need a doctor’s prescription to attend Physical Therapy?

The State of Georgia continues to require an MD, DO, PA, DDS or DC referral for Physical Therapy treatment beyond 21 days or for trigger point dry needling treatment. This has nothing to do with insurance rules or reimbursement, it’s the law!  We can help coordinate with your physician if you don’t have a referral, or direct you to a physician that can help.

What should I expect at my first visit?

  • Wear comfortable clothes and shoes that will allow your injured area to be examined.

  • Be prepared to move.  A thorough examination of your movement, strength, flexibility, posture, and painful areas will be performed.  We will be looking at multiple body parts to assess your full body’s function.

  • The first visit will involve more discussion and questions than subsequent visits as we learn about you and discuss your goals.

  • There will be time for treatment and developing an initial home treatment program.

How long does a typical session or series of sessions last?

Each session is for a full 50-60 minutes.  Because each person and each injury is different, it can be hard to say how long it will take to be 100% again. You are receiving one-on-one hands-on treatment from a highly skilled therapist, so you should get better faster than traditional therapy clinics. Please understand that an acute injury will probably resolve more quickly than a chronic problem. Also, a complex condition might take time to determine the origin of the problem versus a more straight forward injury. Nonetheless, our goal is to get you back at it as quickly as possible.

We also hope you will add us to your team of medical providers.  If pain returns, we ask that you call us ASAP so we can treat it quickly before it returns to its nagging state.  Our role is not to discharge you and never see you again, rather we see this as a continuation of care that may need a “tune up” from time to time.