In unraveling the challenges of concussion management, practitioners start with understanding the patient’s baseline. Baseline refers to pre-injury abilities: concussion baseline measures commonly include cognition, balance, and vision. When managing concussions and formulating the plan of care, the health care provider’s goal is to achieve the patient’s baseline levels. In sports, if an athlete…
The following are some frequently asked questions about insurance:
Do you take my insurance?
Boston Sports Medicine accepts most major insurance plans. Please call to see if we accept yours. Go to our payment and insurance page to see a list of some of the plans we participate in. We DO NOT accept Mass Health unless it is through Neighborhood Health Plan or Network Health. We DO NOT provide free care.
If I don’t have insurance or you do not take my insurance, can I still get treated at Boston Sports Medicine?
Boston Sports Medicine has low self-payment rates and we do accept all major credit cards and flexible spending accounts. Go to our payment and insurance page to see our current self-payment rates. Payment will be due at the time of your visit.
Does my insurance cover physical therapy?
Most plans do have physical therapy coverage. You will need to call the customer service number on the back of your card to confirm that you have physical therapy coverage.
Can your company tell me how much my insurance will cover and what I will be responsible for?
Every insurance plan is different. Employers and groups negotiate coverage and premiums. Occasionally, the coverage of a plan will change or terminate midway through treatment without us knowing. It is not possible for your provider to know that your coverage changes or terminates, how much coverage you have used before coming to Boston Sports Medicine, how much of your deductible has been used, or how many visits you have left under your plan. Privacy regulations prevent your insurance carrier from providing us that information. Please call the customer service number on the back of your card to verify your physical therapy coverage.
Isn’t it your responsibility to tell me how much my insurance will cover?
It is the patient’s responsibility to fully understand their insurance coverage. It is not the responsibility of Boston Sports Medicine to explain the limits of your insurance coverage. Please call the customer service number on the back of your card to verify your physical therapy coverage.
How much is my copayment?
Usually the copament amount is printed on the front of the insurance card. For BCBS, it reads OV. For some insurances it will be listed under specialist. This can be confusing as plans can change before a new card is issued, some plans actually have a different copayment amount than is listed on the card, and some plans do not show the copayment amount on the card. Please call the customer service number on the back of your card to verify your copayment.
Can you waive my copayments or deductible?
No. We would be in violation of our contracted relationship with your insurance carrier and risk losing our contract if we waived your responsibility for paying a copayment or deductible. Without your payment, Boston Sports Medicine would not be able to provide your service.
Is the copayment like a tip?
No. You insurance carrier has a negotiated discounted fee schedule with Boston Sports Medicine. When we receive payment from your insurance carrier for your visit, they deduct your copayment amount from their payment. You are paying for a sizeable portion of your treatment with your copayment.
When is the copayment due?
The copayment is due at the time of your visit. For your convenience we accept all major credit and debit cards and flexible spending accounts.
What if I have a deductible?
We must bill the insurance first and receive a reply from them assigning a balance to “patient responsibility.” After we receive that, you will get a bill in the mail from Boston Sports Medicine for your balance.
If I have a deductible, how much will be assigned to the deductible for each visit?
We have contracted rates with each insurance carrier we are in network with. For these plans, we can tell you the fee assigned to each procedure. It is not possible for the front office or even your therapist to precisely determine which procedures and how many units of each will be billed for your future visits. Your treatment will change accordingly as you recover. We can give you an estimate based on your initial evaluation and treatment plan.
Will my insurance cover the cost of my equipment and supplies, like electrodes, braces, hot packs, Theraband, and orthotics?
Some insurance companies have “Durable Medical Equipment (DME)” coverage, however Boston Sports Medicine is a physical therapy provider, not a DME provider. Any equipment you purchase through Boston Sports Medicine must be paid for at the time of your visit. We can provide you a receipt to submit to your insurance company.
What is your cancellation policy?
Appointments should be scheduled, changed or canceled at least 24 hours in advance. THERE IS A $50.00 CHARGE FOR MISSED APPOINTMENTS WITHOUT GIVING 24-HOUR NOTICE AND A $75 CHARGE FOR NO-SHOWS. This charge is the patient’s responsibility and cannot be billed to the insurance company. The prescribed treatment plan must be followed to maximize the effectiveness of the treatment. If more than three appointments are missed without notification, care may be discontinued.