Physical Therapy FAQ

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AthletePlus - Springdale, Arkansas - Athlete Plus - Physical Therapy - Sports Training - Athlete Plus - Speed Training - AthletesPlus - Core Training the Suckerfish

Phone: 479-751-THER (8437)

Physical Therapy Frequently Asked Questions

What happens during my first visit?
What do I need to bring to the first visit?
Where are you located?
How long will each treatment last?
How many visits will I need?
Why is physical therapy a good choice?
What do physical therapists do?
Why should I go to physical therapy?
When Do You Need a Physical Therapist?
Why should I choose a private practice physical therapist?
Who pays for the treatment?
Who will see me?
What if need to cancel my therapy appointment?
Is it important to come to every visit of physical therapy?
Is physical therapy painful?
How does the billing process work?
Can I go to any physical therapy clinic?
Can I go directly to my physical therapist?
Where should I go for physical therapy or how should I choose a physical therapist?
Will you take my insurance or work with me if I need to be cash based patient?
Do you have flexible hours?
Do you have a form to fill out for feedback or patient satisfaction?
What is your privacy policy?
Do you have any information on insurance and how to get the best coverage?
What Can You Do to Improve Your Physical Therapy Coverage?
Choosing a Health Plan
More on Physical Therapy

What happens during my first visit?

Office manager will take your paperwork if filled out beforehand or give you a clipboard with the forms to fill out. Evaluation will consist of questions about your medical history, current and past injuries, activities that make the symptoms worse or better, effect on activities of daily living, and goals with physical therapy. An evaluation then occurs to assess strength, range of motion, special tests, etc. to assess the injury. Depending on the injury, neurological screening and other tests may occur. Depending on time, treatment may begin on the first day. Your therapist will then discuss the findings and a plan of care. You may ask questions during this time as we will discuss number of treatments per week, goals, home exercise programs, and discharge planning.

What do I need to bring to the first visit?
We ask that you arrive about 15 minutes early before your first visit in order complete paperwork. You may download the paperwork if you want to fill it out and bring to the clinic to save time.

Present Prescription from your MD usually on a small sheet of paper
Present your insurance card and drivers license for us to make a copy. If you are covered by workers comp, bring your claim number and your case manager's contact information. If you are covered by auto insurance, make sure you bring this information.
Wear or bring loose fitting clothing to allow the therapist to access the body part that is injured

Where are you located?
See the map here for our convenient location. Since sitting and driving often aggravate orthopedic problems such as back and neck injuries, there should be a very good reason for you to drive a long distance for physical therapy.

How long will each treatment last?
Each treatment will last 30 minutes to an hour, depending on your diagnosis and treatment needed.

How many visits will I need?
That will depend on your diagnosis, evaluation, plan of care, and response to treatment. Your doctor or insurance also may dictate the number of visits.

Why is physical therapy a good choice?
Physical therapists (PTs) are health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives.

PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

Physical therapists provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a physical therapist practices.

All PTs must receive a graduate degree from an accredited physical therapist program before taking the national licensure examination that allows them to practice. The majority of programs offer the doctor of physical therapy (DPT) degree.

What do physical therapists do?
Physical therapists seek to restore function, whether it is an adult to return to work, an athlete to return to his or her sport, or a senior adult to be able perform gardening for example. In outpatient therapy, our goal is to get to the source of the problem, attempt to solve the problem and get the patient independent in his or her home exercise program to prevent the injury from occurring again. They also restore, maintain, and promote overall fitness and health

Why should I go to physical therapy?

Physical therapists are experts in how the musculoskeletal and neuromuscular systems function.
Physical therapist services are cost-effective. Early physical therapy intervention prevents more costly treatment later, can result in a faster recovery, and reduces costs associated with lost time from work.
Patients pay less when they have direct access to physical therapy services. However, there can be a temptation under managed care to terminate services prematurely. A study conducted to determine whether direct access to physical therapy services was cost-effective found that patients who went directly to a physical therapist had fewer episodes of care, and services were ultimately less costly.

When Do You Need a Physical Therapist?
The following list contains some of the most common reasons to see a physical therapist and those conditions treated at AthletePlus.

Back conditions
Knee problems
Shoulder/arm conditions
Neck conditions
Sprains and muscle strains
Ankle/foot problems
Carpal tunnel syndrome, hand/wrist problems
Hip fracture
Post-surgical rehabilitation
Rehabilitation after a serious injury (eg, broken bones, head injury)
Stroke rehabilitation
Problems with balance
AthletePlus will electronically or manually send your billed charges to your insurance company.
Disabilities in newborns

Why should I choose a private practice physical therapist?
Many physicians own their own therapy department. While there are some good therapists working for physicians, many studies have demonstrated disadvantages to the patient. One study found physician-owned clinics treat patients for 50 percent more visits than do independent clinics (1) Another study demonstrated that self-referral increases the cost of medical care covered by workers' compensation for each of the three types of service studied physical therapy, psychiatric evaluation, and magnetic resonance imaging (MRI)--. (2) Still one more study indicated that licensed and non-licensed therapy providers spent less time with each patient in physician owned clinics and physical therapy assistants were substituted for physical therapists. (3) Physicians will claim they work better with therapist on site and a better continuum of care. Private practice therapists are very qualified and always follow protocols set by orthopedic physicians.

Mitchell JM, Sass TR. J Health Econ. 1995 Aug;14(3):263-89. Physician ownership of ancillary services: indirect demand inducement or quality assurance?
Swedlow A, Johnson G, Smithline N, Milstein A.N Engl J Med. 1992 Nov 19;327(21):1502-6. Increased costs and rates of use in the California workers' compensation system as a result of self-referral by physicians.

Who pays for the treatment?
AthletePlus accepts and will file most insurances, but a copay or co-insurance may be required on your part. Some patients elect to be treated on a cash basis. Speak with our business manager for details on insurance. We have flexible plans for those without insurance.

Who will see me?
A licensed physical therapist will evaluate you and we make every attempt for you to see the same therapist each treatment to develop a relationship and continuum of care. Many clinics will have an unlicensed aide do all the treatment each session.

What if need to cancel my therapy appointment?
If possible, please allow 24 notice if you can not make your appointment. There are usually other patients that could have used that appointment time. If you need to cancel or re-schedule, call 751-8437.

Is it important to come to every visit of physical therapy?
AthletePlus will complete a care plan that requires attendance for an optimal recovery. One reason many patients do not improve is because of inconsistent attendance patterns or many cancels.

Is physical therapy painful?
Because we attempt to find the root cause of the problem, the initial evaluation may cause soreness. But pain relief measures called modalities or hands-on techniques are usually used to decrease the soreness from the first visit.
Exercises should not cause your initial pain to worsen. If pain gets worse and worse during exercises, we ask the patient to perform the exercises in a smaller range of motion or with less weight. If the pain continues to worsen with each repetition, the patient should stop and tell his or her therapist. In some cases where range of motion is vital, such as a frozen shoulder or stiff knee, pain may be caused.

How does the billing process work?
AthletePlus will electronically or manually send your billed charges to your insurance company. We will submit claims on your behalf to your insurance company. For billing questions, amanda@athleteplus.net
or call 751-8437.

Can I go to any physical therapy clinic?
Yes, you have the right to choose any therapy clinic, even if you choose not to go to the therapist at your physician’s office. Just ask your doctor for a referral to the clinic of your choosing.

Can I go directly to my physical therapist?
In Arkansas, we have direct access. This means that you may go to a physical therapist directly for an initial consult. Insurance does not pay for this service, so the patient will be sent to a physician if needed. A patient may pay cash or credit card for therapy treatment without a physician referral.

Where should I go for physical therapy or how should I choose a physical therapist?Is the therapist experienced in treating your injury? Do not be afraid to call the clinic and speak to the therapist directly. Our number is 751-8437. Is the therapist qualified? See our physical therapist bio for qualifications. Care should include a variety of techniques which might include hands-on techniques, soft tissue work, therapeutic exercises and in some cases heat, cold, electrical stimulation or ultrasound. Make sure that you receive physical therapy from a licensed physical therapist. Physical therapists are professional health care providers who are licensed by the state in which they practice. If you are receiving physical therapy from a physical therapist assistant, be sure that he or she is supervised by a licensed physical therapist. <li><a href="PTFAQ.shtml">PATIENT QUESTIONS </a></li>
Keep in mind that your insurance policy may require a visit to the primary care physician first or limit your access to only preferred providers. Your physician may refer you for physical therapy that is to be provided in his or her office or to a facility in which he or she has a financial interest. If either situation is the case, insist that your physical therapy be provided by a licensed physical therapist.

Will you take my insurance or work with me if I need to be cash based patient?
Some clinics will not take a patient if they do not have the right insurance or an insurance that will pay the clinic well. AthletePlus will allow payment plans. Some policies require co-payments for services and the co-payment will be dependent on if the physical therapist is part of the insurer's provider network. You will also have to meet your deductible..

Do you have flexible hours?
AthletePlus offers later appointment times and even Saturday appointments if needed

Do you have a form to fill out for feedback or patient satisfaction?
You can send us feedback through this form

What is your privacy policy?
Our privacy policy can be obtained at our office.

Do you have any information on insurance and how to get the best coverage?
Physical Therapy & Your Insurance: A Patient's Guide to Getting the Best Coverage

The best way to take care of your health is to take an active role in your own health care. To do this, you need to know about your options and your rights as a patient. Patients across the country are becoming better educated and demanding more and better options from their health insurance companies. The right to physical therapist services is an important option, and it is your right as a patient.

Federally qualified HMOs are required to have physical therapy in their benefits packages.

In most states you may see a physical therapist without a doctor's referral, but be sure to check your health insurance plan to see if physical therapist services are covered without a physician's referral.

What Can You Do to Improve Your Physical Therapy Coverage?

    * Talk with your employer/benefits manager. The employers who contract and pay for employee health care plans often have the most influence with insurers. Employers are interested in keeping their employees on the job and their premiums low, so providers who can help employees prevent injuries and avoid recurrence (as well as promote a healthy lifestyle) have particular appeal to them. Arrange a meeting with your human resources director or whoever is responsible for negotiating the terms of the company's insurance plan.

    * Ask your human resources director or insurance company the following questions to determine if your current benefits package gives you access to appropriate physical therapy services:

1. Is your physical therapy benefit "bundled" with those of other providers of care?Physical therapy services should be listed separately in the benefit language so that access to necessary services is not compromised.

2. Does the benefit language permit access to physical therapists for each condition during the year?Benefit language should permit treatment of more than one condition in a calendar year (eg, ankle fracture in January and low back injury in July).

3. Does the benefit language permit access to physical therapists for each episode of care?A person may require more than one episode of care for the same condition. For example, someone with arthritis may receive physical therapy intervention for knee weakness in an attempt to avoid surgery. While this is often successful, some patients may still require surgery for the knee condition (eg, total knee replacement), which may require post-operative physical therapy treatment. The benefit language should support each "episode of care."

4. Does the benefit language ensure coverage that facilitates restoration of function?Benefit language that restricts physical therapy care to a 60- or 90-day period imposes an arbitrary limit on recovery. In determining an appropriate physical therapy benefit that will allow an individual to return to his or her previous level of function, benefit language should reflect the normal amount of time that it takes to recover from an injury or from surgery.

5. Does the benefit language ensure coverage that promotes functional independence for those with chronic conditions?Someone who has a chronic condition may need to be seen periodically by a physical therapist. The physical therapist will determine if the individual's home program, equipment, or adaptive devices should be modified. (For instance, children requiring orthotic devices will need modifications to those devices as they grow.) Benefit language should ensure that someone with a chronic condition may receive the kind of care that promotes personal safety and the greatest degree of function possible.

    * Give the attached educational brochure to your human resources director.

    * Send the attached educational brochure to your insurance company and ask for increased coverage of physical therapy care.

Choosing a Health Plan

Millions of Americans are offered a choice of health plans through their employers, but the question is —What makes a good health care plan? Here are some things to consider when choosing a health plan.

    * Are you choosing a plan simply because it is the cheapest? This may not be the best way to go. Some inexpensive plans have a high deductible and no comprehensive coverage.

    * Is the plan accredited by the National Committee on Quality Assurance? This is a good indicator of quality.

    * Are your current doctors and specialists in the plan? If not, make sure you will be able to see a certain provider or specialist, such as a physical therapist, without too much added expense and difficulty.

    * Is physical therapy coverage adequate?If you should have an injury or illness requiring rehabilitation, you will need a plan that offers an unlimited number of visits to a physical therapist or that allows for the number of visits to be extended if needed.

    * Are there lifetime limits on benefits? If so, you could face a serious financial crisis if you or a covered member of your family suffers a major illness or injury.

    * Does the plan have an out-of-pocket maximum? In this case, once you have paid a certain amount (usually several thousand dollars) the plan would cover the rest.

    * How does the plan handle grievances and appeals? The procedure should be simple, timely, and accessible.

    * Does the plan permit use of outside doctors, specialists, or hospitals? Called "point-of-service" option, this would allow you to see a provider, such as a physical therapist, who is not in your plan. There may be an additional cost, but it may be worth it.

    * What is the plan's disenrollment rate? A high rate of members leaving the plan annually may indicate customer dissatisfaction.

    * Can you help me with common insurance terms?

Navigating your way through health insurance benefits can be a challenge. It is very important to understand the terminology especially when deciding which benefits will work for you and finding a plan that will best meet your needs. This brief glossary will provide insight for some of the more common terms when dealing with health insurance.

co-insurance: in indemnity, the monetary amount to be paid by the patient, usually expressed as a percentage of charges.

co-payment: in managed care, the monetary amount to be paid by the patient, usually expressed in terms of dollars. consumer driven health care (CDHC): refers to health plans in which employees have personal health accounts such as a health savings account, medical savings accounts or flexible spending arrangement from which they pay medical expenses directly.

deductible: the portion of medical costs to be paid by the patient before insurance benefits begin, usually expressed in dollars.

denial: refusal by insurer to reimburse services that have been rendered; can be for various reasons.

eligibility: the process of determining whether a patient qualifies for benefits, based on factors such as enrollment date, pre-existing conditions, valid referrals, etc.

exclusions: services that are not covered by a plan.

flexible spending arrangements (FSAs): an account that allows employees to use pre-tax dollars to pay for qualified medical expenses during the year. FSAs are usually funded through voluntary salary reduction agreements with an employer.

gatekeeper: in managed care, it refers to the provider designated as one who directs an individual patient's care. In practical terms, it is the one who refers patients to specialists and/or sub-specialists for care.

health maintenance organization (HMO): a form of managed care in which you receive your care from participating providers.

health savings account (HSA): a savings product that serves as an alternative to traditional health insurance. HSAs enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.

managed care: a method of providing health care, in which the insurer and/or employer (policyholder) maintain some level of control over costs and utilization by various means. Typically refers to HMOs and PPOs.

member: a term used to describe a person who is enrolled in an insurance plan; the term is used most frequently in managed care.

open enrollment: a set time of year when you can enroll in health insurance or change from one plan to another without benefit of a qualifying evening.

out-of-pocket: money the patient's pays toward the cost of health care services.

payer: the party who actually makes payment for services under the insurance coverage policy. In the majority of cases, the payer is the same as the insurer. But, as in the case of very large self-insured employers, the payer is a separate entity under contract to handle the administration of the insurance policy.

policyholder: purchaser of an insurance policy; in group health insurance, this is usually the employer who purchases policy coverage for its employees.

preferred provider organization (PPO): a form of managed care in which the member has more flexibility in choosing physicians and other providers. The member can see both participating and non-participating providers. There is a greater out-of-pocket expense if member sees non-participating providers.

premium: the cost of an insurance plan shared by employer and employee.

provider: one who delivers health care services within the scope of a professional license.

reimbursement: refers to the payment by the patient (first-party) or insurer (third-party), to the health care provider, for services rendered.

More on Physical Therapy

Physical therapists are experts in "the science of healing and the art of caring." This is what that means:
The Science of Healing.

Patients and physicians are demanding the talents of physical therapists for conservative management of a wide variety of conditions. In many cases, patients are being sent to physical therapy instead of surgery.

Physical therapists help people with orthopedic conditions such as low back pain or osteoporosis; joint and soft tissue injuries such as fractures and dislocations; neurologic conditions such as stroke, traumatic brain injury, or Parkinson's disease; connective tissue injuries such as burns or wounds; cardiopulmonary and circulatory conditions such as congestive heart failure and chronic obstructive pulmonary disease; and workplace injuries including repetitive stress disorders and sports injuries.

Physical therapists practice in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes.

Some physical therapists seek advanced certification in a clinical specialty, such as orthopedic, neurologic, cardiovascular and pulmonary, pediatric, geriatric, sports physical therapy, or electrophysiological testing and measurement.
The Art of Caring.

The individualized, "hands on" approach that characterizes physical therapist care is highly valued by patients. When a physical therapist sees a patient for the first time, he or she examines that individual and develops a plan of care that promotes the ability to move, reduces pain, restores function, and prevents disability. The physical therapist and the patient then work side-by-side to make sure that the goals of the treatment plan are met.

Therapeutic exercise and functional training are the cornerstones of physical therapist treatment. Depending on the particular needs of a patient, physical therapists may "manipulate" a joint (that is, perform certain types of passive movements at the end of the patient's range of motion) or massage a muscle to promote proper movement and function. Physical therapists may use other techniques such as electrotherapy, ultrasound (high-frequency waves that produce heat), hot packs, and ice in addition to other treatments when appropriate.

Physical therapists will also work with individuals to prevent loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

It is important to know that physical therapy can be provided only by qualified physical therapists or by physical therapist assistants working under the supervision of a physical therapist. http://www.apta.org/Content/NavigationMenu/Consumers/consumer1.htm
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