Coinsurance is your share of the costs of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service. You pay coinsurance after you’ve met your deductible. For example, if the health insurance plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your 20% coinsurance payment would be $20. The health insurance plan pays the rest. In-network coinsurances usually are less than out-of-network coinsurances.
Thank you for considering Great Lakes Physical Therapy for your therapy needs. In today’s health care, we are sensitive to the financial concerns of our patients and participate with most health, home, auto, and worker’s compensation plans.
Physical therapy is typically covered by most plans. As a courtesy to our patients, we will verify insurance coverage prior to your arrival to determine if there will be a copay, deductible, or coinsurance for therapy services.
Great Lakes Physical Therapy gladly accepts the insurance plans listed below. If you do not see your insurance listed, please call (231) 744-0077 to verify.
- Accident Fund
- Align Networks
- American Continental Insurance
- ASR Corporation (Physicians Care)
- Auto Owners
- BCBS Federal Employee (FEP)
- BCBS Medicare Plus Blue
- BCN Medicare Advantage
- Central State Indemnity
- Colonial Penn Life Insurance
- Continental General Insurance
- Family Life
- First Agency
- Golden Rule
- Health Net
- Liberty Mutual
- Medicare Part B
- Medrisk Insurance
- Michigan Millers Mutual Insurance
- Mutual Life
- Mutual of Omaha
- Optum Health
- Priority Health
- Priority Health Medicaid
- Priority Health Medicare
- Retiree Medical Insurance Plan
- State Farm
- United American Insurance
- United Health Care
- Veterans Administration
- Veterans Choice
- All Auto/Home Owners Insurances
- Medicare Supplemental Insurances
Out of Network
- Humana Gold
Other Payment Options
- Self-Pay (Cash, Credit or Check)
- Auto Payment Options
The Great Lakes Physical Therapy staff of friendly and knowledgeable billing representatives are here to help all of our patients. Our billing staff is employed by Great Lakes Physical Therapy and will consistently work our patient’s account. We ensure all billing information reaches the insurance company in a timely manner.
What is a coinsurance?
What is a deductible?
A deductible is the amount you owe for covered health care services before your health insurance plan begins to pay. For example, if your deductible is $1,000, your plan won’t pay anything until you’ve paid $1,000 for covered services. Some plans pay for certain health care services before you’ve met your deductible.
What is a copayment?
A copayment is a fixed amount (for example, $15) you pay for a covered health care service, usually when you get the service. The amount can vary by the type of covered health care service. The provider is required by the insurance company to collect the copayment at the time of service. In-network copayments usually are less than out-of-network copayments.
What is an annual limit?
An annual limit is a cap on the benefits your insurance company will pay in a year while you’re enrolled in a particular health insurance plan. Annual limits may be placed on the dollar amount of covered services or on the number of visits that will be covered for a particular service. After an annual limit is reached, you must pay all associated health care costs for the rest of the year.
What are out-of-pocket costs?
Out-of-pocket costs are your expenses for medical care that aren’t reimbursed by insurance. Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered.
How do I know if my insurance plan will cover physical therapy?
You can verify your benefits for physical therapy by calling the number on the back of your insurance card and speaking with your insurance company’s customer service department. You can also speak with your employer’s Human Resources Department or reference your insurance benefits booklet. As a courtesy, our staff will also verify your benefits prior to your arrival.
Do I need a referral?
Michigan Law allows you to see a physical therapist without a doctor’s referral for up to 21 days. However, many health insurance plans still require a doctor referral, so be sure to check your health insurance plan to see if physical therapy services are covered without a physician’s referral.
How does the billing process work?
- Your charges per session are determined by your personalized treatment plan. The charges are sent to our billing department when your daily documentation is complete.
- Those charges are submitted to your insurance company on paper claims or electronically by our billing department.
- The insurance company then processes this information and makes payments according to an agreed upon fee schedule with your participating provider.
- Within 30-60 days, an Explanation of Benefits (EOB) response is generated and sent to the patient and the provider with a check for payment and an explanation of any balance due from the patient.
- The patient is expected to make the payment on the balance due, if any.
It is important to understand that there are many small steps with this process. Exceptions are common to the above example. Any information that is missing or misunderstood by your insurance company can also cause delays in payment.