Physical Therapy Services @ OMBE
From the desk of Jessica L. Molleur, Lic.Ac., DNBAO... OMBE is happy to announce the addition of physical therapy services by Kristen Reynolds, certified Pilates instructor and physical therapist this fall. Here are some frequently asked questions about physical therapy...
Do I need a referral from my doctor to be seen by a physical therapist?
Massachusetts is a direct access state, meaning that a physical therapist can legally treat a patient without a physician’s authorization. If a patient presents with symptoms necessitating treatment outside of the physical therapy scope of practice, then the PT will refer to a licensed practitioner of medicine, dentistry, or podiatry for additional evaluation. In the event that a patient is referred to therapy from another practitioner, then the PT will provide ongoing communication with this licensed professional. It is important to note that some insurance plans require that a patient receives a referral from a primary care physician or specialist.
Do you accept insurance?
OMBE offers physical therapy on a fee-for-service basis and does not file claims with insurance companies, but will be happy to provide patients with a claim form and itemized bill for patients to submit to their insurance companies, health savings account (HSA), OR flexible spending account (FSA). By choosing to not participate in a contract with insurance companies, OMBE is not required to limit the treatment time, quality of service provided, or elevate rates to pay for billing services.
Can I be reimbursed for physical therapy services?
Yes, in most cases clients are reimbursed between 60-80% of the service fees, however, it is not guaranteed. If you plan on submitting a physical therapy claim to your insurance company, it is important to determine whether or not a physician’s referral is required for physical therapy services in advance of your first appointment. Although Massachusetts practices direct access, many insurance companies require the referral from a primary care physician for reimbursement. You may not file a claim if you are a Medicare patient.
How are reimbursement rates determined?
Insurance companies assign a fee to each procedure, which vary and depend upon the amount of time they are performed (e.g. 8 minutes of ultrasound, 30 minutes of manual therapy or 15 minutes of therapeutic exercise). Your treatment plan will likely vary on most visits depending on your current symptoms and progress, therefore, reimbursement rates will change accordingly.
How do I submit a claim to my insurance company?
You will be provided with a detailed receipt that you can send to your insurance company along with any other paperwork that they may require, such as member claim or out-of-network forms. OMBE has several forms for commonly used insurance plans.
Is equipment included in the cost of physical therapy?
Any personal supplies or equipment, such as resistance bands or iontophoresis patches, must be paid for at the time of your visit at the OMBE front desk. Because some insurance plans cover DME (durable medical equipment), these items will be included in your itemized bill.
Jessica L. Molleur is a licensed acupuncturist, herbalist and massage therapist in Massachusetts and California. She holds a Masters of Science in Traditional Chinese Medicine from the American College of Traditional Chinese Medicine in San Francisco, CA. Her training also includes a Bachelor of Science in Exercise Physiology from the University of California at Davis, CA. Jessica first became interested in acupuncture as a soccer player searching for an alternative to knee surgery.
She is a National Diplomate of Acupuncture, Oriental Medicine and Chinese Herbology through the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Following her acupuncture licensure, she became a Diplomate of Acupuncture Orthopedics. This orthopedic specialty certification is held by fewer than 300 acupuncturists in the United States. Areas of specialty include women's health, infertility, pediatrics, and sports medicine. For patients interested in learning more about acupuncture for fertility and IVF, please click here.