At Union Physical Therapy, we believe in transparency and empowering our patients. We know that navigating healthcare costs and billing can be confusing, so we’ve created this guide to help you understand our process from start to finish. Our goal is to make your experience as smooth as possible, allowing you to focus on what truly matters—your recovery.
If you have any questions about your bill, our dedicated team is here to help. Please don’t hesitate to call our office and speak with our Practice Manager or Billing Manager, who can provide the clarity you need.
Patient Billing Process and Billing Cycle at Union PT
The Billing Cycle at Union PT: From Your Visit to Your Invoice
Understanding the journey of a bill can help set clear expectations on when you’ll receive your statement. The process involves multiple steps between our clinic and your insurance provider.
- Step 1: Charges are Submitted (1-5 days after your visit)
Based on the specific treatments you receive, your physical therapist documents the services provided. This generates a claim that details the care you received during your appointment. - Step 2: Claim Sent to Your Insurance (7-14 days after your visit)
Our billing team prepares and sends this claim to your insurance company for processing. While insurers are required to process claims within 30 days, the exact timing can vary. - Step 3: Insurance Determines Your Responsibility (7-30 days after your visit)
Your insurance company reviews the claim and determines what portion of the bill they will pay and what portion is your responsibility. This is based on your specific plan’s benefits, including your deductible, copay, and coinsurance. They communicate this to us through an Electronic Remittance Advice (ERA). - Step 4: You Receive a Statement
Once we receive the ERA, we generate a final invoice for your portion of the bill. You will receive this statement via email or text (from our billing software that may appear as an unknown number), with a link to our secure online payment portal.
Understanding Physical Therapy CPT Codes
When you review your bill, you will see a list of services with corresponding five-digit numbers. These are Current Procedural Terminology (CPT) codes, which are the standard way healthcare providers communicate to insurance companies what services were performed.
At Union PT, we adhere to the billing guidelines set by the American Medical Association (AMA), using a method called the Substantial Portion Methodology (SPM). This allows us to bill for a service if we spend a “substantial portion” of a 15-minute unit on that specific treatment, which is generally at least eight minutes. This ensures our billing accurately reflects the time and skill your therapist dedicates to your care. Each service is considered independently, meaning the time spent on different services is not added together to meet billing thresholds.
This is different from Medicare’s “8-Minute Rule,” which aggregates the total time of all services. Since we do not bill Medicare, we follow the AMA guidelines appropriate for commercial insurance payers. This allows us to bill for multiple distinct services in a single session, ensuring your bill accurately reflects the comprehensive care you received.
What Our Patients Are Saying
Frequently Asked Questions About Billing
What happens if my balance becomes past due?
If your balance is past due, you will receive reminder emails from our billing department. If an account remains unpaid after multiple contact attempts, it may be referred to a collections agency. We understand that financial difficulties can arise, and we are willing to work with you to set up a payment plan if needed.
When can I expect my first bill?
You can typically expect to receive a bill within 7 to 30 days of your visit, depending on how quickly your insurance company processes the claim. Our office sends out patient statements on the 1st and 15th of each month.
Who should I contact if I have a question about my bill?
For any billing questions, please call our office at 206.588.0855 and select option #2 for our Practice Manager or #3 for our Billing Manager. They will be happy to assist you.