Understanding Medical Benefits

Helping patient’s understand their insurance benefits is one of the best gifts we can give. This is not only important for patients who are in-network with our office, but maybe more so for those who have less than desirable coverage situations. Our feeling is that a better educated patient will more confidently buy into their treatment and wellbeing.

Many patients who call our office for physical therapy are unaware of the basics of insurance. They may know that they have a deductible, but not understand what that means for their financial responsibilities. Understanding terms such as copay, coinsurance, deductibles, out-of-pocket maximums, visit limits, authorizations, etc. is vital.

At our office, it is standard practice for Jeanette Adelman (office manager for 20+ years) to verify benefits for patients with both in-and-out-of-network coverage. As part of educating our clientele, we encourage everyone to call their insurance provider to hear their benefits for themselves. The primary objective is to catch any anomalies between what benefits our clinic staff is told versus what the subscriber is told. It is always better to have both parties hear from the proverbial “horse’s mouth”.

For ourselves and our patients, transparency is key. By so doing, we cultivate trust and avoid any unwelcome surprises.