Frequently Asked Questions
Direct Access to Physical Therapy
In California, you may be evaluated by a physical therapist without a physician’s referral. Keep in mind, however, that your insurance policy may require a visit to a physician first or may limit your access to preferred providers. If your therapist determines that you have any signs or symptoms of a condition that requires treatment beyond the scope of practice of a physical therapist, or should you fail to progress in a timely manner, your physical therapist will promptly refer you to your physician.
While your physician may refer you to a specific physical therapy clinic, the choice is ultimately up to you. If you do not already have a specific clinic or physical therapist in mind, a friend, family member, or coworker may have previously treated with a physical therapist that they highly recommend. Often, you can visit or call the physical therapy clinic to see if it’s right for you. If you have health insurance, your health insurance company will likely have a list of preferred providers. There may be good reasons, however, to see a physical therapist who does not participate with your insurance plan. You may need a physical therapist with special skills related to your particular condition or perhaps the location or other aspects of the care or the facility better meet your needs. Most importantly, always make sure that you receive physical therapy from a licensed physical therapist.
Some of the things you may consider when seeking a physical therapy clinic:
- What are the qualifications of your therapist (s)? Do I feel comfortable working with him/her?
- Does the clinic offer a clean, comfortable environment?
- Recommendation from friend, family member or physician.
- Is the Clinic licensed by Medicare?
- What are the hours of operation?
- Can you briefly interview the therapist before the first visit?
- Is the clinic a member in physical therapy provider networks which perform quality assurance programs and accreditation visits (Preferred Therapy Providers (www.preferredtherapy.com) is an independent physical therapy provider networks in CA with quality assurance programs)?
- Do they provide services that can address your problem?
- Do they take your insurance or are they willing to work with you if they are not a preferred provider?
- How long does the therapist spend with me?
Please arrive at your appointment with your paperwork completed (see forms section). If you are unable to complete the forms ahead of time, please make sure to arrive 20 minutes prior to your scheduled appointment time to allow adequate time to complete your paperwork in clinic.
Please be sure to bring your prescription for therapy, insurance card for copying, photo identification and a complete list of medications (name and dosages).
After you paperwork is completed, you will meet your therapist and receive a comprehensive initial evaluation. Your therapist will discuss: Your current problems/complaints, pain intensity (what aggravates/eases the problem) and how it impacts your daily activities, your functional limitations, and short term and long term goals for physical therapy. In addition, your therapist will discuss/review your medical history, medications, tests, and procedures related to your injury. The therapist will then perform the objective evaluation which may include: Range of Motion, Palpation, Muscle Testing, Neurological Screening, as well as others.
Your therapist will analyze your results and, along with patient and physician input, formulate a treatment plan. This plan will outline how many times you should be seen for physical therapy per week, how many weeks you will likely require therapy, short-term/long-term goals, and what is expected after discharge from therapy. Home programs and patient education will also be addressed.
Make sure you bring your physical therapy referral (provided to you by your doctor), any reports relevant to your condition (X-Ray reports/MRI reports), a complete list of medication (dosages included) and your insurance information and photo identification. If you are covered by Workers’ Compensation, bring your claim number and your case manager’s contact information. If you are covered by auto insurance or an attorney lien, make sure you bring this information.
Dress appropriately or bring a change of clothes so that your therapist will have access to the injured and surrounding areas of your body.
Treatment sessions typically last from 45 to 75 minutes.
Depending on your diagnosis, the severity of your impairments, your medical history, and other factors you may need one visit or several weeks or months of care. Should your care last three to four weeks, you will be re-evaluated by your therapist and a progress report will be sent to your physician with recommendations.
Physical Therapists are movement experts. Our therapists will teach you how to prevent or manage your health condition and help motivate you during your treatment so you can function optimally. Your physical therapist will work with you to help you understand your body and achieve long-term health benefits.
Our physical therapy treatments typically include a combination of manual therapy techniques (soft tissue or joint mobilization), therapeutic exercise, and patient education. We may use modalities to help control pain, reduce inflammation or improve tissue reaction to movement or injury. Whatever your needs, our therapists will guide you through the rehabilitation process to best optimize your function and minimize or eliminate your pain.
You were likely referred to physical therapy due to a movement dysfunction associated with pain or injury. Your difficulty with moving part(s) of your body may result in limitations with your daily activities. Physical therapists treat these movement dysfunctions and their associated discomforts and restore your body’s ability to move in a normal manner.
Who is better to see, a PT that works for a physician or a PT that owns a private practice? We’ll leave it up to you to decide but here are some facts: Studies indicate there were more treatments (visits per patient were 39% to 45% higher in physician owned clinics) and the cost was greater for those patients that attended a physician owned physical therapy practice (both gross and net revenue per patient were 30% to 40% higher)
Ultimately, this is your choice, you are free to ask your doctor, look over our profiles or talk to a therapist before you commence your therapy. However, you should know and expect that at Ergo-Rehab you will be evaluated by a licensed and highly trained physical therapist. At Ergo-Rehab, the same therapist will treat you each time as we feel it is very important to develop a one-on-one relationship with you to maintain continuity of care. Since only one physical therapist knows your problems best, he/she is the one that will be working closely with you to speed your recovery.
Billing for physical therapy services is similar to what happens at your doctor’s office. When you are seen for treatment, the following occurs:
- The physical therapist bills your insurance company using Common Procedure Terminology (CPT) codes. Those codes are transferred to a billing form that electronically communicated (or in the case of Workers comp, mailed) to the payer.
- The payer processes this information and makes payments according to an agreed upon fee schedule.
- An Explanation of Benefits (EOB) is generated by your insurance company and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.
- The patient is expected to make the payment on the balance, if any.
It is important to understand that there are often many small steps beyond those above within the process and exceptions are common. At any time during the billing process, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.
Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program while others will complete their rehabilitation and return to normal daily activities immediately. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.
Hours depend on the therapist and clinic, but generally we can accommodate patients from 7AM to 6PM, Monday through Friday. If your schedule is limited by day or time, please let our receptionist know before your initial visit as it may influence which Therapist you are assigned to.
Ergo-Rehab has been a member been an independent, therapist owned physical therapy clinic since 1979.
In most cases, health insurance will cover your treatment. We accept all PPOs, all workers compensation insurance, Medicare, and a limited number of HMOs. We also have plans for cash patients. Please call our office for specific coverage information.