As much as I love working with Medicare-aged clients, I am not a Medicare provider. As I am in solo practice, I devote the bulk of my time to providing patient/client services, and do not employ office help. Keeping my practice simple and focused on you, and helping you reach your goals for your health helps me to keep my costs reasonable, and I feel that contracting with insurance companies, including Medicare, would jeopardize the quality of the services provided.
I do see clients with Medicare, but as I am not a Medicare provider, do not provide billing support for Medicare and my services ARE NOT COVERED UNDER MEDICARE. Supplemental Insurance WILL NOT COVER ANY SERVICE MEDICARE DOES NOT COVER.
I can and do see clients for wellness visits (such as Pilates), which are not a covered service under Medicare, and those clients pay me cash for the visits. These visits are not eligible for re-imbursement, and they may not be submitted to Medicare for re-imbursement.
Many Medicare clients see me for an evaluation for their wellness program, and during that visit we go over their medical history, do a physical exam and plan a course of action for their wellness program. At that visit, we can identify movement dysfunctions and structural issues that may be keeping you from achieving optimal alignment, posture, performance, and movement efficiency and utilize our “PT toolbox” to address those findings . . . the bonus is typically that you look and feel better!
Once we formulate a plan, my Medicare clients often augment their home program with a community based small-group class, which is a low-cost way to help you feel better and regain your health and comfort. I feel that this is a good, very safe course of action for many of my Medicare clients who have had lots of physical therapy, and can benefit from my experience in planning, implementing and succeeding with their wellness program.
If you are a Medicare client, it is necessary for you to print out and sign and ABN form before we meet.
Again, please note that we are NOT enrolled as a Medicare provider. Supplemental Insurance WILL NOT COVER ANY SERVICE MEDICARE DOES NOT COVER – this means that if you have Medicare and a supplemental insurance as well, our services will not be covered, and cannot be submitted for reimbursement, either to Medicare or to your supplemental insurance plan.
If you have Medicare, you will need to use your Medicare benefits first with a Medicare approved PT outside of our services (we would be happy to give you referrals). We cannot accept payment for services for treatment of a specific diagnosis if you have existing Medicare benefits. However, Medicare-eligible clients can be seen for maintenance, preventative, general fitness, and wellness services which are not Medicare eligible interventions. We will have you sign a form indicating that we are performing wellness services only. These charges for wellness will not be billable to Medicare or any other insurance for reimbursement.
WHAT ABOUT MEDICARE?