Southwest Orthopaedic Physical Therapy Information Headquarters

Here is a series of blogs written by SWOPT employees, Kristen, Roby and Tami. They are part of our front office staff and have put together these blogs to give an insight to what it is like to set up an appointment at SWOPT. We hope you enjoy. Leave any questions as comments and someone at SWOPT will respond.

Medicare is an insurance company that people get through the social security administration. Medicare has been a system that has been providing valuable health benefits at a low cost. This makes it easier for many people to receive health benefits especially as they retire and no longer are covered under their employers insurance. Medicare can be a confusing system to navigate and the rules and regulations may seem endless. Physical therapy is a specialty service and this makes the rules and regulations even more challenging to navigate. To make it easier to understand, here are a few important things to know about the rules that are placed with physical therapy.

A physical therapist is not a medical provider that every person typically sees in a year. It may not be until an accident or injury that you are even introduced to what physical therapy is and how it can help. It is this reason that may make people nervous about what to expect for their first visit. It is a nervousness that does not need to happen and can be easily avoided if you know what to expect. It is important to bring these things to your first visit to make your visit a lot easier:

Many people have never heard of physical therapy until a doctor suggests you try it for some sort of injury, after an accident, or if you have exhausted all other treatment options. Physical therapy is becoming more and more popular as a specialized treatment for many injuries and ailments people have. If physical therapy is unfamiliar to you, a big question you may have is how much will it cost. While we can not tell you exactly how much you will pay, we can give an estimate and explanation for what physical therapy will cost.

1. LOCATION: Albuquerque Metropolitan area is one of the largest metro areas in the US. statistics have shown over and over that the more convenient the proximity to the physical therapy clinic the direct correlation at to success of PT outcomes.

On my first day at Southwest Orthopaedic Physical Therapy, I was introduced to the behind the scenes of billing the insurance world. I will admit it was a little intimitating, but the hardest part was understanding the strange concept of an EOB. They are referred to by many other terms most commonly, an explanation of benefits (EOB), an explanation of review (EOR), and an explanation of remittance adivce (ERA). For our purposes, let's stick with an EOB. An EOB is simply a piece of paper from an insurance company, but that paper does so much for providers and patients. All of them describe in sometimes confusing detail how much the insurance company paid, why they paid that amount, and most importantly what the patient responsibility is. I'd like to take the time and break down what these papers mean to the providers and to the patients.

The insurance world is a very confusing place to navigate. The terminology can be almost as foreign as many medical terms. I should know this, when I first began working at Southwest Orthopaedic Physical Therapy, I was a college student with absolutely no idea what health insurance really was. After four years working in this world, I would like to think I have learned a thing or two and I would love to share some things I know. As a medical biller there are a few trends I notice from insurance companies that cost my patients more money than what they expect to pay. I have put together a list of the top five I see on almost a weekly basis. Knowing your insurance plan could save you hundreds or even thousands a year.