Frequently Asked Questions

Do you accept insurance?

What makes Seneca PT and Wellness so much different than other PT clinics?

Why should I come out of network, when I can go to an in-network clinic and just pay a flat co-pay?

Why aren't you an "in-network" provider?

What do you do to help me file for reimbursement from my insurance company?

What will my out-of-pocket expenses be?

When I called in, you said you wanted to "Check our status". What exactly does that mean?

My doctor (or insurance company) directed me someplace else, can I still come to you

Question: Do you accept insurance?

Answer: Yes. As licensed providers of physical therapy in the State of Maryland, the care we provide is reimbursable by insurance. In some cases we are an in-network provider, meaning we’ve agreed to accept payment directly from your insurance company. In other cases, we are considered an out-of-network provider, which means that your insurance company will typically reimburse about 60 to 80% of our charges once your deductible has been met. Our front office can verify your benefits and let you know how your care here is covered.

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Question: What makes Seneca PT and Wellness so much different than other PT clinics?

Answer:

• Seneca PT and Wellness has over 18 years of experience serving our patients. During this long and established history, we have become the referral of choice for many area physicians.
   
• We are focused on the continuum of care from impairment to full health and fitness. Because we integrate our wellness programs into your therapy experience, we both enhance your health for a lifetime and help you reduce costs.
   
• Our wellness program has received the Washington Consumers Checkbook  top rating for quality with 93% of customers rating us “superior for overall value for your money”.  This was higher than any other comparable program within a 75 mile radius.
   
• Compared to other individual physical therapy clinics listed in the Neighbor to Neighbor section of the Washington Consumers Checkbook, (www.checkbook.org), none were close in receiving the number of positive comments about the care they received here.
   
• Take a look at the testimonials page to see what our patients have said about how we differ from other clinics.
   
• All of our therapists are Doctors of Physical Therapy so you can be assured of getting the most up-to-date care from each of us. We also are Board Certified in Orthopedic Physical Therapy and/or are Certified Strength and Conditioning Specialists.

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Question: Why should I come out of network, when I can go to an in-network clinic and just pay a flat co-pay?

Answer:

• We are not as rushed as the typical in-network clinic that is forced to see more patients per hour to generate enough revenue to cover their costs. Therefore:
  • We are able to make medical care decisions based on your individual needs and not on insurance company needs.
  • We are able to treat you as an individual and are able to go above and beyond to deliver the best level of care we can.
     
• We’ve all been in a healthcare provider’s office and had to wait up to an hour (or even more) before we’re seen. This is annoying and a waste of your valuable time. At Seneca, because we’re not in a “rushed” environment, we are able to get you started within 5 minutes of your arrival.
   
• After our initial evaluation, we will provide you with a specific plan of care to resolve your condition and meet your functional goals. We do not employ a template approach to your care in order to meet time constraints.
   
• You can expect to make significant progress in your condition within two weeks or we will re-evaluate our strategy and guide you to a more appropriate plan of care.
   
• Our approach integrates prevention, rehabilitation and long term fitness to support health for your lifetime and reduce your risk for life altering medical conditions.
   
• Because our focus is on you and not on the insurance company requirements, we can maximize your rehab potential.
   
• Last, but certainly not least, all healthcare providers are under increasing paperwork pressure from insurance companies. This is evidenced by a recent NY Times article about one physician who tired of the insurance game. It’s an interesting read if you have time and gives you an example of why we chose to become out-of-network providers.

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Question: Why aren’t you an “in-network” provider?

Answer: For the first 17+ years, we were an “in-network” provider for most insurance companies.  Over the past few years, we have become increasingly dissatisfied with the unnecessary burdens insurance companies put on us, which in the end, affect how we treat our patients. It was a drastic step, but a necessary one, as we’ve always prided ourselves on being focused on the patient first. Our recurring patients recognize the superior care they receive at Seneca PT and come back for treatment regardless of our status as an in- or out-of-network provider.

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Question:  What do you do to help me file for reimbursement from my insurance company?

Answer:  We want you to be able to focus on your treatment without being distracted by trying to figure out how to file your own claims. So, as a service to you, we will:

• authorize your visits with your insurance company, and provide you with a detailed outline of your benefits
   
• prepare and submit the required Health Insurance Claim Forms for each visit, with a cover letter directing the insurance carrier to pay you directly
   
• assist you as best we can in getting reimbursed in a timely manner, although we cannot guarantee prompt payment from your insurance company

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Question: What will my out-of-pocket expenses be?

Answer:  Once your deductible has been met, insurance companies typically reimburse 60% to 80% of our charges. While your actual cost may be higher than in-network rates, your level of care is far more individualized and results oriented. 

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Question: When I called in, you said you wanted to “Check our status”.  What exactly does that mean?

Answer: There are many different insurance contracts out there (some having behind-the- scenes arrangements with each other). We have found that we can give you much more accurate information if we check with your insurance company first. The very last thing we’d want to do is surprise you when you come in. This will enable you to know what to expect when you arrive.

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Question: My doctor (or insurance company) directed me someplace else; can I still come to you? 

Answer: Yes!! Access to specific physical therapists cannot be limited by physicians or insurance companies. Beware of insurance company recommendations. It is in their best financial interest to pay in-network rates, which usually amounts to 30 to 60 cents on the dollar. Insurance company profits (which are typically quite generous) depend on low reimbursement rates and patients not questioning the modified level of care.

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