We are a participating provider with Medicare. We will bill your Medicare for you. In most cases, Medicare will pay 80% of allowable charges. The vast majority of our patients have secondary insurance. This will be automatically billed for you.
Please take note that Medicare insurance requires a prescription from your Doctor for services to be paid.
Medicare does not cover any Equipment that you receive in our office.
Medicare also requires for patients to be discharged from Home Health Care services before coming to outpatient Physical Therapy.
If you have any questions please feel free to call our office staff and they will be happy to help you understand your Medicare benefits.
Groschan and Associates is a Non Participating Provider with Commercial Insurance carriers.
We DO accept your insurance as a non-par provider.
We WILL submit your claims for the care given at Groschan and Associates.
We will bill you for the amount not covered by your insurance including deductibles, co-pays and non-covered amounts.
Since October 1, 2011, Groschan and Associates has operated as a non-participating provider with health insurance companies. Why we operate in this manner is very simple. We are guided by our mission to provide the quality of care and depth of relationship to all those we treat.
Over the past 20+ years, our experience is that the insurance companies’ restrictive policies are contrary to our patient’s best interests. In short, they have significantly “de-valued” our professional care. We have 2 choices. The first is to either stay totally focused on our purpose to care for patients in a manner aligned with our mission. The second choice is to follow the path that the insurers direct, which is centered on a volume based non- relationship model.
By stepping away from the conventional participating provider arrangement, we have chosen the former option. The benefits are many, but central to your understanding is this simple fact, we are no longer bound by the determination of care as defined by an insurance company. We are governed by a mission based upon our clinical relationship. By understanding your needs, we will develop and implement a care plan that achieves your goals.
Functionally, as a non-participating provider, Groschan and Associates works with your insurance company but does not accept the insurance company’s fee schedule as full payment. We set our fees at a fair rate for the services rendered which may or may not match your insurance company’s fee schedule. In many cases, after the out-of-network deductible has been met, the out of pocket expense is equivalent to the in-network benefit.
The fee schedule for our services is aligned closely with Medicare’s current fee schedule. We feel that the Federal Government uses a great deal of statistical information to generate what they feel to be reasonable fees for physical therapy services.
Groschan and Associates will file your claim for each treatment you receive. We do this very efficiently through electronic filing. Your claim will be filed no later than the second business day after the treatment has been rendered. We have historically been experiencing less than 21 business days for the payment to be received from the insurance company. While we have no control over how quickly the insurance company will fulfill their obligations to you, we will do everything we can to allow you to be reimbursed as quickly as possible.
The insurance company may pay you directly for the services rendered by Groschan and Associates. If this occurs, we require that you remit this amount to us immediately upon receipt. Payment for deductibles and co-insurance is due at the time of service. We prefer payment by check and also accept credit cards.
If you have any questions, we will be happy to answer them.