A Note to Our Patients – PNBC’s Commitment to Health Care Value
We recognize that many of our patients pay various "out of pocket" costs for treatment at our clinics. This may involve co-pays, deductibles or withdrawals from medical savings accounts.
We want our patients to know that we deeply respect the financial commitment they make to participate in our treatment program. Further, we realize that our patients have the right, indeed the responsibility, to demand value for the services we provide. As we see it, ‘value’ means providing the most effective and lasting treatment outcome for the least amount of health care dollars spent.
We have demonstrated with insurance companies and through published data that patients who complete our program are 67% less likely to reutilize the medical system for spine care when compared to patients that elect other forms of treatment. In other words, money spent on our treatment yields greater value, because there is significantly less need to spend more money later on the same problem.
Also, we have demonstrated through published research that patients can often avoid the costly option of surgery by completing our program. We continue to document our outcomes on an ongoing basis so that our patients, referring physicians and insurance providers can judge our effectiveness.
Finally, we are very open to discussing flexible payment options with our patients as the need arises. We will never turn patients away for financial reasons.
Our pledge as a health care provider is to help stem the rising tide of health care costs through the most effective, lasting, and, value-based treatment available.
Blue Cross Blue Shield now ranks clinics based on quality. PNBC is proud to have been designated as Tier 1, the highest rating. |
Insurance
Coverage & FAQs
Physicians Neck & Back Clinics
(PNBC)’s treatment is covered
by almost all major health plans within Minnesota and Western
Wisconsin. A referral may or may not be needed based on
a patient’s specific health plan. However, if a referral
is required, more than 1,500 physicians in the Twin Cities
metro area have referred patients to PNBC. We also treat
workers’ compensation patients and those injured
in motor vehicle accidents. Following are some Frequently
Asked Questions regarding insurance coverage at PNBC:
- Do I have to pay a
co-pay each time I attend the clinic?
- I have previously
gone to physical therapy and not had a co-pay. Why
do I have a co-pay here?
- Instead of paying
at each visit, can you just bill me when I’m
done with the program?
- Will my health insurance cover this treatment?
- If
I call my health insurance carrier to inquire about
my benefits, what should I ask them?
- What should I
do if my insurance plan changes while I am coming
to your clinic?
- I don’t have
insurance. Can I still come to your clinic?
- I really think my pain
is from an old work comp injury or a motor vehicle
accident. Can you
bill them instead
of my private insurance?
- Does insurance pay
for items such as ice wraps, therapeutic pillows,
or Roman Chairs?
- How often do you send in claims to
my insurance carrier?
- How will I know if my insurance
carrier is paying for my treatment here?
- What is my
current balance?
- Can you just send all bills do my
attorney?
- If I have an attorney involved in my
No Fault claim, do I need to
sign a lien?
- Do I have to pay a co-pay each
time I attend the clinic?
It depends on what
level of healthcare benefits you have. In most cases,
this information can be found on your insurance card. If not, you can
find out by
simply calling your insurance carrier. Some co-pays are a flat amount such
as $15 at each visit. Other policies have a co-insurance instead of a co-pay.
This means that instead of a flat fee, you are responsible for a certain
percentage of the bill at each visit. If you have co-insurance, PNBC
will bill you for
that monthly rather than collecting it at the front desk before each visit.
- I
have previously gone to physical therapy and not had a co-pay. Why
do I have a co-pay here?
There could be several reasons for this. Your insurance benefits
may have changed. Some policies have different reimbursement levels
depending on the setting.
Perhaps your previous therapy was performed in a hospital setting while
this therapy is at an outpatient clinic. Perhaps when you were attending
physical
therapy previously you had fully met your deductible, but this year you
have not. Your obligation may change depending on whether or not
PNBC is in your
approved network of providers. Your obligation may also vary depending
on whether or not you have a physician referral. Much of this information
may be on your
insurance card, but if not, you will have to call your insurance carrier.
PNBC is an approved provider for almost all networks in the Twin
Cities, but check
with your insurance carrier or the PNBC front desk personnel to be sure.
- Instead
of paying at each visit, can you just bill me when I’m done
with the program?
No. We must collect co-pays at each visit.
-
Will my health insurance
cover this treatment?
Almost all insurance carriers cover the Physical Medicine delivered
at PNBC, but you need to call your insurance carrier to be sure.
- If
I call my health insurance carrier to inquire about my benefits,
what should I ask them?
Ask them about the following:
a) What are my physical therapy
benefits?
b) What is my deductible?
c) What is my physical therapy co-pay?
d) If I have coinsurance rather than co-pay, what
is the percentage of the bill that I am responsible
for at each visit?
e) Is PNBC an approved provider for me?
f) Do I need a referral to go to PNBC? (With some policies you may
not need a referral, but without one you will pay more. You should
ask about
this.)
- What should I do if my insurance
plan changes while I am coming to your clinic?
Be sure to inform the front desk personnel or the PNBC billing
department. Please bring your new insurance card in for the front
desk personnel
to photocopy.
- I don’t have insurance.
Can I still come to your clinic?
Yes. We offer a self pay financial agreement
for people without insurance. Payment of $75.00 is required
at the time of service for each visit.
The remaining balance will be billed to you at the end of the
treatment program.
- I really think my pain is from
an old work comp injury or a motor vehicle accident. Can
you bill them instead of my private insurance?
Yes, if the claim is still open. If not, it will
not be covered. You can determine whether or not
your claim is still open by contacting
the work comp carrier
(you may need to call your employer at the time of the injury to
find
out the name of the company and how to contact them) or your automobile
insurance company.
- Does insurance pay for items such
as ice wraps, therapeutic pillows, or Roman Chairs?
Most workers compensation insurance will usually cover
these types of supplies. Private plans or No Fault
auto insurance typically
will not
pay for these types
of medical supplies, but this is not always true. You will need
to contact your insurance company to determine their specific
policy.
- How often do
you send in claims to my insurance carrier?
Weekly. The only exception to this
is for people with BlueCross BlueShield insurance.
In this case, the bill
is sent after 10
treatments.
- How will I know if my insurance carrier is paying
for my treatment here?
You will receive an “Explanation
of Benefits” form
in the mail that will show the payment being made or give
reasons for any denials.
- What is my current balance?
Our billing personnel can help you with this question.
To reach our billing office, you can simply call
the clinic directly.
At some
clinic locations,
you will hear a recorded option to select to be connected
with the billing office. At other locations,
our front desk personnel
can
assist you in
reaching the billing office.
- Can you just send all bills do
my attorney?
No, but each patient can forward bills to his/her
own attorney for payment.
- If I have an attorney
involved in my No Fault claim, do I need to sign a
lien?
Yes, if you don’t have private insurance and/or don’t want to pay
co-pays.
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