Insurance Plan and Provider Information for Off-Season Sports and Physical Therapy
If you would like to save some time before your first visit, please download and fill out the appropriate forms
At Off-Season Sports and Physical Therapy, we know how confusing and ambiguous health insurance can be.  We are dedicated to making insurance clear and understandable in order for patients to know their benefits and coverage.  The staff is adept at obtaining authorizations and explaining financial responsibilities. We are always more than happy to take the time to assist patients.  If you have any questions, please do not hesitate to call the office.

We are providers for all major insurances including the following:

  • Medicare
  • Aetna
  • Blue Cross Blue Shield
  • Cigna/Orthonet
  • Harvard Pilgrim
  • Tricare
  • United Health Care
  • Unicare
  • PPOs
  • Tufts (we are out-of-network at this time, but accept patients who have out-of-network benefits, and for HMO if they are also able to obtain an out-of-network referral from their PCP)
  • Workers Compensation
  • Auto or Personal Injury Insurance
  • We also offer a Cash Pay Program
Will my insurance pay for my treatment?
All insurance plans and carriers will vary on coverage for physical therapy.  Our staff encourages patients to call their insurance provider and verify their own benefits prior to their treatment.  It is vital to find out the yearly deductible, the co-pay, and your maximum out of pocket expenses.  You can contact your insurance provider with the contact number that is on the back of your insurance card or you can go to your insurance provider’s website.

Glossary of terms for better understanding of insurance coverage:

  • Deductible:  A deductible is the amount you will pay out of your own pocket before your insurance will begin to pay a portion of your health costs. The amount of a deductible will vary from person to person. Deductibles are typically based on yearly health costs depending on your policy and may include different amounts for families.  It is very important to understand your deductible so you are prepared for any out of pocket costs.
  • Co-payment:  This is the set amount your insurance company will require you to pay each date of service you attend treatment. This will vary from policy to policy.
  • Co-Insurance:  This is a percentage that your insurance company will require you to pay each date of service you attend treatment.  Example: your policy could have an 80%-20% plan. Therefore, this means your insurance will pay 80% of the cost and you are responsible for the remaining 20% each visit.
  • Out-of-Pocket Expenses:  All costs that you pay for are called “out-of-pocket expenses” because you pay for them out of your own pocket.  These costs include copays, coinsurance, and deductibles.
  • Out-of-Pocket Maximum:  This is the most that you should have to pay for your healthcare during a plan period (usually one year). Before reaching the out-of-pocket maximum, you pay for part of your medical care, such as copays and coinsurance. Once you have paid the amount set by the out-of-pocket maximum, your insurance will pay 100% of the allowed amount for your covered healthcare expenses, up to a preset benefit maximum.
  • Pre-authorization:  Some policies will require that physical therapy has a pre-authorization policy before or on your first date of treatment. It is important to be aware of this for your own knowledge and to inform the front office staff so they can begin the process of obtaining authorization for you.
  • Maximum visits:  Some policies will have a set amount of physical therapy visits that are allowed annually per calendar year.  If your maximum visits are met during your treatment and you require continued care, cash pay programs are available.
  • In-Network Benefits:  This means that we are contracted with your insurance provider. If we are in-network providers, we are bound by our contact to accept their determination of all charges and allowed amounts
  • Out-of-Network Benefits:  These are the benefits that your insurance company will consider if we are not a provider for your insurance or in-contract with them. This means you may be financially responsible for a larger portion of the total costs of treatment.
What if I do not have insurance but need physical therapy?
Our office provides a cash pay program that allows patients to receive physical therapy without insurance. Please call our office for more information and rates.

Will the front office staff assist me with my insurance?

Our front office staff is more than happy to assist you regarding insurance questions.   Prior to your first visit to our office, we will contact your insurance and obtain your eligibility and benefits. We strongly advise that you directly contact your insurance provider personally and obtain all your insurance information. Please keep in mind that all benefits are quoted from your insurance company and not an authorization and promise for payment. We encourage patients to remember that insurance policies are subject to change and can vary beyond our control.

If you have any questions that are not covered here, or would like assistance with understanding your insurance coverage, please feel free to contact us.
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