Insurance & Billing
We ask that you please clarify any insurance issues prior to making an appointment. We have provided the best possible information for you to verify coverage benefits.
All billing for Arroyo Physical Therapy is done through The Balance Disorders Institute, and will be reflected as such on your Explanation of Benefits and Billing Statements.
Medicare: Balance Disorders Institute is a Medicare provider for Physical Therapy and diagnostic testing. Generally, you do not need to verify or call Medicare for coverage unless:
Restrictions for diagnostic testing – Medicare only allows 1 diagnostic balance test per calendar year. If you have had a prior test and did not disclose this, you may be billed for the entire amount of testing. If you think you may have had testing within the year, please do call Medicare to see if you qualify for current testing.
Restrictions for treatment – Treatment is billed as “Physical Therapy” and is generally covered by your Medicare and secondary as payment in full. However, therapy is not covered if you are currently receiving ANY FORM OF HOME HEALTHCARE that is currently paid for by Medicare, even if it is unrelated to why you are being referred here. Also Medicare will not cover therapy if you are currently receiving physical therapy at another out patient clinic. Additionally, Medicare may restrict Physical Therapy benefits if you have had prior treatment elsewhere. Please contact Medicare if you think you have benefit limitations. You may be liable to cover therapy services if you have not disclosed Home Healthcare or prior Physical Therapy utilization.
Private Insurance: We are authorized service providers for Anthem Blue Cross & Blue Shield of Californai, and although we accept many other private insurances, we may not be listed as an approved provider. Therefore, we strongly recommend that you call your insurance company to verify your coverage and benefits prior to scheduling an appointment. Arroyo Physical Therapy is happy to bill your insurance company as a courtesy to you as a patient, however please understand that you as a patient are ultimately financially responsible for all services rendered. Questions to ask are;
- In-network and out-of-network coverage?
- In-network and out-of-network deductible amounts?
- Co-pay per treatment?
We have provided the following information for your insurance carrier to verify your benefits and coverage with us.
Billing codes used: 97001, 97110, 97112, 97116, 97530
Note: These are commonly billed codes. Not all codes are used for every diagnostic test or therapy visit.
Cash: If you are paying cash, please request rates and payment options. Our cash rates are very affordable! Email: info@arroyopt.com
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