Insurance Plans / Faqs

Working with you and your doctor, we can discuss your options and help determine if physical therapy will help you. Contact us today to discuss your current condition and if physical therapy is right for you. You may even set up a free consultation if you choose.

Connecticut allows for Direct Access to a physical therapist. What does this mean to you? It means that you can see a PT for up to 6 visits within a 30 consecutive day period without a prescription (provided that your injury/condition is not the result of a Motor Vehicle Accident, Workman’s Compensation injury, or requires some spinal procedures). The doctor of your choosing (or PCP) will be faxed your initial evaluation.

That being said, some insurance companies do not recognize Direct Access and will require a prescription to be considered for payment. In the event your insurance company does not cover your therapy without a prescription, you will be responsible for payment.

By law, physical and occupational therapists are required to perform evaluations on all patients despite the fact that they may have been evaluated by a physician or another physical therapist. This law is appropriate because without the evaluation, it is impossible for the physical or occupational therapist to set up a specific program that would best fit the patient’s problem. Therefore, the patient would be on a more generic program which would be ineffective.

As a patient you have the right to receive physical therapy at any place you choose. At Carlson ProCare, you will receive the highest quality care while achieving the results you need. We pride ourselves on providing a positive, encouraging environment with well-trained, friendly staff. We are confident in our ability to help you reach your goals and live a pain-free life.

Patients needing physical therapy services can receive therapy directly from a therapist, without the need for a prescription from a physician.

Not always. Some insurance companies generally cover Direct Access, but when you get to the policy level, it may not be covered. We strongly recommend you contact your insurance carrier to discuss your specific physical therapy benefits.

Medicare, Workman’s Compensation, and Grade V spinal manipulations are not eligible for direct access.

You may receive up to 6 visits within a 30 day period. If you require continuous treatment or are not making appropriate gains, you will be required to see a doctor and get a prescription before treatment can continue.

Yes, in most cases it does. Our office will be happy to assist in contacting your insurance company and determining your coverage based on your individual policy. For more information, visit our insurance plan page and please do not hesitate to contact our office. We do offer different payment options for your convenience.

Patients are responsible to provide current and accurate insurance information and to let us know if there are any calendar year changes. We will call to verify your benefits and coverage as a courtesy before your first appointment; we will handle any authorization that may need to be done.

After your first appointment, we will bill your insurance carrier in a timely fashion. Copays are due at the time of your visit. After we receive payment from your insurance company if there is a balance it will be your responsibility and you will be billed. This may be your deductible or your co-insurance.

We are able to determine (in most cases, to the penny!) what we expect your patient portion to be. Most people find it more affordable and more convenient to pay a little at a time, instead of being billed for multiple visits in one bill in a larger sum. We do our best to be accurate, but the explanation of benefit ultimately determines your patient responsibility. Therefore, if you have any remaining balance due as your insurance company processes your claims, you will be billed accordingly, or refunded in the event of an overpayment.

If it is known prior to treatment your insurance will not cover Direct Access, you will be required to obtain a prescription from your physician or pay directly at the time of service. If your insurance denies payment due to lack of prescription, you will be billed accordingly for any sessions denied by your insurance carrier.

For patients who do not have insurance, we offer a discounted fee, due at the time of service.

Unfortunately, no. A copay is a set amount that is determined between your insurance carrier and your employer. Per your insurance contract, it is required to be paid at the time of service.

We know that copays can be high for some people, but this amount is subtracted from what your insurance company pays us, not in addition to. Please bring your payment at each visit.

We accept cash, check, debit card, and credit card. We are happy to discuss payment plan options as well. It is our policy that payment is made at the time of service. Your insurance benefits will be determined before your second visit, and you will be informed of what, if any, payment is necessary on that date.

Our scheduling is easy and we offer a convenient location and appointment times for you. We have morning and evening appointments available to meet the demands of your busy schedule. Call us today or request an appointment online now.

When you first walk through our clinic doors, you will be greeted by one of our great support staff. You will be given paperwork to fill out before seeing your therapist. This includes a demographic form, medical history, our financial policy, and any other forms required by your specific insurance company. We try to make this process as painless as possible, but since everyone’s “pain tolerance” is different, we ask that you come 10-15 minutes before your scheduled appointment to complete this paperwork.

Your physical therapist will introduce themselves, and bring you into the gym or a private room, depending on diagnosis and/or your personal preference. You will be asked questions about your particular condition, and measurements and ranges will be noted. Your therapist will discuss his findings with you and answer any questions you have.

Your time is valuable, and so is ours. To prevent you from reading an entire novel in our waiting room when you could be doing better things, our therapists run on time (within a couple of minutes, of course!) If you are running late, it will cut into your appointment time. You are more than welcome to come for your visit, providing you are no more than 10-15 minutes late. If you are able, please call us and let us know that you will be late so we can expect you and not worry that something may have happened. We would rather you cancel last minute than no show for your appointment and leave us wondering.

We ask for 24 hours notice on any cancellation or changes in your schedule. Your appointment is reserved for you and you only. Because we only book two patients an hour, it can negatively impact our schedule if you fail to show for your appointment or cancel at the last minute. By doing so, we are not able to offer this appointment to a patient who may be on our waiting list that needs it. If you were on our waiting list, we are sure that you would be grateful for the opportunity for that appointment. If you No-Show or cancel last minute, you will be charged a $50.00 fee payable at your next visit. We reserve the right to cancel remaining appointments for patients that chronically no-show or cancel. You will be more than welcome to return when circumstances enable you to make your appointments regularly.

You will need to bring your prescription from your physician, your insurance card, a photo id (so we may protect your identity), a list of any medicines you are taking, and your co-payment (or co-insurance, if applicable). If your insurance policy requires you to have a referral on file, please make sure to notify your MD to prevent lapse in your treatment previous to your arrival.

If you have been in a motor vehicle accident and are going though your health insurance because you do not have medical coverage on your auto policy, you will need to bring a statement from your auto policy that states you do not have medical coverage. This is necessary to process your claims with your health insurance.

Physical therapy is not meant to hurt, but to relieve pain. However, as you restore your mobility, pain levels, at times can fluctuate. You might experience some temporary soreness from using muscles that are weakened or recovering. This is a normal response to therapy treatment. Good communication with your therapist will help minimize any discomfort. We want you on your way to quick pain relief and back to normal activities.

Wear something comfortable and loose. Jeans are fine if they are not too tight and you can move freely in them. If you are coming to us with a knee problem, it is helpful to bring shorts with you or wear pants that can be pulled up and over your knee. Good fitting and supportive shoes are also recommended for patients performing exercises.

We do not recommend wearing a skirt, simply because you will be lying on a table. We can make modifications if you forget or don’t have time to change. Feel free to change in our restroom or a private room if you need to!

Each patient’s diagnosis is different, so together with your referring physician, your therapist will develop a plan of care that is right for you. Your plan of care and number of visits will be determined during your first visit and explained to you by your physical therapist.

Your appointment is scheduled for 30 minutes. Some patients may require additional modalities, including ice, electrical stimulation or iontophoresis. Some patients may also wish to stay and perform their exercises. This will add anywhere from 5 to 20 minutes to your time in our clinic after your time with your therapist.

Phase I
Evaluate, identify systems that influence your and your doctor’s goals.

Phase II
Use a variety of techniques such as muscle energy, counter strain, myofascial release and mobilization (just to name a few!) to facilitate your body’s healing process.

Phase III
Design, implement, correct and progress your individual stretching, strengthening and conditioning program. This includes education lifestyle (ie ergonomic body mechanics) and referral to other practitioners that can assist you on your road to wellness.

Phase IV
Prevention. Upon discharge, you will leave with a wellness prescription. This is a Home Exercise Program that can be executed at home without the need for skilled care. We can also direct or recommend you to programs that will further enhance your goals and take you to the next level.

Phase IV Gym Program
After you are discharged from therapy, patients are able to use our gym to execute their HEP (or any other exercises they wish!) for a modest month to month fee. While use of our equipment does not constitute physical therapy, patients have said they enjoy coming and knowing that they are in a medically supervised environment. If a question arises while performing your exercises, in many cases, it can be answered immediately.

These exercises are designed to get you back to “normal” quickly as possible. Home exercise programs are a key part to your rehab success.

Physical therapists have years of university level training in anatomy, physiology, kinesiology (study of joint movement), neurology, and many of the other medical sciences. Our physical therapists have graduated from accredited physical therapy programs and are state licensed. Depending on the university, the physical therapy program is either a masters or doctorate level degree. Rest assured, your therapist is well trained to evaluate and treat your condition.