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(803) 862-0042

For Patients

For Patients

Patient Forms

For your convenience, we email our patients forms for you to complete online. To help expedite your first visit, please complete the forms prior to your first appointment. If you need assistance, call us, we are happy to help. If you choose to fill out the patient form packet at our office, please arrive 10-15 minutes before your appointment to allow enough time to get them completed before your appointment.

Forms will be emailed or completed in person
For Patients

Insurances

Patients may call to receive a complimentary screen to assess the need for physical therapy services. Please contact our office for specific service information and pricing.

Patients are required to cancel and/or reschedule appointments within 24 hours of the scheduled appointment time to avoid a $25 cancellation fee per company policy.

We currently file insurance claims with:
  • Humana (pending)
  • Tricare 
  • Aetna
  • UHC/Optum 
  • Medicare 
  • BCBS 
  • Cigna/Rehab ProviderNetwork 
  • MedRisk/SPNet 
  • Corvel/Care IQ 
  • Streamline

What Does "Out-of-Network" Mean?

When a healthcare provider is considered “out-of-network,” it means that they do not have a contractual agreement with a particular insurance company. This can happen for various reasons, such as the provider choosing not to participate in certain insurance networks or the insurance plan not covering services provided by that provider.

How Does Out-of-Network Billing Work?

If you receive services from an out-of-network provider, you may still be able to receive reimbursement from your insurance company, but the process may be different from using in-network providers. Here’s how it typically works:
  • Payment Upfront: With out-of-network providers, patients often need to pay for services upfront at the time of the appointment. This is because the provider does not have a pre-negotiated rate with the insurance company.
  • Submit Claim for Reimbursement: After paying for the services, the patient can submit a claim to their insurance company for reimbursement. The claim should include details such as the date of service, a description of the service provided, and the amount paid.
  • Reimbursement Amount: The insurance company will review the claim and determine the amount of reimbursement based on the patient’s out-of-network benefits. This amount may vary depending on the patient’s insurance plan and deductible, and it may be subject to coinsurance or other cost-sharing requirements. Most reimburse approximately 40-80%,

Important Considerations:

  • Coverage Limits: It’s essential for patients to understand their insurance plan’s coverage limits for out-of-network services, including any deductibles, co-payments, or coinsurance requirements. We will do our best to verify your insurance benefits however, YOU are responsible for understanding YOUR insurance coverages. 
  • Preauthorization: Some insurance companies may require preauthorization or prior approval for certain out-of-network services, so patients should check with their insurance company before seeking treatment.
  • Appeals Process: If a claim for reimbursement is denied or only partially covered, patients have the right to appeal the decision and provide additional information or documentation to support their claim.

We also have affordable concierge cash-based options available

At Tessera Physical Therapy, we understand that navigating insurance coverage can be confusing, and we’re here to help. If you have any questions about out-of-network services or reimbursement for concierge cash-based services, please don’t hesitate to contact us.

Do I Need A Referral From My Physician For Physical Therapy?

No, South Carolina is a direct access state. That means that in most instances we can treat for 30 days before you will need a referral from your physician. The only exceptions are Medicare and Tricare beneficiaries. If you need assistance getting a referral, please let us know, we are happy to help.

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Pain and limitations are common but that doesn’t make them normal. No matter if you’re recovering from an injury, managing a chronic condition, or simply striving to enhance your physical well-being, our experienced Doctors of Physical Therapy are here to support you every step of the way.

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