Out- of Network Provider

Balance + Flow Physio is an out of network provider clinic.  These means that we do not directly bill insurance companies and it is the responsibility of the client to check their out of network benefits and how to submit for reimbursement.  We accept cash, checks, credit cards and HSA/FSA card.  
Super-Bills are an itemized receipt provided for each session that include proof of payment, and the necessary codes and information the insurance company will need for claims.  

Costs









Frequently Use Codes 
New Pricing below effective 2/01/2022
  • Comprehensive Physio Evaluation- $325.  This will be a 90minute intake appointment and physical exam, treatment planning and initiation of home program
  • Myofunctional Therapy Evaluation- $280. 60 minute orofacial myofunctional and breathing assessment (in person or video), treatment planning and initiation of home program
  • Follow up Sessions (PT or Myo): 60min- $225,   45 min- $168.75,   30min- $112.50
  • Progress notes or re-assessment reports will be charged for time spent ($1/minute)  These reports typically take 10-30minutes.

Telehealth appointments are available for both PT and Myo and costs are the same as in person

If you have any questions regarding pricing and all that is included in a session, please feel free to contact us.



PROCEDURE CODES
  • PT Evaluation- 97163
  • PT Re-Evaluation- 97164
  • Therapeutic Exercise- 97110
  • Neuromuscular Re-Education- 97112
  • Manual Therapy- 97140
  • -25 modifier will be added to coding as needed 

COMMMON DIAGNOSIS CODES 
  • For most injuries/conditions including those for hypermobility- M99.00-M99.08
  • TMJ- M26.629, M26.601-603
  • Breathing- R06.5, R29.810
  • Hypermobile type Ehlers-Danlos Syndrome- Q79.62
  • other codes may apply as per unique case

FAQ

Why would a provider choose to be out of network!?!     
    It was a difficult decision to uncouple with insurance companies as we know how hard people work to pay for their insurance and how expense health care costs can be.  However, insurance companies are unwilling to negotiate rates with small providers and do not adjust rates to account for increases in cost of business.  It also requires software and staffing to bill and keep up with authorization, submissions and arguing denied claims.  Basically, it takes away from the time and energy we have to focus on YOU.  In order to continue to provide the high quality PT we pride ourselves on and stay in business, we had to say good bye to working with insurance.
How can I afford this?
     We do our best to make sure you get the most for the money you invest in your wellness by providing one-on-one care, spacing out appointments so it works best with your budget, and a reduced frequency of visits.  Sessions are tailored to your specific needs and activities are given to practice at home to solidify the concepts. This is not your typical PT model of 2-3x/week for 4-6 weeks.  Typically clients are seen 1x/week for 4 weeks then, depending on the reason and complexity of the case, sessions can be spread out.  We also try to provide online educational resources when possible to help with learning concepts outside of the direct session. 
Can you work with my current PT for integrating in specialized training?
     Absolutely!  Since we are a highly specialize practice, we can perform an assessment and make recommendations on findings that may have been over looked or not evaluated.  True healing is a team effort and we love a collaborative model.  We also work with client's massage therapists, fitness, pilates and yoga instructors as well to compliment the work that is done directly with us. 
Do you do at home visits?
Yes, however it is case and location dependent. Costs vary.  Please email for more information. 
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