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Insurance FAQs

  • What does “Out–Of–Network” mean? 

 

Answer: Healthcare providers who are considered nonparticipants with your insurance company.

 

  • Why aren’t you an in-network provider with my plan?

Answer: Moore’s goal is to enhance physical performance for each individual patient. If Moore Center were to contract with them, we would not be able to devote as much time to individual patients due to the low reimbursement from your health insurance which will put a time restriction on your treatment. 

 

  • How would I know what my in & out of benefits are?

Answer: Once we have your insurance information and can verify your benefits, we will be able to tell you what your approximate cost will be.

 

  • Why can’t you give the precise amount I would be paying out-of-network?

Answer: We cannot determine your precise financial responsibility because it is generally not possible to know the exact allowed amount your insurance is going to pay.  The charged amount for each visit can change pending on what course of treatment your therapist is going to perform for that given day.  We will have a better idea on what the amount is going to be after first week of treatment and 2-3 weeks of claim submittal. 

 

  • Would I need to submit my own paperwork if I’m out-of-network?

Answer: For your convenience Moore will submit to your insurance company so you can concentrate on getting better.

 

  • What does “Customary and Reasonable” mean?

 

Answer:  Price adjustment between what the provider (Moore) bills and what the insurance covers. Insurance companies often pay claims based on the average cost of the procedure in the geographic area. 

 

  • What does “Balance Bill” mean?

Answer: The difference between what the provider (Moore) bills and what the insurance allows, which is the customary and reasonable rate.

 

  • If I’m out-of-network, am I going to be responsible for the full amount?

Answer: For most out of network policies, Moore is willing to accept the customary and reasonable amount covered by your insurance so you won’t be balanced billed the difference of what your insurance doesn’t cover. Your responsibility will be based on the allowed amount only.

 

  • What is a deductible?

Answer: Deductible is the amount you must pay before your insurance covers the costs.

  

  • What does “Out-Of-Pocket” mean?

Answer: A predetermined limited amount of money that you must pay out of your own pocket (which applies to your co-pay, deductible, and co-insurance), before your health insurance covers 100%.

 

  • What does “Co-Insurance” mean?

Answer: Co-Insurance refers to a percentage that you are required to pay for treatment, after your deductible has been met.

 

  • What does “Co-Pay” mean?

 Answer: Co-Pay is a predetermined (flat) fee that you pay each visit, in addition to what your insurance covers.

 

Have other questions, please call one of our locations below.

“We have been associated with the Moore Center's physical therapists for over 10 years. Our staff has had the pleasure of collaberating with the Moore Center on many occasions; and as professional colleagues, they demonstrate a knowledge base that is unparralled in Fairfield County. They continue to seek out the latest advances in the fields of functional physical therapy, sports medicine, and wellness. Combining multiple disciplines creates a unique and individualized environment to achieve maximum rehabilitation or performance enhancement.”

— David Armet, P.T., President/Owner
Jennifer Armet, P.T.
Williamstown Physical Therapy, Inc.
Williamstown, MA

 
 
 
Proactive Health Professionals Enhancing Physical Performance

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