Work comp patients pay nothing out of pocket.

No copay, no deductible, no bill — on an accepted workers’ comp claim, or when your employer or a state program arranged your care. The rest of this page is for patients using their own health insurance or paying for themselves.

For patients / Using your insurance

For patients using health insurance

How your health insurance works here.

A plain-English guide from our billing office: what the words on your insurance card mean, what we collect at each visit, and why the final amount comes from your insurance company.

Which plans we take Self-pay rates Questions about a bill

The one thing to know first

What we tell you before your first visit is an estimate.

Before you start, we check your benefits with your insurance company and tell you what it says you will owe at each visit. It is the best information anyone has that day, but it is still an estimate. Your insurance company makes the final decision when it processes each claim, and it tells both of us in an Explanation of Benefits, or EOB.

At your visitYou pay the estimate from your benefit check.

Your insurance decidesIt processes the claim and sends the EOB.

It matchesNothing more to do.
You owe moreWe mail you a statement for the difference.
You paid moreWe refund the difference.

The EOB is the final word. The amount on it is what you owe, even when it differs from the estimate.

Step by step

From your first visit to your last bill

1

We check your benefits

Before your first visit we ask your insurance company for your copay, deductible and coinsurance, and whether your plan needs a referral or prior authorization.
2

You pay your share at each visit

Your copay, or an estimated prepayment toward your deductible or coinsurance, is due at each visit.
3

We bill your insurance

After each visit we send the claim to your insurance company for you.
4

Your insurance decides

It processes the claim and sends an EOB showing what it paid and what you owe for that visit.
5

We settle up

Paid too little: we mail a statement. Paid too much: we refund you once all of your claims are processed.

The words on your insurance card

Copay, deductible, coinsurance — in plain English

Who pays for covered care as your plan year goes on

An example plan with a $2,000 deductible and 20% coinsurance. Some plans charge a copay instead of coinsurance, and your plan’s numbers will differ.

YouYour plan

Until you meet your deductiblefor example, the first $2,000 of covered care

You 100%
After your deductiblecoinsurance, until you reach your out-of-pocket maximum

20%Your plan 80%
After your out-of-pocket maximumfor the rest of the plan year

Your plan 100%

Copay

A fixed amount you pay for each covered visit, set by your plan.

How we handle itWe collect the copay your insurance company quotes us, at each visit.

Deductible

What you pay for covered care each year before your plan starts paying. With a $2,000 deductible, for example, you pay for the first $2,000 of covered care yourself. After that, you usually pay only a copay or coinsurance.

How we handle itUntil your deductible is met, we collect an estimated prepayment at each visit. Once it is met, we switch to your copay or coinsurance.

Coinsurance

Your percentage of the cost of a covered visit once your deductible is met. If your plan allows $100 for a visit and your coinsurance is 20%, for example, you pay $20.

How we handle itWe collect an estimate at each visit and adjust it when your insurance processes the claim.

Out-of-pocket maximum

The most you pay for covered care in a plan year. Your deductible, copays and coinsurance all count toward it. Once you reach it, your plan pays 100% of covered care for the rest of the year.

Benefit limit

Some plans cap how much they pay for therapy in a year, in visits or in dollars. Once you reach the cap, further treatment is yours to pay.

How we handle itIf you are close to your limit, we talk with you about payment before your care continues.

In network

We have a contract with your insurance company. We file your claims directly, and you pay the in-network share.

Out of network

We have no contract with your insurance company. Your plan pays only if it has out-of-network benefits, and your share is usually higher. Most PPO and POS plans have some; most HMO and EPO plans cover out-of-network care only in an emergency.

Explanation of Benefits (EOB)

The statement your insurance company sends after it processes a claim. It shows what the plan paid and what you owe for each date of service. It is the final word on your bill.

Your insurance card

Six things to find on your card

Plan typePPO and POS plans usually pay for some out-of-network care. HMO and EPO plans usually don’t.
Member IDWe need it to check your benefits.
Group numberIt ties you to your employer’s plan.
CopaysSome cards print them. Your benefit check tells us what applies to therapy.
Suitcase logo (Blue plans)“PPO” in the suitcase means we are in network. A blank or “EPO” suitcase means we check your plan.
Member services numberOften on the back. Call it and ask whether we are in network for physical therapy.

Insurance networks

Which plans we take

For physical and occupational therapy at our Maryland and Virginia clinics. Your exact plan decides, so we confirm network status every time we check your benefits.

Insurance networks by state
Plan	Maryland clinics	Virginia clinics	Good to know
CareFirst BlueCross BlueShield, Anthem, FEP (Federal Employee Program) and most out-of-state BlueCard PPO plans	In network	In network	BlueChoice HMO and Open Access POS plans may need a referral from your primary care doctor or a prior authorization. Marketplace plans vary.
Aetna, plans based in Maryland	In network	Out of network	No referral needed for PPO or Open Access plans. At our Virginia clinics we are out of network.
Aetna, plans based in Virginia	Out of network	Out of network	Covered only if your plan has out-of-network benefits, usually a PPO or POS plan. EPO and HMO plans usually have none.
Cigna	Out of network	Out of network	Covered only with out-of-network benefits, usually a Cigna PPO or Open Access Plus plan. Marketplace (Cigna Connect) and LocalPlus plans often have none.
UnitedHealthcare	Out of network	Out of network	Choice Plus and Options PPO plans may have out-of-network benefits; Navigate, Charter and Compass plans do not. Some plans send physical therapy through Optum.
TRICARE Select	Certified out-of-network	Certified out-of-network	We bill TRICARE directly, and you don't need a referral for PT or OT. Your share is higher than with an in-network provider.
Johns Hopkins EHP	Plan by plan	Not accepted	We are not contracted with EHP. Some employer groups reimburse out-of-network care; we check yours.
Union, Teamsters or "Local" plans, and plans run by a third-party administrator that carry a CareFirst or Anthem logo	Plan by plan	Plan by plan	The logo on the card does not settle it. We check each plan.

Plan not listed? Call us — we check any plan.

Not accepted: Medicare as your primary coverage, including Medicare Advantage plans; Medicaid, Medical Assistance and state-funded HMO plans; and TRICARE Prime and TRICARE For Life. Have Medicare and an employer plan too? Call us first — whether we can see you depends on which plan pays first.

We may decline a plan based on what the benefit check shows, the plan’s authorization rules or our contract. A benefit check is a courtesy: it records what your insurance company told us that day and is not a guarantee of coverage or payment.

Out of network, or no coverage for therapy

If your plan won’t pay us, you can still be seen.

Your plan has out-of-network benefits

We bill your plan for you. Expect a larger share than in network, usually a deductible and coinsurance, and we collect an estimate at each visit, as with any plan.

No out-of-network benefits, or no coverage for therapy

You can be treated as a self-pay patient. You sign a self-pay authorization before you start and pay our self-pay rate at each visit. After you’re discharged, ask us for a copy of the claim, and you can send it to your insurance company yourself.

Our self-pay rates for physical therapy

Evaluation$230Your first visit

Treatment visit$120Each visit after that

Paid at each visit, and the price does not change afterwards. Functional capacity evaluations, work programs and other services are quoted separately.

Missed visits

Can’t make a visit? Let us know 24 hours ahead.

Call your clinic at least 24 hours before your visit to cancel or reschedule, and there is no charge. Cancelling later than that, or not coming at all, counts as a missed visit.

24 hours’ notice or more$0Cancel or reschedule at no charge.
First missed visit$0No charge the first time.
Second, and each one after$45Charged for each missed visit.

Your insurance doesn’t pay this fee. It applies to visits paid by health insurance or by you, not to workers’ comp. Find your clinic’s phone number.

After your visits

Bills, refunds and paying a balance

When you get a billOnly when your EOB says you owe more than you paid. Statements are mailed monthly, and payment is due when you receive one.
Paying a statementBy card over the phone with our billing office at (301) 838-2040, or by check mailed to our corporate office — the address is below.
RefundsIf you paid more than your EOB says, we refund you after all of your claims are processed: automatically to the card you used, or by check if you ask.
Tell us about every plan you haveYour main insurance, any second plan, and any change as soon as it happens. That’s how we bill the right plan the first time. If we can’t, the charges can end up being yours.

Paying by check

Make checks payable to Rehab at Work, Corp. and mail them to our corporate office:

Rehab at Work, Corp.
7668 C Standish Pl.
Rockville, MD 20855

Write the account number from your statement on your check.

Your clinic handles your care. Our billing office handles your bill.

The front desk at your clinic can tell you what your benefit check says. For anything else — an estimate that looks wrong, a statement, a refund, a plan that changed — call our billing office at (301) 838-2040. They work from the same EOBs you receive and can go over your estimate with you before your next visit.

Questions

Insurance questions, answered.

Why is my bill different from what I paid at the visit?

Because what we collect at the visit is an estimate, based on what your insurance company told us. The final amount comes from your EOB. If it is more, we mail you a statement for the difference; if it is less, we refund you after all of your claims are processed.

Do I have to pay the estimated prepayment?

Collecting it at each visit is our policy, and without it we may not be able to continue your treatment. If the amount is a problem, call our billing office at (301) 838-2040 before your next visit and they will go over it with you.

How do I know if you’re in network with my plan?

Start with the table above, then check with your plan: call the member services number on your card or look us up in its online directory. If you are told we “participate” or “accept” your plan, ask whether we are in network — they are not the same thing. We also confirm it when we check your benefits.

Can I see you if you’re out of network?

It depends on your plan. Most PPO plans let you see any provider; many HMO and EPO plans do not. Your plan’s summary of benefits, or your employer’s HR office, can tell you. If your plan has no out-of-network benefits, you can still be seen as a self-pay patient.

Why do you need my secondary insurance too?

To bill correctly we need every plan you have, and any change as soon as it happens. Without complete information we may bill the wrong plan, and the whole bill can become yours.

What if I reach my plan’s visit or dollar limit?

Your plan stops paying, and further treatment is your responsibility. We talk with you about payment before your care continues.

What if I miss a visit or cancel late?

Call your clinic at least 24 hours ahead to cancel or reschedule, and there’s no charge. A later cancellation, or not coming at all, counts as a missed visit. The first one is free; from the second on, each missed visit is $45. Your insurance doesn’t pay this fee.

Do you accept Medicare or Medicaid?

No. We don’t accept Medicare as primary coverage (including Medicare Advantage), Medicaid, Medical Assistance, state-funded HMO plans, TRICARE Prime or TRICARE For Life.

I’m here for a work injury. Does any of this apply to me?

No. On an accepted workers’ compensation claim, or when your employer or a state program arranged your care, you pay nothing — no copay, no deductible, no bill.

Want to know what care has actually cost our patients? See what care costs.

Questions about a bill or an estimate?

Call our billing office. They work from the same Explanation of Benefits you receive.

Call billing: (301) 838-2040 Find your clinic