FREQUENTLY ASKED QUESTIONS

 
 

Where are you located?

Our clinic is located inside of Maniac CrossFit in South Portland, Maine. We have a fully functional clinic space separate from the main gym, with our own equipment including rigs, barbells, weights, a GHD, and everything needed to get you back to pain-free activity.

Do I need a referral from my doctor for physical therapy?

In the state of Maine, a referral is NOT required for an individual to receive physical therapy services. This is referred to as direct access, meaning you can go directly to a physical therapist for treatment without the hassle of attending several other office visits prior to initiating physical therapy. This results in less delay and quicker assessment, treatment, and recovery. As an Orthopedic Certified Specialist, our Doctors of Physical Therapy are familiar with situations when an individual's condition is not appropriate for physical therapy or if imaging (x-ray, MRI, etc) is recommended by evidence-based guidelines, and will ALWAYS refer to the appropriate medical provider in these cases.

 

Do you take my insurance?

Infinite Capacity does not have any direct contracts with insurance carriers, but are a fee-for-service practice. Upon request, you will be provided with documentation of each visit, which can then be submitted to your insurance for reimbursement of out-of-network services. Because of this, and due to certain laws and regulations, we are unable to see individuals who are covered by Medicare, Medicaid (MaineCare), TRICARE, other Federally Funded Payers, or worker’s compensation carriers.

If you are interested in utilizing your out-of-network insurance benefits, you can find all the information you need in this step-by-step guide. CLICK HERE to access the guide. It walks you through every question you need to as your insurance company to find out what your benefits are, and how much you can expect to be reimbursed.

 

What Is fee-for-service?

Infinite Capacity is a fee-for-service physical therapy practice. This means we do not bill your insurance. Each therapy treatment will be paid by the patient on the day of the treatment. You can then request documentation of the session, which can be submitted to insurance for reimbursement of out-of-network services. We bill thru an automated payment system, therefore require a credit or debit card (all major credit/debit cards, and Health Savings Account debit cards) at the time of booking an appointment, but arrangements can be made for other forms of payment (cash, checks, etc).

For more information on why this may be the best option for your treatment, CLICK HERE to read a blog post on this topic.

 

How do i know if my insurance will reimburse me?

Changes made daily by insurance companies make it impossible for us to accept the responsibility of knowing exactly your insurance benefits, coverage, and financial liability. We encourage our patients to contact their insurance carrier by phone for explanation of their benefits, so they have a better understanding of what their financial responsibility may be. It is important to know that any information given over the phone is not a guarantee, only an estimate.

Here some tips and questions to ask while discussing your benefits with your insurance carrier:

  • Call the number on the back of your insurance card and select the option to speak with a customer service representative…

  • Ask the customer service representative to quote your benefits for physical therapy out-of-network services

    • Specifically, what percentage will be covered and what percentage will you be responsible for?

  • Find out if a pre-authorization is required for services to be covered

    • If yes, do they have one on file?

  • Find out if a medical doctor’s referral is required for services to be covered

    • If yes, do they have one on file?

      • If yes, great!

      • If no, you will need to contact your family doctor’s office to have them submit a referral

  • Do you have a deductible, how much is it, and how much has already been met?

  • Is a special form required to be filled out in order to submit a claim?

    • If yes, where is the form?

      • How to submit it prior to initiating therapy (mailing address, online, etc.)

 

how do I submit to my insurance for reimbursement?

The first step is to contact your insurance carrier to find out the options for submitting. Some insurances may accept submission online, while others may require it be mailed.

After each therapy visit, you will be supplied with a document called a Superbill. This document has all of the information on it required for your reimbursement. You can then submit the required documentation (Superbill, your payment receipt, insurance claim submission form, etc.) to your insurance carrier.

 

Additional questions?