Insurance & Reimbursement

Pillar Core is an out-of-network, cash-pay practice. That means payment is collected at the time of service, and you have the option to seek reimbursement from your insurance company through your out-of-network benefits. Many patients are reimbursed a meaningful portion of the cost, depending on their plan.

Here is how it works:

1. You pay for your visit at the time of service.

2. I provide a superbill, which is an itemized receipt with all the codes and information your insurer needs.

3. You submit the superbill to your insurance company.

4. Your insurer reimburses you directly, based on your out-of-network benefits.

A superbill works a lot like a receipt you keep for a return. The practice gives you the documentation, and you bring it to your insurer to claim what you are owed.

Checking your benefits

Coverage varies widely from plan to plan, so it is worth a quick call to your insurance company before your first visit. A few questions to ask:

• Do I have out-of-network benefits for outpatient physical therapy?

• What is my out-of-network deductible, and have I met it?

• What percentage of the cost is reimbursed once my deductible is met?

Why out-of-network

Working outside of insurance allows me to spend a full, focused session with you, one on one, without the visit limits or time constraints that insurance often dictates. You get more time, more individualized care, and faster scheduling. For many patients, that combination is worth the out-of-network model, even after factoring in reimbursement.

HSA and FSA

Most patients are able to use HSA and FSA funds to pay for treatment. If you have one of these accounts, it can be a convenient way to cover your visits.

A note on Medicare: I am unable to provide physical therapy treatment to Medicare beneficiaries. Due to Medicare regulations, this applies even if you do not plan to use your Medicare benefits or wish to pay out of pocket. I do, however, offer wellness services to Medicare beneficiaries, such as fitness, movement, and general conditioning work that falls outside the scope of physical therapy treatment. If you are a Medicare beneficiary and interested in wellness services, reach out and I am happy to talk through what that looks like.

Questions about cost or coverage?

If you are unsure about your benefits or want to talk through what treatment would cost, reach out through my Inquire page and I am happy to walk you through it.