Who Pays for Physical Therapy After Car Accident?

Apr 15, 2024

Who Pays for Physical Therapy After Car Accident? Car accidents can leave you reeling. You’re dealing with the physical pain of your injuries, the emotional trauma of the event, and on top of it all, the looming question of medical bills. Physical therapy is often a crucial part of recovering from a car accident, but who foots the bill can be a confusing mess. Here’s the good news: having a trusted physical therapy provider by your side can make a world of difference. This blog post will equip you with the knowledge of who pays for physical therapy after car accident so you can focus on healing with confidence.

Understanding Insurance Coverage for Physical Therapy

Most US health insurance plans cover physical therapy, but the specifics and coverage amounts can vary greatly depending on your plan. Here’s a breakdown of some key terms to understand how insurance plays a role:

  • At-fault vs. No-fault States: Car accident liability varies by state. In at-fault states, the insurance of the driver who caused the accident is primarily responsible for your medical bills, including physical therapy. In no-fault states, your insurance might cover some or all of your medical costs, regardless of who caused the accident.
  • Bodily Injury Liability (BIL): This coverage on the at-fault driver’s insurance policy pays for your medical bills if they were responsible for the accident. The coverage limits will determine the maximum amount the insurance company will pay.
  • Personal Injury Protection (PIP): This is optional coverage on your insurance policy that can help pay for medical expenses, lost wages, and other costs arising from a car accident,  regardless of who caused it. PIP coverage limits vary by state and by plan.

Who’s Responsible for Your Physical Therapy Bills?

Several factors determine who ultimately pays for your physical therapy:

  • Fault: In at-fault states, the at-fault driver’s BIL insurance is usually the primary payment source. You may need to file a claim with their insurance company to get reimbursed.
  • Health Insurance: Your health insurance may also cover some or all of your physical therapy costs. However, you might have a deductible (a set amount you pay before insurance kicks in) and potentially co-pays (a fixed amount you pay for each covered service).
  • Out-of-network vs. In-network Providers: If you choose a physical therapist who is out-of-network with your insurance plan, you might be responsible for a larger portion of the cost. It’s always best to check with your insurance company beforehand to see if a physical therapist is in-network.
  • Up-front Costs and Reimbursement: Sometimes, you might need to pay for physical therapy upfront and then seek reimbursement from the responsible insurance company. Make sure to keep detailed records of all your receipts and treatment documents for this process.

Visit our Guide to Managing Medical Expenses After a Car Accident to learn more

Filing a Claim for Physical Therapy Reimbursement: A Step-by-Step Guide

If you need to file a claim with an insurance company to get reimbursed for physical therapy, here’s what to do:

1. Get a Referral

Talk to your doctor and get a referral for physical therapy. This ensures your treatment is medically necessary and documented for insurance purposes.

2. Contact Your Insurance Companies

Get in touch with both your own insurance company and the at-fault driver’s insurance company (if applicable).

3. Gather Documentation

Keep meticulous records of everything related to your physical therapy, including:

  • Receipts for all physical therapy services
  • Your treatment plan
  • Doctor’s notes and any medical records related to your physical therapy

4. File a Claim

Each insurance company might have a specific process for filing claims. Make sure you understand their procedures and submit all required documentation promptly.

5. Be Patient and Persistent

The claim process can take time. Stay in touch with the insurance company and follow up promptly on any requests for additional information. Don’t be afraid to be persistent if you encounter delays or denials.

What If Your Claim Is Denied? Exploring Your Options

Filing a Claim for Physical Therapy Reimbursement Hitting a roadblock with your insurance claim can be frustrating.  Here’s the good news: even if your initial claim for physical therapy is denied, there are still steps you can take to get the coverage you deserve.

Appeal the Decision:  Most insurance companies have an appeals process in place.  Carefully review their guidelines and file an appeal if you believe the denial was made in error. This might involve submitting additional documentation to support your medical need for physical therapy.

Seek Legal Advice:  If your appeal is unsuccessful, consider consulting with a personal injury attorney specializing in car accidents.  An experienced lawyer can help you navigate the complexities of the appeals process and explore other options, such as filing a lawsuit against the at-fault driver to recover your medical expenses, including physical therapy costs.

Explore AICA’s Car Accident Treatment and Physical Therapy Services

At AICA, we understand the physical, emotional, and financial toll a car accident can take.  Our team of experienced professionals is here to help you navigate every step of the recovery process, including navigating the complexities of medical billing.

We can help you get the physical therapy you need:

  • Finding the Right Physical Therapist: We can connect you with a qualified physical therapist in your area who specializes in treating car accident injuries.
  • Streamlined Communication with Insurance Companies: Our team can assist you with communicating with your insurance company and the at-fault driver’s insurance company to ensure your physical therapy bills are covered.
  • Focus on Healing: We help you understand your billing options and answer any questions you may have about the process. This allows you to focus on your recovery and getting back to the activities you love.
  • Treatment Tailored to Your Needs: Our physical therapists will develop a personalized treatment plan designed to address your specific injuries and help you regain strength, mobility, and function.

Contact us today to learn more about our comprehensive car accident treatment services, including physical therapy.  We’re here to guide you through every step of the journey towards a full recovery.

SHARE:

Search

Contact Us

  • * By submitting the form you consent to be contacted by AICA Orthopedics via text message, phone call, and email at the contact information provided.

  • This field is for validation purposes and should be left unchanged.

Visit one of our 17 Metro Atlanta Locations

Winder

16 Lee St Winder, GA 30680

McDonough

259 Jonesboro Rd McDonough, GA 30253

Lawrenceville

217 Scenic Hwy S, Lawrenceville, GA 30046

Stone Mountain

1000 Main Street, Ste C Stone Mountain, GA 30083

Macon

626 1st St Macon, GA 31201

Newnan

2700 Highway 34 East Newnan, GA 30265

Duluth

3775 Venture Drive, Building F Duluth, GA 30096

Chamblee Tucker

3166 Chestnut Drive Connector, Suite 100, 200 Atlanta, GA 30340

College Park

1624 Virginia Avenue College Park, GA 30337

Conyers

2375 Wall Street Southeast #135 Conyers, GA 30013

Jonesboro

750 Mount Zion Road Jonesboro, GA 30236

Kennesaw

3825 Cherokee Street Northwest Kennesaw, GA 30144

Lithia Springs

530 Thornton Road Lithia Springs, GA 30122

Marietta

1965 North Park Place Southeast, Suite 200 Marietta, GA 30339

Snellville

2346 Wisteria Drive, Suite 110 Snellville, GA 30078

Stockbridge

260 Corporate Center Drive, Suite E Stockbridge, GA 30281

Buckhead

2045 Peachtree Road Northwest, Suite 700 Atlanta, GA 30309