How does the billing process work?

Billing for physical therapy services is similar to what happens at any medical facility. When you are seen for treatment, the following occurs:

  • The clinic bills your insurance company, Workers' Comp Co., or charges you directly based on Common Procedure Terminology (CPT) codes.
  • Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
  • The payer processes this information and makes payments according to an agreed upon fee schedule.
  • An Explanation of Benefits (EOB) is generated and sent to the patient and Lone Peak Physical Therapy with a check for payment or a balance due by the patient.
  • A statement for the balance due will then be mailed to the patient. Payments can be made online or by mailing a check or credit card information from the billing statement.

It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. In the majority of cases, the billing process is completed in 60 days or less.

Please give Patient Services a call with any billings questions you might have: 406.522.7488.