Today's post is contributed by Greg Babiec, Physical Therapist, and Owner Evolve Physical Therapy & Sports Rehabilitation in New York. Greg is also a member of WebPT. You can follow him on Twitter at @DrBadBack. Thanks, Greg, for contributing your insights and expertise today!

As a PT, understanding how health insurance works can sometimes be an unpleasant yet important part of the profession.  Of course, treating patients is our primary role but since we spend so much time with our patients, taking an opportunity to educate them about their insurance can set us apart from other health care professionals.  I recommend a bit of research about the insurances you deal with most and a good place to start is on the APTA website.  

In my experience there are a few key things that we as PTs should know about insurance:

1) Understanding the insurance verification

2) What is the patients responsibility

3) What is your responsibility as the PT  

Once a patient attempts to schedule an appointment for PT, most PT clinics have an administrative staff member perform an insurance verification.  I think all PT’s should do a few just for the experience.  If you have never done an insurance verification before, its very simple and usually is best done with a phone call to the insurance company.  Once the patient provides you with their information, call the insurance company to speak to a representative.  

The rep will tell you about the co-payment, co-insurance, deductible and maximum out of pocket costs.  Do a web search for these terms or read something like this so that you know the difference.  The rep will also tell you if the patient needs authorization, how many visits they get and if there are special forms that need to be filled out.  Try to get a good understanding of what needs to be done so that you know what the patient needs to do and what things you need to do.