PT and Chiropractic Are Not Covered Concurrently

PT and Chiropractic Are Not Covered Concurrently

Most insurances, including workers comp & no-fault do not allow patients to be treated for the same condition with both chiropractic and physical therapy during the same time period. Sometimes the patient will not mention to the provider that they are already receiving treatment. Then the provider sees the patient, submits the claim, but gets denied since the patient is already receiving care.

If you provide physical therapy, or if you are a chiropractor it is important that you ask the patient if they are already receiving or if they have received treatment for this condition, and if yes, by whom. Do not just assume that the patient will know to tell you.

If the patient informs you that they are currently receiving care you need to inform them that the services will not be covered. If the patient still wishes to be treated, you need to have him/her sign a waiver stating that they consent to the treatment, they understand that it will not be covered by insurance, and that they accept the financial responsibility for the services. The waiver should be signed each time the patient comes in for treatment.

You do not want to make the mistake of treating a patient with chiropractic manipulations several times before finding out that they are also seeing another provider for physical therapy for the same condition. Your claims get denied and it is too late to get the patient to sign a waiver.

The patient may not have known that it mattered, or maybe they just did not care. It really does not matter because either way you are out the money for your services. So make sure you cover yourself by asking the patient on their intake form if they are currently being treated or if they have been treated by another provider for the same condition. Then, based on how they answer that question you can ask them about their other treatment. This way you will be sure to get paid for your services.

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