McNerney & Associates, P.A. participates with a number of insurance plans and will continue to do so for as long as it is financially feasible.
We do not participate with most HMO plans. If you choose to be treated outside of your network or plan, you will be billed directly for any visits and you must then submit the charges to your insurance carrier for reimbursement.
In some cases, a physician referral or prescription is required by your carrier. Bring the referral with you to your first visit.
Aetna PPO
Aetna POS
Blue Shield- Federal
Blue Shield- State of Maryland
Blue Shield- PPO
Blue Shield-HMO and all other Blue Shield products
Cigna Products
EHP (Employee Health Plans)
Humana
Johns Hopkins Health Care Plan
Medicare
Medicare Advantage Plans - we take them but we are not participating with all Medicare Advantage plans. If you have a Medicare Advantage HMO plan it is likely we do not participate. These advantage plans follow the same guidelines as Medicare.
Most Tricare products
United Health Care (non-participating however patients may have out of network benefits) If you have out of network benefits we can forward claim to your insurance so that your claim can be processed according to your out of network benefits and you will be responsible for payment after claim has been processed.
If you are being seen and we do not take your insurance at all, you will be responsible for payment on the date of service.
If you are unsure as to if we take your insurance, we are happy to contact your insurance to verify what your benefits might be and find out if we are participating.
Copayments are collected at each visit. You may pay for services or supplies by cash, check, Discover Card, MasterCard, American Express or Visa at the time of treatment. No-shows or appointments cancelled with less than 24-hour notice may incur a $50 missed appointment fee per 50-minute time slot. Any one-hour appointments that are missed may result in a $75 missed appointment fee.
McNerney & Associates, P.A. is a Medicare certified out-patient provider of physical therapy services. If you are a Medicare patient, a prescription from your medical doctor is required for treatment. Please bring it with you at the time of your first visit. Medicare no longer has a cap on what they will cover for Physical therapy, however certain criteria must be met to continue therapy. Once goals in the plan of care are met your therapist will discharge you from care. Medicare does not not cover maintenance therapy. If the therapist can not provide documentation showing certain goals are being met, you may not be covered by your Medicare Part B. There is an annual therapy threshold of $2330.00 for physical therapy, occupational therapy, and speech therapy combined. If you reach $3000.00 in charges you will be asked to sign an Advanced Beneficiary Notice stating you understand you could be billed for the services after review by Medicare.
If it is determined after review by Medicare that physical therapy services were not medically necessary, Medicare may retract any payments made and you become personally responsible for any charges incurred.
Insurance-related information will be verified at the time of your first visit. This verification is NO GUARANTEE of payment. It is a quote from your insurance at the time we call for what your out- patient physical therapy benefits state on the date of your initial visit. Typically they will verify the amount of the copay, any deductible you may have, if authorization is needed and how many visits may be covered by the insurance. The actual amount that will be paid on a claim submitted to your insurer is not known exactly until the time the first payment and co-pay paperwork is received in our office. You may have a deductible amount due or you may have fewer than the specified number of visits if you have received prior care at another facility. These circumstances will influence the extent of payment for your treatment visits.
It is recommended that you contact your insurance carrier by calling the number on the back of your insurance card as it is ultimately your responsibility to know your benefits and to determine if a physician referral or prescription is required for your insurance coverage.
We will bill secondary insurers once the coverage details are confirmed. We do not bill third-party carriers.
We accept Workers Compensation and Personal Injury Protection Insurance (PIP) to the limit allowed by your carrier. Injury cases that are involved in litigation may be accepted upon review and only if special arrangements are made. If we accept your case, full payment is expected as treatment is rendered. We do not await the settlement of a legal case for payment.
For questions about your account or for additional insurance or billing information, please contact our office at 410.740.1047.
