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
Coventry Health Care
EHP (Employee Health Plans)
Humana
Informed
Johns Hopkins Health Care Plan
Medicare Multiplan
Tricare
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 or Visa at the time of treatment. No-shows or appointments cancelled with less than 24-hour notice may incur a $25 missed appointment fee per 40-minute time slot. Any one-hour appointments that are missed may result in a $50 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. Since January 1, 2006, Medicare has a placed a cap on monies available to pay for combined, non-hospital based out-patient physical therapy and speech therapy care per calendar year. The amount of that benefit this year is $1920 and it may be applied entirely to physical therapy services. There are some exclusionary diagnoses that may allow you to exceed this $1920 cap. Total joint replacements are permitted additional visits. Patients being treated for certain conditions who also have an additional diagnosis such as diabetes, Parkinsonism, visual impairment or one that may affect the usual course of treatment may likewise qualify as an exception to the cap limit.
A running tabulation is kept by our office on the amount of the benefit that you use over the course of your visits so that you do not exceed your limit. Although exclusionary diagnoses permit you to exceed the $1920 cap, you will be required to sign an Advanced Beneficiary Notice with each visit. This is a form provided by Medicare informing you that your claims are subject to review by Medicare. If it is determined that physical therapy services were not medically necessary, Medicare may retract any payments made and you become personally responsible for any charges incurred above the cap limit. You are advised to keep track of your own visit number and the amount of your benefit that is used. The extent of physical therapy coverage, the amounts and the use of exclusionary diagnoses and the use of the Advanced Beneficiary Notice may change at the end of 2013 with implementation of the new healthcare legislation. For more information about your Medicare Part B out-patient physical therapy coverage, please go to http://www.medicare.gov.
Insurance-related information will be verified at the time of your first visit. At that time or by your second visit we will inform you of the number of visits that are covered by your policy, the amount of your deductible and the estimated amount of your co-payment. These numbers are provided to us by your insurance company and are not guaranteed by us. 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.
You may contact your insurance carrier by calling the 800 number on the back of your insurance card if you require further clarification or 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 manager, Joann Stupi, at 410.740.1047.
