The 7 Questions To Ask Your Insurance Reimbursement

Insurance Benefits Cheat Sheet

At Lunara we believe health care costs should not be a surprise. To better serve our clients we made sure they could quickly understand their cost of care for both each visit and the likely number of visits needed. This allows people to know their costs and is part of our 100% transparent billing practices. No surprises here

For people that are considering out-of-network benefits, you will find the 7 questions to ask to make sure you understand your out-of-network reimbursement. Unfortunately, it’s easier to understand the cost to go to an in-network provider. Have your insurance card ready when you call.

7 Questions to ask your insurance About Out Of Network Benefits

  1.    Do I have out-of-network benefits?

If yes, continue on. If not, you will not be able to submit for reimbursement for care at Lunara, you can still use a health spending account however using pretax dollars to pay for your care.

  1. Do I have a deductible for out-of-network care?

If yes, how much and how much has been met?

  1. What type of reimbursement do I have for an out-of-network provider?

(Often a percentage or dollar amount, if asked for the type of service let them know it is for outpatient physical therapy.)

Specific codes billed to confirm reimbursement: 97161, 97530, 97140, 97110

  1. Do I need a form for reimbursement?

If yes, how do I get one?

  1. Do I need a preauthorization or a referral for outpatient physical therapy?

If yes, what do I need to do to obtain these things?

  1. Do I have a dollar or visit limit on my plan per year?

If yes, what are they?

  1.    How do I submit a claim?

This will help you understand the process and should be written down to limit the need to call in the future.

Your insurance provider is supposed to be working for you to pay for your care. Every plan is different and provides reimbursement for your physical therapy benefits. Once you have the information above we can assist in answering any questions you may have regarding how reimbursement works and what we provide you.