Frequently Asked Questions (FAQ)

• Arrive at your appointment with your paperwork completed (you can download it from our website - see the paperwork or forms link).
• You will provide us with your referral for physiotherapy if you have one. If you don't have a referral, let us know when you schedule your first visit with us (note - a referral is not always needed).
• We will copy your insurance card.
• You will be seen for the initial evaluation by the therapist.
• The therapist will discuss the following:
  1. Your medical history.
  2. Your current problems/complaints.
  3. Pain intensity, what aggravates and eases the problem.
  4. How this is impacting your daily activities or your functional limitations.
  5. Your goals with physiotherapy.
  6. Medications, tests, and procedures related to your health.
• The therapist will then perform the objective evaluation which may include some of the following:
  1. Palpation - touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
  2. Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
  3. Muscle Testing - the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
  4. Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
  5. Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
  6. Posture Assessment - the positions of joints relative to ideal and each other may be assessed.

You should wear loose-fitting clothing to expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice. For low back problems, wear a loose-fitting shirt and pants, again so we can perform a thorough examination.

Treatment sessions typically last 30 to 60 minutes per visit.

This is highly variable. You may need one visit or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc. You will be re-evaluated on a monthly basis and when you see your doctor, we will provide you with a progress report with our recommendations.

More than half of all Americans are suffering from pain. Whether it is a recent episode or chronic, an ABC News/Stanford study revealed that pain in America is a serious problem. However, many do not even know that physiotherapist are well equipped to not only treat pain but also its source.

Physiotherapist are experts at treating movement and neuro-musculoskeletal disorders. Pain often accompanies a movement disorder, and physiotherapist can help correct the disorder and relieve the pain.

You have probably heard of the profession of physiotherapy. Maybe you have spoken with a friend about how physiotherapy helped get rid of their back pain, or you might know someone who needed physiotherapy after an injury. You might even have been treated by a physiotherapy yourself. But have you ever wondered about physiotherapist--who they are and what they do? Many people are familiar with physiotherapist' work helping patients with orthopedic problems, such as low back pain or knee surgeries, reduce pain and regain function. Others may be aware of the treatment that physiotherapist provide to assist patients recovering from a stroke (e.g., assisting them with recovering using their limbs and walking again).

The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we can continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.

Because physiotherapist are experts in movement and function, they do not confine their talents to treating people who are ill. Preventing injury, loss of movement, and even surgery is a large part of a physiotherapist's program. Physical therapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide sports therapy and sports performance services for athletes of all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, several physical therapists provide consulting services for recreational golfers and fitness clubs to develop safe and effective workouts, especially for people who already know that they have a problem with their joints or backs.

The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physiotherapist also educate patients to take care of themselves and perform certain exercises independently. Depending on the particular needs, physiotherapist may also "mobilize" a joint (that is, perform certain types of movements at the end of your range of motion) or massage a muscle to promote proper movement and function. Physiotherapist also use methods such as ultrasound (which uses high-frequency waves to produce heat), hot packs, and ice.

Although other practitioners may offer some of these treatments as "physiotherapy," only qualified physiotherapists or physiotherapist assistants who must complete a 2-year education program and work only under the direction and supervision of physiotherapists can provide physiotherapy.

Your insurance will cover most forms of physiotherapy treatment, but the coverage will vary with each plan. All 50 states offer direct access to physiotherapy, which means that patients are not necessarily required to see their physicians before seeing a physiotherapist. In many cases, all you have to do is ask your doctor if physiotherapy is right for you. Contact us for more information on direct access.

Reference: APTA

Who is better to see, a PT that works for a physician or a PT that owns a private practice? We leave it up to you to draw your own conclusions but here are some facts. The studies indicate there were more treatments (visits per patient were 39% to 45% higher in physician owned clinics) and the cost was greater for those patients that attended a physician owned physiotherapy practice (both gross and net revenue per patient were 30% to 40% higher)¹.

Another study indicated that licensed and non-licensed therapy providers spent less time with each patient in physician owned clinics and physiotherapy assistants were substituted for physiotherapists.²

Another older study concluded that "Therapists who had treated patients through direct access were significantly more likely to believe that direct access had benefited them professionally and benefited their patients than were therapists who had not practiced through direct access."³

We believe that we can provide you with the highest quality of care available and do it in a cost-effective manner.⁴ You will work closely with your physiotherapist and in most instances, your case will be managed by the same physiotherapist from the beginning to the end of your experience with us.

1. Mitchell, J., Scott, E., Physician Ownership of Physiotherapy Services: Effects on Charges, Utilization, Profits, and Service Characteristics, Journal of the American Medical Association, 1992.
2. "Joint Ventures Among Health Care Providers in Florida," State of Florida Health Care Cost Containment Board, 1991.
3. Domholdt E, Durchholz AG. Direct access use by experienced therapists in states with direct access. Phys Ther. 1992 Aug;72(8):569-74.
4. Federal Office of the Inspector General May 1, 2006 - This report calls into question billing processes done by non-physiotherapist owned practices.

Orthopedic Physiotherapy - Probably the most common physiotherapy specialist is the orthopedic specialist. These specialists care for post-surgical patients, arthritis, tendinitis/tendinosis, fracture rehabilitation, muscle sprains and strains, neck and back pain, hip and knee problems, shoulder, elbow, and wrist conditions. Some are board certified as Orthopedic Certified Specialists (OCS).

Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Grade five mobilizations, Mulligan mobilizations with movement, Maitland and Kaltenborn techniques, functional technique, neural mobilization, joint mobilization, craniosacral therapy, strain/counter strain, myofascial release, etc. These are some of the more popular manual therapy techniques. Many manual therapists will take continuing education courses, obtain certifications in manual therapy, and will sit for board certification from the American Physiotherapy Association and other organizations. Most physiotherapists incorporate manual therapy techniques as a part of a complete treatment plan.

Geriatric Physiotherapy - Some therapists specialize in the rehabilitation of seniors. As the body ages, a variety of challenges arise. We stiffen, we lose strength, our balance skills decline, our bones become brittle (osteoporosis), our endurance decreases, and we take longer to recover from injuries. Balance and fall prevention are of paramount importance to the therapist who is working with seniors and some clinics are solely dedicated to caring for those with balance problems. Most physiotherapists work with seniors/geriatric patients. Some have obtained additional education, have passed a board examination, and have earned the Geriatric Certified Specialist (GCS) title.

Sports Rehabilitation - Experts in assisting with recovery after injury and surgery. Many sports specialists help with retraining the athlete utilizing running, throwing, jumping, and sport-specific programs to name a few. A therapist with the Sports Certified Specialist (SCS) title has passed a board-certified test.

Fitness and Wellness - Physiotherapist are well trained to help with your fitness needs and wellness programs. If you need an exercise program, have trouble with your weight, are concerned about osteoporosis, have an issue with diabetes, or would like to learn how to prevent falls, physiotherapists can help. The previous examples are just a few of the many programs physiotherapists offer.

Hand Therapy - Most physiotherapists are well trained to treat hand and wrist conditions. Some therapists have taken additional courses and training and have passed a hand therapy certification examination. These therapists are called Certified Hand Therapists (CHTs).

Women's Health - Some therapists specialize in women's issues such as pregnancy problems, pelvic pain, and incontinence. Special treatment is available for women who have these problems. Many that suffer from incontinence do so needlessly. A physiotherapist may be able to help.

Industrial Rehabilitation - Specialists in industrial rehabilitation help with those that have suffered on-the-job injuries. Moreover, they will evaluate work tasks, fabricate assistive devices, evaluate your ergonomic situation, and help redesign workflow/tasks to decrease the incidence of injury. Often, industrial rehabilitation specialists will evaluate your ability to perform certain job tasks with a Functional Capacity Evaluation (FCE).

Pediatric Physiotherapy - Pediatric therapists specialize in the rehabilitation of children. They may assist with kids who suffer from cerebral palsy, developmental disorders, neurological disorders, and/or orthopedic problems. A Pediatric Certified Specialist (PCS) is a board certification that some may obtain from the American Physiotherapy Association.

Aquatic Physiotherapy - Aquatic therapy takes advantage of the physical properties of water to assist with the rehabilitative process. Buoyancy, turbulence, hydrostatic pressure, and thermal properties of water can assist with the rehabilitation of a patient. Those suffering from chronic pain, osteoarthritis, fibromyalgia, rheumatoid arthritis, lumbar fusion surgery, or with a limited weight-bearing status are just a few of the many different patient populations that can benefit from aquatic therapy.

Cardiac and Pulmonary Rehabilitation - A small percentage of physiotherapists practice in this discipline. Those that pass the board certification have the title of Cardiovascular and Pulmonary Certified Specialist (CCS) work with patients who have had heart attacks, bypass surgeries, angioplasty, breathing problems, emphysema, and other heart/lung related conditions. Physiotherapists are well equipped to work with these types of patients because many of them have orthopedic ailments that limit their ability to function. In other words, a physiotherapist can address the heart and lung problems as well as the muscle problems that are concurrently present.

Neurological, Spinal Cord Injury, and Traumatic Brain Injury Rehab - A large portion of physiotherapists work with patients who suffer from these conditions. Functional retraining including, walking, wheelchair use, getting in and out of bed or chairs (transfer training), moving in bed (bed mobility), and retraining patients to use their shoulders, arms, and hands are just some of the services these therapists provide to those with neurological involvement. A certified specialist holds a Neurologic Certified Specialist title (NCS).

Balance, Dizziness, and Vertigo Rehabilitation - Many suffer from dizziness or BPPV (benign paroxysmal positional vertigo). Some clinics specialize in the rehabilitation of patients with vertigo. Patient education, strengthening, safety awareness, posture and balance exercise, walking exercise, and special techniques that affect sensory and balance centers of the brain and limbs are all important components of a rehabilitation program.

Amputee Rehabilitation - Many physiotherapist specialize in the rehabilitation of amputees. Caring for the injured limb, functional and walking training, training in the use of assistive devices (crutches, canes, prosthetic limbs, etc.) are all provided by a therapist who specializes in care for amputees.

Wound Care - Some therapists specialize in the treatment and care of wounds. This is accomplished by the removal of unviable tissue (debridement), the application of special dressings and prescription drugs/ointments, and the use of ultrasound, electrical stimulation, and aquatic modalities to promote healing. Exercise and patient education are also routine components of a wound care program.

ECS (Clinical Electrophysiologic Certified Specialist) - A physiotherapist who is board certified to perform electroneurophysiology examinations such as nerve conduction studies and electromyography.

Lymphedema Rehabilitation - We take it for granted but a special component of the circulatory system, the lymph system, helps filter and drain fluid from our arms and legs. When this drainage system is damaged, painful swelling can result. Some therapists specialize in the treatment of lymphedema as it is called. Special positioning, massage and bandaging techniques are utilized by the lymphedema specialist.

Osteoporosis Rehabilitation and Prevention - Some practitioners specialize in the evaluation and treatment of osteoporosis patients. Working in concert with your medical doctor, the therapist will often design a specialized weight-bearing and resistance training program for those with this silent disease.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physiotherapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physiotherapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be painful. Your physiotherapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

Massage may be part of your treatment. Rehabilitation specialists are trained in a variety of techniques that may help with your recovery. Deep tissue techniques may be part of the rehabilitative process. Massage is used for three reasons typically - to facilitate venous return from a swollen area, to relax a tight muscle, or to relieve pain. Contrary to common thought, massage does not increase circulation.

Flare ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

In most cases, you have the right to choose any physiotherapy clinic. Our practice is a provider for many different insurance plans.

The best thing to do is give us a call and we will attempt to answer all of your questions.

All fifty states have some form of direct access. In most cases, if you are not making significant improvement within 30 days, the therapist will refer you to/back to your physician.

Seeing a physiotherapist first is safe and could save you hundreds of dollars or even thousands of dollars. Click here for details

1. The physiotherapists bills your insurance company, Workers' Comp, or charges you based on Common Procedure Terminology (CPT) codes.
2. Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
3. The payer processes this information and makes payments according to an agreed upon fee schedule.
4. An Explanation of Benefits (EOB) is generated and sent to the patient and the physiotherapy clinic with a check for payment and a balance due by the patient.
5. The patient is expected to make the payment on the balance if any.

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.

These are some things you may consider when seeking a physiotherapy clinic:

• The therapist should be licensed in the state.
• The first visit should include a thorough medical history and physical examination before any treatment is rendered.
• The patient goals should be discussed in detail during the first visit.
• Care should include a variety of techniques which might include hands-on techniques, soft tissue work, therapeutic exercises and in some cases heat, cold, electrical stimulation or ultrasound.
• Do they have a service that can address your problem?
• Do they take your insurance or are they willing to work with you if they are not a preferred provider?
• They should be conveniently located. Since sitting and driving often aggravate orthopedic problems, there should be a very good reason for you to drive a long distance for rehabilitation.
• What are the hours of operation?
• Can they provide satisfaction survey results?
• The therapist should provide the treatment.
• Can you briefly interview the therapist before the first visit?
• Ask your family and friends who they would recommend.

YOUR RIGHT TO A "GOOD FAITH ESTIMATE"

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our number on our website for more information.