Patient Resources

If you see one of our hand therapists, you may receive two services during your appointment: occupational therapy (OT) and durable medical equipment (DME). DME is the specialized splinting that may be created for you to help in your recovery. DME and OT are separate health insurance benefits, and depending on your health insurance plan, you may have completely different frequency/visit limitations, authorization requirements, and costs between the two services.

We ask that you bring your insurance card, photo identification, and any documentation from a doctor or surgeon. We also suggest that you dress comfortably and allow access to the injured area. For example, wear shorts if you have a knee injury.

A copay, or copayment, is a fixed dollar amount for each visit predetermined by your health insurance. This is due at the time of your check-in at each appointment.

A coinsurance is a fixed percentage of the allowed amount for each appointment that you are responsible for paying. For example, if your health insurance plan has an “80-20% coinsurance”, your health insurance will pay 80% of the allowed amount of the cost of the visit, and you are responsible for paying the remaining 20%.

Your health is our priority. We offer financial assistance to those who qualify. To check qualifications and submit an application, click here. If you do not qualify, we are happy to arrange a payment plan that works with your budget so you can pay for your care over a reasonable timeframe. Simply ask to speak with a member of our billing team or email staff-billing@jointventurespt.com

A deductible is the total amount you are responsible to pay before your health insurance makes payments toward any healthcare expense (not just treatment at Joint Ventures). For example, if you have a $1,000 deductible, you are responsible to pay the entire allowed amount for each appointment until you have spent $1,000 on services subject to a deductible (of note, some healthcare services are covered without having to meet your deductible, but that is individual to each health insurance plan). In other words, you are paying the amount your health insurance company would pay if you didn’t have a deductible. Once your deductible is met, your financial responsibility will likely change. In some health insurance plans, you will be responsible for a copay, a coinsurance, or your health insurance could cover all of your future healthcare expenses until your plan year resets.

Payment is expected at the time of service. While copayments are the only fixed cost, a “cost estimate” is detailed in your specific healthcare benefit if a deductible or coinsurance applies. This will be emailed to you prior to your first appointment. You can also request a copy at your first appointment. In an effort to offset any large balances, all patients with an unmet deductible will be charged a minimum of $60 at each appointment. There may be additional balances after your health insurance has processed your claim.

For your convenience, Joint Ventures will automatically charge your credit card on file each billing cycle (once per month) to avoid mailed statements and past due balances. We will email you a receipt and maintain a clear record of all payments and charges. In the unlikely event that an overpayment is made, your account will promptly be credited and reimbursement will be put back on the same credit card.

The two most common types of health insurance plans in New England are HMOs (Health Management Organization) and PPOs (Preferred Provider Organization). HMOs require you to have selected a Primary Care Physician (PCP) and have a referral from your PCP in order to see a specialist, like a physical or occupational therapist. PPOs typically do not require you to have a PCP or referral from your PCP in order to see a specialist, but may require a prescription on file.

A referral is a request submitted by your Primary Care Physician (PCP) to your health insurance for authorization of physical therapy (PT) or occupational therapy (OT) visits. If it is approved, we receive notification directly from your health insurance company. Most HMO health insurance plans require a referral from your PCP in order to authorize treatment with a PT or OT.

A prescription is a recommendation from your medical doctor indicating that they believe physical (PT) or occupational (OT) therapy would help your condition. Some health insurance companies specify that you are covered for any non-emergency care or specialist care (like PT or OT) only if it is “medically necessary”. A prescription from a medical doctor is a way to prove to your health insurance company that your care is “medically necessary” and therefore we require a copy of this recommendation on file. Even if it is not required by your health insurance plan, we encourage all patients to have a prescription on file.

A prescription must be dated less than 30 days prior to your first visit. It also must include the diagnosis you are being seen for; must specify the type of therapy (PT or OT); the suggested duration of care (number of weeks); the suggested frequency of visit (how often per week); the date it was written; and the doctor’s signature (electronic or hand-written). All of the parameters of care will be confirmed by your therapist at the time of your first visit and if the therapist thinks a different frequency, duration, or diagnosis should be considered, the therapist will reach out to the doctor directly.

Joint Ventures offers Self Pay rates.  Contact Staff-  Billing@JointVenturesPT.com for details.

Joint Ventures Physical Therapy accepts Cash, Personal Checks, and Credit Cards (Mastercard, Visa, and Discover) for the payment of services.
If you would like to pay your Joint Ventures Physical Therapy bill online, click here.

A claim will be established by your employer, usually with a third-party company, who will assign an adjuster to your case and manage approval and payment of your visits. Upon booking, we ask that you provide us with your WC claim number and your adjuster’s name and contact information so that we may verify your coverage prior to your appointment. Your adjuster will usually pre-approve the initial evaluation over the phone, but any further approval of visits must be requested from the Utilization Review (UR) department at the third party company managing your claim. It is very important that we receive prior authorization from UR for all visits as work-related injuries are not covered by health insurance. Joint Ventures will process these authorization requests on your behalf and will work to advise you ahead of time if there is any potential lack of coverage.

If you were injured in a motor vehicle accident (MVA), you need to report your injuries to your motor vehicle insurance company. They will assign you a claim number and Adjuster to monitor your case. You must also submit a Personal Injury Protection (PIP) application to your Adjuster in order for them to cover any of your care (not just for Joint Ventures). Most commonly, there is $2,000 worth of PIP coverage available and once it is exhausted (meaning you have spent $2,000 in MVA related medical care – not just therapy treatment at Joint Ventures), we will transition the financial responsibility of your care to your personal health insurance. Any “patient responsibility” (i.e. copays, coinsurance, and/or deductibles) will be billed to your motor vehicle insurance company for coverage up to $8,000.

We have found that in most cases, you will not have any financial responsibility unless: 1) your health insurance benefits run out and you continue to require medical care; 2) your motor vehicle insurance company denies further coverage due to their determination that there is a lack of medical necessity, or 3) you exhaust the available funds from your claim. If you have an attorney helping you navigate this process, please let us know! We work with many attorneys to ensure that you can get the care you need.

https://www.patientnotebook.com/jointventures/Enhanced/SendMoney/MakePayment
For quick and easy payment of your statement, please click here. You will receive a receipt instantly for your records. You may also call our billing department at 617-536-1161, ext. 4, to make a payment over the phone for treatment at any of our offices.

Having physical therapy (PT) or occupational therapy (OT) coverage simply means that you are eligible to receive therapy services. But in most cases, your coverage includes some financial responsibility. Typically with PT or OT services you will be responsible for a copayment, coinsurance, and/or deductible for each visit. These costs are determined by your health insurance company and depend on the plan you and/or your employer chose.

We know your time is valuable, so to prepare for your appointments, we suggest you make a list of questions for your therapist. This will help you to organize your thoughts and concerns. You can also write down a list of your symptoms and include details, such as how and when they began, what they feel like, what activities or movements make them worse…etc. Lastly, be familiar with your medical history. While some information may not seem relevant to your injury, it can still be helpful to your therapist.

We suggest that all new patients arrive at least 15 (fifteen) minutes early so that you can avoid missing any critical one-on-one time with your therapist. Though you may have filled out your health questionnaire and initial paperwork, there may still be additional paperwork to review and complete.

When you arrive at Joint Ventures, the administrative staff will be here to greet you with all of your paperwork ready to go or review if already complete! They will sit with you to review our office and financial policies, your insurance benefits and even provide a cost estimate for your treatment. The administrative staff will also make a copy of your insurance card and any doctor orders (e.g. your prescription). They will also securely place your credit card on file and be available to answer any questions. Once everything is complete and in order, you are ready to meet with your therapist.

Your therapist will review your medical history, inquire about your current problems/complaints, and discuss your personal goals and what you hope to achieve at Joint Ventures. Your therapist will then perform an evaluation which includes taking objective measurements and assessing things like your range of motion, strength, posture, etc. You will then receive some initial treatment of your condition to begin to restore optimal movement patterns. This could be exercises or manual treatments.

Your therapist will educate you on techniques to manage your current condition. They will also teach you exercises to do at home and send you the details via email. You will conclude your initial evaluation with an understanding of the root cause of your problem and a clear and defined plan of care to get you to your individual goals.

Finally, there will be time to ask questions or revisit any topics needing additional clarification. Your therapist will walk you out to the front desk so that you can book appointments that will facilitate your optimal recovery and ensure you have appointment dates and times that work best for your schedule.

Most health insurance companies will limit the number of physical/occupational therapy visits, the duration/time frame allowed for your care, or both. The most common plans in New England are “60 visits per calendar year”, “60 consecutive days”, or “8 visits, then authorization required”. Your plan may also have shared limitations for PT and OT While your health insurance company might allow “up to 60 visits”, they may only authorize/allow them in small increments (4 – 8 visits at a time). For these plans, a re-evaluation is performed by your therapist and submitted to your health insurance company.  They will either approve or deny further coverage of care.

Please bring, or wear, clothing that will allow you to move comfortably and also provide your therapist with easy access to visualize the injured area.  We recommend shorts for any back, hip, knee, ankle or foot injury; and a tank top for any neck, shoulder, elbow or wrist injury.

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From young athletes hoping to recover or prevent future injuries to geriatric patients recovering from a fall or rehabilitating a new hip joint, we treat orthopedic issues for all ages and abilities! Our specialists have the resources to help you live your best life.