Patient Information

Frequently Asked Questions

  • Typically, we review your medical history, current symptoms, concerns, and goals for treatment. We then do a full body assessment, looking for “restrictions” of motion and patterns in your body. Your entire session will be done in a comfortable, private room. The treatment is hands-on, skin-to-skin with a light but firm touch that engages the fascial layers, restrictions, and areas of dehydration. You will be provided with a home program right away so you can continue making progress before your next session.

  • Myofascial Release is best done skin to skin. For this reason we ask that you wear a tank top or sports bra and loose shorts for women and a pair of loose shorts for men. If you are comfortable you can just be in your bra and underwear as well. While being treated you will be covered by a sheet and/or blanket.

    PLEASE DO NOT WEAR ANY BODY LOTION THE DAY OF THE SESSION. IF WE SLIDE ON THE SKIN THE TREATMENT WILL NOT BE AS EFFECTIVE

  • The first visit is 90 minutes so that we have time to do an evaluation and full treatment. After the first visit, typically sessions are 60 minutes however we also offer 90 minute sessions by request.

  • We strive at SoulCare to get you better as quickly as possible.. As every person is unique,even if you have the same diagnosis, the number of sessions will vary. We believe in the wisdom of the body meaning your body has what it needs to heal itself Our treatments help you to remember this and help your body guide itself to wellness and freedom from pain. Most clients will come an average of 6 sessions, some only need one or two sessions to feel better. After our initial session we will have a better understanding of your body and be able to give you a better understanding of how long you will need sessions.

  • At SoulCare we typically have a patient see the same therapist throughout their time with us. Having said this it can sometimes be helpful to have another therapist see you as well. We are all trained in the John Barnes Method of Myofascial Release yet each therapist is unique and often a second set of eyes and hands can be very therapeutic.

  • We are out of network with all insurance companies. This means that you will need to pay for your visit when you come in and have your insurance company reimburse you for physical therapy. We will provide you with a superbill that you submit to your insurance company. Depending on your out of network coverage you may or may not be reimbursed.

  • Our office does not take Medicare. We are unable to see patients with Medicare insurance for physical therapy, even if you would like to pay out of pocket This is a federal law. We can see you for wellness services which means we can not provide you with a superbill and you can not submit the treatment to your insurance company as a claim.

  • We accept cash, check, credit card and HSA OR FSA.

  • Yes in the state of CT we have direct access. This means we can see you without a prescription from your doctor. We will see you for 6 visits and at that time we will ask your MD to provide us with a prescription if you continue to require care. We will ask you to see the appropriate provider if we feel it is necessary before the 6 visits.

  • We provide you with what is called a superbill. It has all of the information required for your claim to be processed. SoulCare does not process any claims. You will submit the bill to your insurance company on your own.

  • We ask that you call your insurance company prior to your first visit and ask these questions

    1. Do I have out of network physical therapy benefits?

    2. Do I need prior authorization and if so ask for the number for the provider to contact?

    3. What is my out of network deductible?

    4. Have I met any of my deductible?

    5. What will be covered once the deductible is met?

    6. How many visit a year do I get for PT?

    It is very important that if your insurance company requires prior authorization that you contact the office and let us know so we can do the paperwork needed for the visit to be covered.

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 one (1) business day before your medical service or item. You can also ask your health care 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 1-800-985-3059.

NO SURPRISE ACT

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or are treated by an out-of-network provider at an in-network health care facility, such as a hospital, you are protected from surprise billing or balance billing.

Note: No Surprises Act doesn’t apply to individuals with coverage through programs such as Medicare, Medicare Advantage, Medicaid, Medigap and the Children’s Health Insurance Program (CHIP).

What is "balance billing" (sometimes called "surprise billing")?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – such as when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

Why am I receiving this notice?

You are receiving this notice because:

  • You are a covered individual under a group health plan or a health plan offered by a health insurance issuer, like the Federal Employees Health Benefits Program; and

  • Your doctor or this health care facility is going to provide a treatment or service for which the provider or health care facility is going to ask you to pay a copayment, coinsurance, or deductible or is going to submit a bill to your health plan.

For what types of services am I protected from balance billing?

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you receive services from an in-network hospital or ambulatory surgical center, certain providers at that facility may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

When balance billing isn’t allowed, what other protections do I have?

  • You are only responsible for paying your share of the cost (such as copayments, coinsurance and/or deductibles) that you would pay if the provider or facility was in-network. Your health plan will pay out-of-network providers and facilities directly.

  • Your health plan generally must:

    • Cover emergency services without requiring you to get approval for services in advance (prior authorization).

    • Cover emergency services by out-of-network providers.

    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the Department of Health and Human Services, who will work with the Departments of Treasury and Labor and the Office of Personnel Management, by calling 1-800-985-3059.

Visit www.cms.gov/nosurprises for more information about your rights under federal law.

Click here for information about your rights under your state’s laws.

Good Faith Estimate

Click here to learn more about your right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

DIRECT ACCESS

Public Act 06-125 (direct access in Connecticut) was signed into law by Governor M. Jodi Rell and went into effect on October 1, 2006. It allows patients to see a physical therapist directly without a physician referral for 6 visits or 30 days, whichever occurs first, as long as they have a primary care provider.

There are a number of benefits that come from Direct Access.

  • Direct access allows you to see a licensed physical therapist without seeing a physician first, minimizing the wait time and allowing you to receive the care you need sooner rather than later.

  • Our physical therapists have gone through extensive training for medical screening and musculoskeletal exams and are highly qualified musculoskeletal experts. During an evaluation, your therapist will ask specific questions related to your health, including past medical history and medications, to determine if physical therapy is appropriate at the moment.

  • Physical therapists are trained to recognize “red flags” that require a referral to a physician and will guide you through that process, if necessary.

  • Once a treatment plan is in place, our team will work with you, your family members and your healthcare provider(s) to work toward achieving your goals.

  • Direct access can decrease overall healthcare costs, improve functional outcomes and minimize overall frustration throughout your recovery process.

  • Direct access enhances communication with your primary care provider because we send our initial findings ad ongoing progress, which gives your provider better information on the effectiveness of therapy or the need for further diagnostic recommendations.

  • There are also some limitations with Direct Access to Physical Therapy.

  • A patient can go directly without a physician referral for 6 visits or 30 days, whichever occurs first, as long as he/she has a primary care provider. If the patient demonstrates measurable, objective, functional progress, the physical therapist may continue treatment. Otherwise, he/she must be referred to a physician.

  • If the patient did not show a reasonable response to physical therapy treatment in a time period consistent with standards of practice established by the legislation, the physical therapist would have to consult with an appropriate health care practitioner.

  • Workers’ Compensation patients are not eligible for direct access care.