UNDERSTANDING THE REFERRAL PROCESS TO PHYSICAL THERAPY

• FOR POTENTIAL PHYSICAL THERAPY CLIENTS
• FOR REFERRING PHYSICIANS

INFORMATION FOR POTENTIAL PHYSICAL THERAPY CLIENTS

In Virginia access to physical therapy services can be confusing.

The first issue is Virginia State law has some restrictions on accessing a licensed physical therapist. The second issue is most Health Insurance Plans place various restrictions on accessing a physical therapist.

If a physician signs a referral to physical therapy a client can have unlimited access to physical therapy services, unless you are using your health insurance to pay for the services. Most health insurance plans limit the number of visits and/or the amount of time you can see a physical therapist. Each individual health insurance plan has different limits. Your health insurance card has a customer service telephone number which can provide answers. We will gladly assist you in determining the limitations accessing your benefits.

If you wish to see a physical therapist directly without obtaining a referral from a physician, chiropractor, podiatrist, dentist, or nurse practitioner you can under the following conditions:

• If you have a recurrent problem for which you have been referred to a physical therapist in the previous 2 years.
• If you have a new problem you can be evaluated by a physical therapist. If additional treatment after the initial evaluation is required Virginia State law requires that a licensed physician will need to approve the recommended treatment plan. Our office will gladly assist you in obtaining the necessary physicians signature to continue treatment.

For more specific information regarding limitations accessing physical therapists in Virginia go to the links page for the Department of Health Professions Physical Therapy Practice Act.

Again, if you wish to use your health insurance to pay for physical therapy services we will need to check with your health insurance company in order to determine if your health insurance contract requires a physician’s referral for physical therapy services.

INFORMATION FOR REFERRING PHYSICIANS

Referral to Physical Therapy

In a majority of circumstances Virginia State law requires that a physician sign a referral to physical therapy. The referral can be on your prescription pad or in a simple letter.

What to include in the referral

• The patients name
• Diagnosis or problem to be addressed
• Treatment goals
• Results of any key previously preformed diagnostic testing
• Other pertinent information
• Please sign and print your name

Either give the signed referral to the patient so that he/she can bring it on the first visit to our office or fax it to 840-594-0319.

If the patient’s health insurance plan requires you to initiate the authorization, please send along the authorization number or appropriate insurance referral form.

Currently Medicare requires a physician to approve a physical therapy treatment plan with a signature every 30 days if treatment is continuing. Our office will send you updated progress reports, with a continuing treatment plan outlined. Please indicate your approval by signing and returning it to our office.

Our office will gladly provide you with progress reports including objective measurements and progress towards treatment goals. Of course, we will phone you if the patient's condition warrants your immediate attention. Depending on your preference we can mail, fax, or email the progress reports.

We are eager to help you manage your patients. Please contact us with any particular concerns or suggestions you may have.