New Patients: Prior to your first appointment please print and fill out the patient registration/medical history form and the medically informed consent, assignment, and release form in their entirety and bring to your first appointment. If you are unable to print these forms, please arrive 15 minutes before your first appointment to complete them.

We are Available for Appointments: Monday 8:30 a.m. - 6:00 p.m. Tuesday 7:00 a.m. - 3:30 p.m. Wednesday 8:30 a.m. - 6:00 p.m. Thursday 8:30 a.m. - 6:00 p.m. Friday 7:00 a.m. - 1:00 p.m.

Please click here to download the patient registration/medical history form.

Please click here to download the medically informed consent, assignment, and release form.

Insurance Information

As a courtesy to our patients, Kinetic Physical Therapy Institute files primary insurance. We are Medicare Certified and a provider for many managed care plans. Self referred patients without insurance receive a 30% discount. Out of network coverage may also be available.

Coverage for physical therapy varies depending on the type of insurance coverage you have. Some insurance companies require pre-certification and some have a limit on the amount of physical therapy visits you may receive. It is always advisable to call your insurance company and find out the specific requirements regarding your coverage.

During the first visit to Kinetic Physical Therapy Institute we will call your insurance company to determine the specifics of your coverage and will advise you of this information when requested. Typically, you should expect to pay your deductible if it has not yet been met, and any co-insurance or co-pays required by your insurance company. It is important to remember that your insurance coverage is a contract between you and your insurance company. Kinetic Physical Therapy Institute will do all it can to help you in receiving coverage for services rendered, but ultimately it is your responsibility.

If you are covered by MEDICARE, you will need a prescription for physical therapy from your medical doctor. A referral from a different health professional, such as a dentist or chiropractor, will not be accepted by MEDICARE. Once you have received a prescription, it will expire for use in thirty days. Therefore, please schedule your first appointment within that thirty day time period.

Effective January 1, 2006, a financial limitation (therapy cap) was placed on outpatient rehabilitation services received by MEDICARE beneficiaries. These limits apply to outpatient Part B therapy services from all settings except the outpatient hospital clinics. The cap imposed by Congress for physical and speech therapy (combined) per calendar year is $1740. If you have either of these services in an outpatient facility, please contact MEDICARE to find out how much of your $1740 remains for this calendar year.

Other Payers

WORKERS COMPENSATION - Your workers compensation carrier will be billed for your physical therapy charges. In the event these claims are denied, you will become financially responsible for all charges. In the event that you seek legal representation in the settlement of your claim, we ask that you adhere to the policies listed under “Personal Liability/Litigation”.

MOTOR VEHICLE ACCIDENT (MVA) - Your automobile insurance will be billed provided your policy covers auto med-pay. If that benefit is not available, claims will be submitted to your health insurance provider. In the event that you seek legal representation in the settlement of your claim, we ask that you adhere to the policies listed under “Personal Liability/Litigation”.

PERSONAL LIABILITY/LITIGATION - If you are working with an attorney for your claim, and are not yet to the point of settlement, our financial policy is as follows:

*If your account balance reaches $500, as a courtesy we ask for 10% payment monthly, or $50.

*If your account balance reaches $1000, we ask that you continue to make 10% monthly payments, or $100.

*Should your account balance reach $1500, you will be seen on a pay-as-you-go basis.

*If your claim is denied, you are to assume full responsibility for payment.

SELF-PAY - Self-paying patients are asked to pay a minimum of $100 on the first visit and $50 on each subsequent visit. If these payments do not cover all treatment costs, you will be billed for the remaining amount per a monthly statement. In certain situations, a payment plan can be established to meet your budget. Please call our clinic to arrange such a plan. All plans require payment on a monthly basis.