Frequently Asked Questions

DO YOU TAKE MY INSURANCE?

We currently accept traditional Medicare plans only and will bill Medicare directly. For all Medicare Advantage plans, we are unable to bill them directly. This means you are responsible for the bill at time of service, but you will receive an itemized bill that can be submitted to your insurance plan for reimbursement.

We are OUT OF NETWORK with all other plans. This means payment for the session is billed to you and due at the time of service. You will then be provided with a "Superbill" that you can submit to your insurance for possible reimbursement.

WHY ARE YOU OUT OF NETWORK?

Unfortunately, most health insurance policies reimburse quite poorly for Physical Therapy services and do not recognize the level of specialty PT service this is. They typically limit your access to visits and services, make you jump through hoops for payment, make you prove you need it, and still in the end may deny treatment. In order for us to provide this highly specialized level of care and 1:1 services, we are unable to work with most insurance plans.

The benefit of choosing an out of network provider is that YOU have the control in your treatment plan and not your health insurance. This allows us to provide longer sessions for your best comfort and healing. A longer, more thorough session also means you will likely need less sessions in total. You will never be "cut off" because your insurance said so, and we will get to work together until you have decided your goals have been met.

Self-pay also means you can choose to come in as frequently or infrequently as possible. For example, some may start at 1x per week for a few weeks, then drop to every other week or 1x per month. Some who have achieved their goals may decided to come in for a "check-up" or to progress their strengthening home program. Or if you have been feeling great, but have a sudden flare-up, you can call us and come back in immediately for treatment. You can avoid the sometimes extensive process with medical appointments, prescription/referrals, prior authorization for insurance, etc. This makes for the simplest and most individualized pelvic health care for you.

Our goal is for you to feel improved, educated, empowered and capable of managing your symptoms and healing process in as few visits as possible.

WHAT IS THE COST?

Initial evaluation: $180

Follow-up visits: $145

The initial evaluation is approximately 60- minutes long and includes a full functional assessment, education, treatment, and ways that you can immediately begin self-managing your symptoms. You will be provided with educational handouts and exercises for home as applicable. If further visits are needed, this will be discussed at your first visit and a plan of care that suits your individual needs and schedule will be created together.

*Please note that internal pelvic floor muscle assessment is sometimes a part of a full exam, but only with proper explanation and consent. Please see below for further information.

WHAT FORM OF PAYMENT DO YOU ACCEPT?

We accept cash, check, credit card, HSA or FSA cards

DO I NEED A REFERRAL FROM MY MEDICAL PROVIDER?

No, NJ is a direct-access state, so you do not need a referral or prescription from your Physician. Although for certain health issues and pregnancy, it is beneficial and recommended that you have seen a medical Physician first prior to starting PT. For example, if you are pregnant or recently had surgery, than you will need to be cleared by your medical provider before the start of physical therapy treatment.

All MEDICARE recipients will need to follow the separate Medicare rules & restrictions which requires a prescription and signed plan of care to continue Physical Therapy past the initial 30 days period.

WHAT SHOULD I ASK MY HEALTH INSURANCE PROVIDER REGARDING BENEFITS?

Some policies have out of network benefits, and others do not. Some of a high deductible and others have low ones. You may be eligible for hidden benefits or "out and in benefits" which is when there are no in-network provider within a certain mile radius of you, then you may be eligible for reimbursement. This information is not a statement of your direct benefits, but is meant to be used as guidance for your conversation with your insurance representative if you are choosing to seek reimbursement eligibility.

You can call your insurance provider ahead of time to know what your benefits are and if they will reimburse in full or partially for out of network pelvic floor physical therapy services.

WHAT SHOULD I EXPECT FOR MY FIRST VISIT?

Your first visit will be approximately 60 minutes to review your current symptoms and other pertinent medical history, complete examination, provide education, and initiate treatment. It is my goal to make you feel comfortable with discussing areas of the body that are not commonly talked about. All examination and treatment techniques will be discussed and will only be performed with your consent before initiating.

It is recommended that you dress in comfortable clothing, as the evaluation typically involves assessment of your functional movement patterns and posture. Proper dressings, drapes, gloves, etc. will be provided to ensure hygiene and modesty at all times.

One way to assess how well the pelvic floor muscles are working is through a trans-vaginal or trans-rectal technique where one gloved finger is placed internally to feel the muscles. This exam technique will be discussed with you IF appropriate at your first visit, and will only be performed with your consent. There are many other things to look at on your first visit, so if internal pelvic is not something you are comfortable with, then it will not be done and we can treat many different ways instead.

HOW DO YOU ASSESS THE PELVIC FLOOR?

The majority of muscles in your body can be examined externally (from the outside). The pelvic floor muscles are unique and can be examined both externally and internally (from the inside). Just like any other muscle of the body, by feeling and testing it's function we can determine if the muscle is weak or strong, tight or overstretched, painful, and other possible functional issues. These can be assessed with one gloved finger placed internally through the vaginal opening or the rectal opening to palpate the muscles. You may be asked to contract, relax, cough, bear down, etc. while assessing the function of each muscle. An internal assessment is only a small part of the comprehensive examination. It will ONLY be performed if appropriate and WITH YOUR CONSENT. If you are uncomfortable with this, than it does not need to be performed on the first visit or any following visits. There are still many other ways we can test and treat your symptoms.

The internal assessment is not like the exam you've had by your OB/GYN. There are no instruments involved, no scooting to the edge of the table with legs propped open, and only one finger is used to palpate the muscles. At Jersey Shore Pelvic Health, we have brand new pelvic health specific tables that are comfortable and can electronically position in many different ways with support to make you as comfortable as possible.

WHAT HAPPENS IF I HAVE MY PERIOD ON THE DAY OF MY APPOINTMENT?

No worries, we ask that you still continue with your appointment. We can still treat the same, or can treat externally depending on your preference. Sometimes symptoms and pain/discomfort can change during our menstrual cycle, so that can be an important time to be assessed and treated. As long as you are comfortable proceeding, then so are we.

CAN I BRING MY KIDS WITH ME TO THE APPOINTMENT?

Absolutely! We have a box of toys for them to play with and are happy to have them join you