Frequently Asked Questions

FAQ:

As a patient of Merz/Embody, you may have questions regarding our services, billing, insurance, or setting up a visit with us. We have listed some common questions and answers for you that will help explain and provide additional information. If your questions go beyond what is listed below, we would love to help, please call our office directly at 952.935.4037 or email us at admin@merzpt.com.

Q: Do I need a referral to go to physical therapy?

A. No. Merz/Embody Health and Performance accepts clients without a physician referral. Minnesota is a direct access state, meaning you have the right to access physical therapy without a referral for 90 days. However, Medicare and some other insurances may require a physician referral in order to cover your PT visits. You may call your insurance company’s customer service number on the back of your insurance card to verify your policy’s direct access coverage requirements.

Q: When would I utilize Merz/Embody Services?

A:  Anytime you’re looking to maximize your health, life, and/or sport performance.  You don’t need to be injured or recovering from surgery in order to consider the services of a physical therapist, though Merz/Embody also specializes in rehabilitation.

Q: Should I bring my insurance card with me?

A. Yes, Merz/Embody will need the information on your insurance card to correctly file a claim with your insurance company. You will be asked to present your insurance information at your initial visit.

Q: How do I know if I am in-network with my Insurance?

A. We are contracted with most major insurance companies. Prior to scheduling, please contact your insurance company directly to inquire whether “Merz Physical Therapy” is in-network for your health plan. If it still looks like you are out of network, call us and we can help verify your coverage.

Q: Do I need a prior authorization?

A. The need for a prior authorization differs by insurance plan and the type of procedure or service being provided. Typically, Merz/Embody will initiate the prior authorization request from your insurance company for you.  However, it is the client’s responsibility to make sure that prior authorization is obtained before receiving certain health care procedures and/or services.

Q: What if I don’t have insurance? 

A. Merz/Embody welcomes you. We offer cash pay for anyone without insurance. You can see our fee schedule here. This is also a great and more cost effective option for patients with high-deductible insurance plans. Payments are due before the start of every visit and we accept most major credit/debit cards, check and cash payments.

Q: How do I update my insurance information?

A. Please notify the clinic immediately of any insurance changes and present your new insurance card at your next visit. It is the patient’s responsibility to ensure insurance information on file is current. This will ensure claims are properly submitted and processed in a timely manner and to maximize your coverage.

Q: When will I receive my first statement?

A. Merz will submit a claim on your behalf to your insurance carrier via our third party billing partner, WebPT. After your insurance provider processes your claim, WebPT will mail a statement outlining any out-of-pocket costs you may have. Your statement will include any deductibles and/or coinsurance amounts you may owe. You will receive a statement approximately 60-90 days after you receive services. For specific questions about your bill, please call our Billing Company, WebPT, at 877.288.2162, and ask for Kelly.

Q: Why didn’t my insurance company cover my entire bill?

A. Out-of-pocket expenses are determined by your insurance plan during claim processing. These amounts may include co-payments, deductibles, and/or co-insurance. If you have questions or don’t understand the amounts you owe, please contact your insurance company directly as they determine patient responsibility amounts for any services provided to you based on your insurance plan contract. For specific questions about your billing statement, please call Merz/Embody at 952.935.4037.

Q: When do I become responsible for my bill?

A. You are responsible for your bill at the time you receive services from Merz/Embody. Co-payments are due at the time of service. We will work with you and your insurance company to get all eligible benefits processed in a timely manner. We will send you a statement approximately 60-90 days after you receive services for any patient responsibility amounts you may owe. If you are having trouble paying your bill, or need a payment plan, please reach out to our business office at 952.935.4037.

Q: How can I pay my bill?

A. Payments can be made by calling our office to pay over the phone or you can pay in person at any of our office locations – our front desk staff will be happy to help you. You can also mail payment with the information provided in your statement.

Q: How long is a typical visit at Merz/Embody Health and Performance?

A. The initial evaluation is typically 75 min or less (including any time to fill out intake paperwork) from the start of your scheduled appointment time. Any visits beyond that may vary depending on the needs of the patient, but typically run 45-60 min. We only bill for services rendered during the visit and thus, not every visit is the same.

Q: My insurance has strict limits on how many physical therapy visits I have per year. What options do I have when my benefits run out?

A large percentage of our practice is performed on a “cash pay” basis. Moreover, we will work with you specifically by providing a thorough “home exercise program” with appropriate “upgrades” to allow you to do much of the work on your own.