Points North Physical Therapy is a participating provider with all Vermont-based PPO plans including Blue Cross Blue Shield plans, MVP, and CIGNA, and also is a participating provider with Green Mountain Care (VT Medicaid), Medicare, Worker’s Compensation, and TriCare. Points North PT also can file a claim as an out-of-network provider with other plans including the AETNA and United PPOs and negotiate a reasonable rate. A reasonable out-of-pocket rate is offered for clients who are uninsured or who have an insurance plan that is not one of the plans listed above. **Please note that Points North PT is unable to accept HMOs or Medicare Advantage plans.** It is very important that you know the details of your health insurance plan when you enroll.
In-network provider regulations prohibit Points North PT from offering the out-of-pocket rate to those clients with one of the plans in which Points North PT is a participating provider. These regulations, mandated by the insurances, are for the protection of the client, and as a participating provider, I have to follow the rules.
Doctor referrals are strictly required by Medicare and Green Mountain Care. Alternative medicine referrals, such as those from a naturopath or chiropractor, unfortunately are not accepted at this time by these insurances. BCBSVT, MVP, and CIGNA, AETNA and United PPO plans do not require referrals. Most private insurance plans nationwide do not require a referral for physical therapy.
Points North PT does not participate in litigation cases. Clients receiving treatment through an auto accident or other lawsuit may pay the out-of-pocket fee and then seek reimbursement on their own.
Copies of health records will be provided one time only, to either the client or the client’s attorney who must provide a signed release form by the client. Any other parties involved in litigation or a worker’s compensation case must request copies directly from the client or the client’s attorney.