We gladly accept most insurance plans and are not limited to the ones mentioned below. If your plan is not listed, please call us at 352-373-2116 as we are always adding new insurance plans.
Blue Cross/Blue Shield
Medicare
Aetna
Tricare Standard
Humana
Worker’s Comp
Auto
As a courtesy to our patients, we will verify your health benefits before your arrival to determine if there will be a copay, deductible, or coinsurance for therapy services.
For those patients who do not have health insurance or those who have maxed out their benefits, we offer a private pay plan. Please contact ReQuest Physical Therapy today at 352-373-2116 for more information on our fees for service and payment details.
Good Faith Estimate
If you are a self-pay or uninsured patient, you have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.
Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.
- You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- If you schedule a health care item or service at least 3 business days in advance, make sure your healthcare provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling.
- You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
- If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate and the bill.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurpr·ises/consumers, email ederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.
PRIVACY ACT STATEMENT: CMS is authorized to collect the information on this form and any supporting documentation under section 2799B-7 of the Public Health Service Act, as added by section 112 of the No Surprises Act, title I of Division BB of the Consolidated Appropriations Act, 2021 (Pub. L. 116-260). We need the information on the form to process your request to initiate a payment dispute, verify the eligibility of your dispute for the PPDR process, and to determine whether any conflict of interest exists with the independent dispute resolution entity selected to decide your dispute. The information may also be used to ( 1) support a decision on your dispute; (2) support the ongoing operation and oversight of the PPDR program; (3) evaluate the selected IDR entity’s compliance with program rules. Providing the requested information is voluntary. But failing to provide it may delay or prevent the processing of your dispute, or it could cause your dispute to be decided in favor of the provider or facility.