During your first visit you can expect the following:

• Arrive at your appointment with your paperwork completed (you can download it from our website - see the paperwork or forms link).
• You will provide us with your prescription for physical therapy.
• We will copy your insurance card.
• You will be seen for the initial evaluation by the therapist.
• The therapist will discuss the following:
  
  1. Your medical history.
  2. Your current problems/complaints.
  3. Pain intensity, what aggravates and eases the problem.
  4. How this is impacting your daily activities or your functional limitations.
  5. Your goals with physical therapy.
  6. Medications, tests, and procedures related to your health.
• The therapist will then perform the objective evaluation which may include some of the following:
  
  
  1. Palpation - touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
  2. Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
  3. Muscle Testing - the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
  4. Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
  5. Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
  6. Posture Assessment - the positions of joints relative to ideal and each other may be assessed.

The therapist will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient's input. This includes how many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created with input from you, your therapist, and your doctor.

Make sure you bring your physical therapy prescription (provided to you by your doctor) and your payment information. If your insurance is covering the cost of physical therapy, bring your insurance card.

You should wear loose fitting clothing so you can expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination.

This is highly variable. You may need one visit or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc. You will be re-evaluated on a monthly basis and when you see your doctor, we will provide you with a progress report with our recommendations.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physical therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physical therapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be painful. Your physical therapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

Flare ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

Billing for physical therapy services is similar to what happens at your doctor's office. When you are seen for treatment, the following occurs:

1. The physical therapist bills your insurance company, Workers' Comp, or charges you based on Common Procedure Terminology (CPT) codes.
2. Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
3. The payer processes this information and makes payments according to an agreed upon fee schedule.
4. An Explanation of Benefits (EOB) is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.
5. The patient is expected to make the payment on the balance if any.

It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.