Patient Information

Patient Forms

*Please, print out and bring these completed forms to your evaluation!

What to Bring to Your Appointment

  • Your insurance card
  • Completed Patient Forms (refer to previous section)
  • Physician referral forms
  • List of prescriptions and/or over-the-counter medication, including dose and frequency
  • Information about your medical and surgical history
  • Recent x-rays or relevant records
  • Please, arrive 20 minutes early to initial evaluation

Insurance and Payment Information

In order to maintain our high standard of care and individualized treatment sessions, Beyond Basics Physical Therapy is an out-of-network provider for most insurance plans.

Our Pledge

  • Your plan of care will be based on the professional assessment of your physical therapist and physician.
  • Insurance companies will not dictate the care you receive.
  • Functional goals will be established to meet your specific needs and not industry minimums set by insurance companies.

Billing

  • Payment is expected when services are rendered.
  • The patient is responsible for all charges for services provided by Beyond Basics Physical Therapy.

Courtesy Option*

If insurance was pre-verified* by Beyond Basics and your credit card information is on file for payment purposes, Beyond Basics will submit claims on the patient’s behalf. The patient pays the co-insurance at the time of visit and the insurance co. will pay us directly. Any charges not covered by the insurance company are the responsibility of the patient.

* Verification is not a guarantee of payment by the insurance company. The patient is responsible for knowing their insurance benefits and coverage.
** This option is not available for insurances that we do not accept assignement with. These insurance companies reimburse the patient directly.

Beyond Basics can submit claims for the patient, but the patient is responsible for the full charge at the time of visit. Please understand that the patient is ultimately responsible for all charges for services provided by Beyond Basics Physical Therapy.

Cancelled/Missed Appointments:

Late arrivals and no show appointments are subject to the full fee for the session. We require 24-hour notice for cancellations. Appointments that are cancelled with less than 24 business hours’ notice are subject to a charge of 60% of the appointment fee, which is not reimbursable by insurance companies.

If you have any questions regarding your insurance information, please don't hesitate to contact us at 212.354.2622.

Out of Town Patients

We offer high quality and individualized treatment consisting of a series of daily sessions beginning with a 2 hour initial evaluation and 1½ hour follow up appointments. In order to maintain our high standard of care, Beyond Basics Physical Therapy is an out-of-network provider for most insurance companies.

We would like you to continue treatment on a regular basis with a physical therapist that has experience with pelvic pain and pelvic floor dysfunction. If you are unable to find someone in your area, we recommend that you return to us for a re-evaluation and treatment once/month for a couple months, depending on the severity of your symptoms. However, we realize that this may be difficult, so we will do our best to give you as many tools to work on at home as possible.

For more information about our program click here. Please call us for insurance and pricing information, at 212.354.2622. In addition, a phone session option is available for a reduced fee.

What you will gain:

  • a proper and extensive musculoskeletal evaluation
  • treatment sessions that will get you started towards your healing process
  • a comprehensive home program specific to our findings and to your needs.

Examples of some of the exercises: relaxation techniques, massage therapies (myofascial trigger point release, connective tissue mobilization, visceral manipulation), stretches, strengthening exercises, biofeedback and electric stimulation.

NOTE: We recommend that you come, with a friend or a significant other, who can help you with your home program.

Please call us for insurance and pricing information, at 212.354.2622.

Privacy Practices

Our Notice of Privacy Practices describes how we may use and disclose your protected health information. A copy is given to all new patients and is available upon request.