We can bill Aetna directly for each physiotherapy session that you complete with us. All we need are a few personal details, along with your Aetna insurance membership or policy number and your pre-authorization code.
How do I get my pre-authorisation code?
You will need to ring up Aetna explain your injury/concern and request to see one of our physiotherapists by name and Spectrum Health UK specifically for physiotherapy.
Please note that many providers will not authorise treatment retrospectively so best to do this in advance of your appointment.
Some insurance companies request additional information regarding your injury/concern before authorising physiotherapy, so as to be sure they feel it is the best treatment option for you. Often they will do this by way of either:
- A triage call with an in-house specialist. Some companies allow you to do this immediately and others require you book in a future time for this.
- Request you to get a referral from your GP, however this is only for some companies so to save yourself time, best to call and check first.
Most policies through Aetna include an excess payment. An excess is a specified amount of money that Aetna expect you to pay for any outpatient service your receive before they will start covering you for further treatment you receive over that amount. Following payment of your excess to Spectrum Health in full, generally Aetna will cover 100% of your treatment. An excess is paid on an annual basis, from a start date nominated by Aetna.
Before engaging with physiotherapy, it is best to ensure you are aware of the following things:
Does my policy have an excess? If so, how much?
When does my policy date start? [This allows you to understand when you will be liable to pay your excess again]
Please note that any questions regarding the excess for your policy must be made to Aetna and we cannot contact them on your behalf to enquire for privacy reasons.
How many sessions will my insurance cover?
Each insurance provider operates slightly differently in how many sessions of physiotherapy they will initially authorise. This depends on a few factors, such as the limitations of your policy, if you have seen a consultant [any specialised doctor] who has recommended the course of physiotherapy, or if you have had surgery.
No matter how many sessions you are initially authorised by Aetna, we can always request more to progress you through your rehab with us. You will simply need to call Aetna and request further sessions and if they ask for a treatment plan or progress report to support your request, our team will be more than happy to complete this for you, which normally results in us getting more sessions. Please do refer to your specific policy however for wording regarding caps and limitations.