JOI Provides Quick Answers to your Frequently Asked Questions in this article.
What do I need to bring the first visit? We have the answers for you.
JOI Quick Answers for your Frequently Asked Questions (FAQs)
Appointment / Prescription Frequently Asked Questions
By: Chaz Johnson, Site Coordinator
1. If I have had treatment by another physician, should I bring any records to my JOI appointment?
The quick answer is yes. Any information you have regarding previous treatment for a particular problem would assist the JOI physician in his/her development of your treatment plan. Medical records, such as office notes, X-rays, and lab reports allow your JOI physician to learn more about your condition. As well as give insight to the historical progression of your medical problem. Most physician offices will furnish medical records upon request.
2. When scheduling an appointment at one of the JOI physician office locations, do I have to have a referral from my primary care physician?
Each individual healthcare plan has very specific guidelines regarding referrals to specialists. JOI currently participates in over 140 health plans. We make every effort to assist you in the procurement of insurance referrals. However, it is ultimately your responsibility to ensure a referral is available for each physician visit.
3. What is JOI’s policy on calling in prescription refills after business hours?
For your protection, JOI’s policy is that all medication refills be handled during the course of the business day when your physician has access to your chart. This allows your physician to check for drug allergies, as well as other medications you may be taking. Therefore, preventing the potential for drug interaction. However, there are exceptions that may require a prescription after business hours. One exception could be for surgical patients. We encourage you to monitor your medical supply and allow a minimum of 24-hours for prescription refills at your pharmacy.
JOI Rehab Frequently Asked Questions
JOI Rehab Provides Quick Answers to your Frequently Asked Questions
Can I go to Physical Therapy without seeing a doctor?
The quick answer to this is yes in the state of Florida for 30 days for most insurances. To read more about this, go to Direct Access to Physical Therapy.
What do I wear for therapy?
Comfortable gym clothing that allows access to the problem area.
What do I need to bring the first visit?
- Prescription for Physical Therapy or other services.
- Insurance Card
- Driver’s License
- Medicare patients need to bring discharge summary from any Home Health services.
- Any other medical information pertinent to your treatment
When do I need to get there?
Please arrive 15 minutes early for your initial evaluation to complete paperwork prior to your appointment time. For each visit after that please arrive 5-10 minutes early to allow check-in prior to appointment time. You can also request to complete your paperwork at home.
How long will each therapy session last?
The initial evaluation typically lasts 45 minutes to 1 hour depending on your diagnosis and history. Subsequent visits thereafter typically last about 1 hour.
How many times do I have to come?
This varies and will be determined based on diagnosis, prescription and plan of care by the doctor and therapist.
Do I need to take pain medicine before therapy?
Your physician would determine if this is necessary.
How much does a therapy visit cost?
This varies depending on your insurance a plan. JOI Rehab will obtain your individual financial obligation before you start therapy.
Billing for Physical Therapy
1. Why was I charged for “surgery” when my diagnosis was for a fracture?
The two most common types of fracture treatment are “open” treatment and “closed” treatment. Closed treatment or “fracture care”, specifically means that the fracture site is not surgically open. Open treatment is fracture stabilization in an operation not through a scope. The coding of these does not always indicate a surgery. Surgical coding guidelines and global service packages apply to both treatment methods. The global service package includes a certain period of time for treatment in a specific problem.
An office visit charge is included in the global fee. For example, a patient that is has Fracture Care for a wrist fracture, has a global period of 90 days. During this 90-day period, a patient will be seen and/or treated for follow-up care at no additional charge. However, X-rays, medical supplies, including reapplication of cast(s), and medical equipment are not subject to the global fee package and are changed in addition to the Fracture Care. If you have questions related to this section, our JOI Billing Team will certainly answer your questions.
2. What is the difference between a “new patient” charge and an “established” patient charge? New problem?
The American Medical Association’s current procedural terminology (CPT) guidelines for a “new patient” visit. A patient who has not had any professional services from the physician or another physician of the same specialty who belongs to the same group practice within the past three years. An “established patient” or “new problem” is a patient who has professional services from the physician or another physician of the same specialty who belongs to the same group practice within the past three years. However, for a different medical problem that was previously seen.
3. When I receive a bill from JOI, why does the balance vary with each statement?
JOI is pleased to submit claims to carriers (insurance companies, managed care organizations, HMO’s, etc.) that we contract with. You are expected to pay their office visit co-pay (usually $10-50) at the time of service. If you are responsible to pay a portion of the balance, JOI will mail you a statement. The statement will include the insurance company billing amount, what the insurance allows for treatment, and what amount you owe (“New Balance Pay This Amount”).
When you have had multiple dates of service (office visits, surgery, tests, etc.), we send multiple claims to the insurance company. As the insurance company processes the claims for these dates of service, the amount due from the patient may change according to your co-pay or deductible. Therefore, it is possible to receive statements showing different amounts due.
1. If I have primary or secondary insurance coverage, why doesn’t the secondary carrier pay my co-pays?
Most often secondary insurance carriers will not pay an account balance until you have met the deductible and pay the applicable office co-pay. Office visit co-pays are your responsibility by HMO plans. However, you may want to check with your secondary insurance carrier regarding their specific policy for dealing with primary insurance deductible amounts.
2. Why does JOI charge patients a fee for the completion of medical forms (i.e.: short-term and long-term disability forms) required by disability insurance companies for loan payments, mortgage payments, car payments, etc?
JOI recognizes the importance for the completion of these forms, so that loan payments are paid during the time of your disability. However, the completion of these forms do not fall within the scope of the your actual medical care. Additional staff and resources are needed, so this fee is a way of off-setting these additional expenses.
3. Why do insurance companies delay processing my claim until they receive accident information from me?
When we process your claim for an injury from an accident, most insurance carriers would write you and request accident details. This information is allows them to assess the insurance carrier’s liability. If your injury is the result of an automobile accident, the health carrier would not be responsible for processing the claim, but rather the auto insurance carrier. Also, did your injury occur at a business establishment, whether it is a work-related or a slip-and-fall, again the health insurance carrier may not be responsible for the claim. This is why it is very important to respond to your insurance carrier’s request for accident details in a timely manner.
More JOI Frequently Asked Questions
1. What is a drug formulary?
A drug formulary is a list of medications, both name brand and generic products, which the insurance carrier agreed to cover the cost. Most insurance carriers have a drug formulary, and the list changes on a regular basis. If your doctor prescribes a medication that is not on your carrier’s formulary, you will may have to pay out-of-pocket for the prescription. However, some carriers authorize certain medications prior to you filling the prescription.
2. Does JOI perform arthroscopic surgery?
Arthroscopic surgery is a minimally invasive procedure using a surgical arthroscope (camera), which is approximately the size of a pencil. This procedure is the most common surgery in orthopaedics, and is the most frequent device used to treat shoulder, knee, elbow, wrist, hip, and ankle joints. Your surgeon is available to view the inside of the joint on a video monitor where he/she can inspect, remove, repair, or reconstruct parts of a joint through several small incisions of approximately one-half inch. Arthroscopic procedures are less invasive, allowing you to return home the same day.
3. What is osteoporosis?
Osteoporosis is a disease process where your bones are weak or thin. Your bones are more susceptible to fracture with only minimal injury. Osteoporosis is most commonly seen in women who are post-menopausal age. However, men can be have this disease as well. A bone densitometry test can evaluate how thin your bones are. This is a specialized X-ray that generates a picture by using X-ray beams and detects how much the X-ray beam changes after it passes through the bones. The change in the X-ray beams’ intensity shows how dense or thin the bones are that are in the study. The three most common sites for bone densitometry test are in the spine, hip, or wrist. This test is very helpful in assisting your physician to diagnose osteoporosis and implement a treatment plan to build up your bones.
4. What are Synvisc/Hyalgan injections?
This is a series of three injections to treat osteoarthritis of the knee. These injections are to replace the natural chemical hyaluronan that is found in the body in high volume within the joint tissues and the fluid that fills the joint. In patients with osteoarthritis, there may not be enough hyaluronan in the joint fluid and tissues; therefore, causing wear and tear on the bones within the joint.
The body’s own hyaluronan acts as a lubricant and shock absorber in the joint and is necessary for the joint to operate properly. These injections are most often performed on patients that have not received significant pain relief with the use of medication, physical therapy, or corticosteroids that are injected directly into the joint.
5. I have had a total joint replacement. Why is it necessary to take antibiotics prior to dental procedures or other surgery?
Infection may occur in total joint replacements long after surgery. If the joint replacement is exposed to bacteria in the bloodstream, an infection can occur. It is uncommon for an infection to occur long after surgery. However, it is possible. For this reason, some physicians recommend that patients who have had a total joint replacement take antibiotics prior to dental or other surgical procedures.
6. What exactly is a ganglion?
Ganglions are benign, fluid-filled cysts. These cysts grow from the tendons or the lining around bones and may occur anywhere in the body. However, they are most commonly seen on the top of the wrist. A cyst is a sac usually consists of thin or watery fluid. The fluid in a ganglion is a thick or a clear jelly-like substance. Cysts often need an aspiration to resolve. However, they may recur and may need to surgical removal.
7. What is scoliosis?
Scoliosis is abnormal curvature of the spine. This condition can affect adults, but is most common in young people. Especially girls between 10 and 16 years of age. Scoliosis is usually first seen on school screening exams or by a child’s pediatrician. An orthopaedic physician will evaluate and X-ray to assess and measure the degree of the curve. The most common type of spinal curves is the “S-shape” and “C-shape”. These curves are seen in degrees and can range from 10 degrees up to 50 degrees. Depending upon the magnitude of the spinal curve, medical treatment may include simple observation, bracing, and, in severe cases, surgical intervention.
8. Do I have gout?
Gout is a condition that causes sudden, severe attacks of pain redness and swelling of the joints. Most often, gout affects a single joint in an episode and is commonly seen in the big toe. The cause of gout is due to an accumulation of uric acid within the joint fluid. Uric acid is a substance in our bodies to transport waste material via the kidneys.
When the uric acid level becomes too high, gout or joint pain may occur. Diagnosis may include aspiration of a small amount of fluid from the affected joint. This is sent to a laboratory or your MD will use a blood test to determine the uric acid level.
The treatment for Gout is a dose of nonsteroidal anti-inflammatory medications. Allopurinol is the medication for after an attack of gout to prevent future attacks. A change in diet is needed for those who are diagnosed with Gout. A decrease in the consumption of alcohol, maintain a healthy weight and foods that contain a high content of uric acid.
These foods have the highest level of Uric Acid:
- Red meats like: Beef, pork, lamb, venison and other wild game.
- Seafood and shellfish: Shrimp, lobster, anchovies, Tuna, scallops & sardines
- Organ meats of animals: Liver, kidney, heart
- Drinks which are high in fructose.
- Vegetables which are high in purines: asparagus, mushrooms, peas, spinach, and cauliflower.
In orthopedics, gout can cause inflammation, pain and damage to the joints of the body. It is important to see your doctor if you think you have gout.
9. What is Direct Access to Physical Therapy?
Direct Access to physical therapy is a program that you can attend physical therapy for 30 days without a prescription from a physician. To learn more, please read this article on Direct Access.
To schedule an appointment for physical therapy, please call JOI Rehab at 904-858-7045.
We hope that we have been able to answer you frequently asked questions of JOI. If not, please give us a call.
Finally, to schedule with an JOI MD, please call 904-564-2000 or schedule online.