Pelvic Floor PT FAQ
Pelvic Floor Physical Therapy (PFPT) is a specialized form of physical therapy that focuses on the muscles, ligaments, and nerves of the pelvic region.
It can be helpful for individuals experiencing a variety of pelvic floor conditions, including urinary incontinence, pelvic pain, and sexual dysfunction. Here are some frequently asked questions about Pelvic Floor PT and how it can help address these conditions.
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Healthcare costs are uncertain. Insurance is confusing. Billing is unclear.
Many people don’t truly know the cost of their healthcare services until they get an insurance claim statement. This is sometimes after multiple visits and the patient responsibility is often much greater than the person expected. Nobody wants to be blindsided by unexpected out-of-pocket costs.
At Chicago Pelvic Health, we feel very strongly that you, the patient, should be able to make fully informed decisions about your care. Many factors need to be considered when determining what’s right for you, including cost.
You will always know your cost up front at Chicago Pelvic, so YOU get to use the information to choose a care plan that you are comfortable with.
Please visit our page dedicated to answering your insurance questions.
Please give us a call and we can help answer your specific concerns. 773-219-2749.
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We have partnered with Reimbursify to assist in determining your insurance benefits. Please follow the below link to check your benefits! Don’t forget to include your contact number for a faster response.
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We accept cash, Visa, Mastercard, Amex, and Discover.
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Your first visit will be scheduled for 60 minutes, one on one with your Doctor. Together you will take a thorough deep dive of your current health concerns, discuss your medical history, and explore what is going on with your pelvic floor through a physical assessment.
You will only share or participate in what you are comfortable with, providing a safe space is our priority.
At the close of your seccion, both you and your doctor will determine what the best plan of care is going forward.
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An internal pelvic floor examination is different than one performed by a gynecologist or primary care physician. Doctors of Physical Therapy examine to see if the muscles are weak, the coordination of how they contract and relax, and muscle tone. OB/Physicians may assess for signs of infection, swelling, or tissue abnormalities.
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No. Illinois is considered a state with direct access. This means you can have access to physical therapy services without a referral or prescription from your primary doctor.
We do communicate with your health care provider about the pelvic health care you will receive. This also allows us to have the most updated medical information in order to treat our patients in a holistic way.
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Wear something you are comfortable to move around in and perform exercises. For more details visit our blog on "What to wear to Pelvic PT"
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No, pelvic physical therapy is so much more than kegels. In fact, we may even recommend you to not do kegels at all!
Treatment might include bladder and bowel retraining, soft tissue massage, strengthening and stretching exercises, coordination training, dry needling, postural retraining, and education for self-management.
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We believe healing is not linear, and thus your individual case should not follow a "cookie-cutter" protocol/plan. Together you and your therapist will decide what plan of care best fits your needs.
The average frequency of treatments is once a week.
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Yes. We are still able to provide other beneficial services such as external manual therapy, therapeutic exercise, and self-care education. If you are comfortable we are also able to perform internal manual work. If you have any questions do not hesitate to email or call us with concerns.
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Unfortunately we are unable to medically treat Medicare or Medicaid patients. We are happy to provide some recommendations to pelvic floor clinics that are authorized to take Medicare or Medicaid patients.
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This Patient Notice of Privacy describes the health information I collect and shows the ways in which your medical information can be used. You must sign that you have received the Notice of Privacy statement before you begin treatment.
Understanding your Health Information
Each time we work together, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnosis, treatment, and a plan of care for your treatment. This information is often referred to as your health or medical record.
Your Rights
Although your health record is the physical property of Chicago Pelvic Health and Wellness, the information belongs to you. You have the right to:
• Obtain a copy of the notice of privacy practices upon request
• Inspect and copy your health record
• Make changes in your health record
• Make a list of who your medical record was shared with
• Request communication of your medical record in certain places (for example, you may want us to call you at work instead of home)
• Request a restriction on certain uses and sharing of your information
• Revoke your permission for use or sharing of your medical record except to the extent that action has already been taken
My Responsibilities
I am required to:
• Maintain the privacy of your medical records
• Provide you with this notice as to our legal duties and privacy practices with respect to your medical records we collect and maintain about you
• Abide by the terms of this notice
• Notify you if we are unable to agree to a request restriction
• Accommodate reasonable requests you may have to communicate your medical records by alternative locations
I will not use or share your medical record without permission, except as described in this notice.
Use and Sharing of Health Information for Treatment, Payment, and Health Operations
The law allows me to use your medical records without your permission for treatment, payment, and business operations. The following are some examples: patient billing, third party billing, quality of care and improved services, other specialty care, caregiver/ family member notification/ communication, research, organ and tissue donation, marketing, fundraising, Food and Drug Administration (FDA), Workers Compensation, law enforcement, and public health.
Federal law makes provision for your medical records to be released to an appropriate health oversight agency, public health authority or attorney, provided that a workforce member of business associate believes in good faith that we have engaged in unlawful conduct of have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.
For more information or to report a problem
If you have any questions or require additional information, please contact our staff at help@chicagopelvic.com.
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Please give us a call at 773-219-2749 and someone from our staff will be happy to help, or you can fill out the form below.
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We can be reached at 773-219-2749 and help@chicagopelvic.com
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Please log into Janeapp to access your account.
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Please visit Janeapp to login to or create your account.
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Yes, we currently have a Pregnancy Package aimed at helping our mothers experience the best birth outcomes possible.
Coming Soon! We are also working closely with our urology partners in the community to bring you a Prostatectomy Package.
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DOES ILLINOIS HAVE AN INSURANCE “PROMPT PAYMENT” LAW?
The Illinois Insurance Code contains a section entitled “Timely payment for health care services” that requires health care payers to pay claims within 30 days after receipt of a properly documented claim (sometimes referred to as a “clean claim”). If payment is not made within that period, the payee is entitled to interest at the rate of 9% per year.
* Time requirement: 30 days
* Interest Rate: 9%
The provision is found at 215 ILCS 368a as follows:
(c) All insurers, health maintenance organizations, managed care plans, health care plans, preferred provider organizations, and third party administrators shall ensure that all claims and indemnities concerning health care services other than for any periodic payment shall be paid within 30 days after receipt of due written proof of such loss. An insured, insured’s assignee, health care professional, or health care facility shall be notified of any known failure to provide sufficient documentation for a due proof of loss within 30 days after receipt of the claim for health care services. Failure to pay within such period shall entitle the payee to interest at the rate of 9% per year from the 30th day after receipt of such proof of loss to the date of late payment, provided that interest amounting to less than one dollar need not be paid. Any required interest payments shall be made within 30 days after the payment.
The 30-day “clock” begins to run on the date the health plan receives a properly documented claim. Of course, the issue is how each plan defines “properly documented.” Various plans may have different requirements. However, the law states that the payer must notify the patient or health care professional (to whom the patient has assigned payment) within 30 days of receipt of the claim if the payer deems it to be insufficient; otherwise, it is considered sufficient and interest would be due from the 30th day after receipt of the claim. If the plan notifies the health care professional within 30 days that the claim needs additional documentation, the 30-day “clock” will start to run when the plan receives the additional documentation that completes the claim or results in a “clean” claim.
When interest is due, payers may include it with payment or may remit the interest separately within 30 days after payment.
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Claim Denial
If you believe a claim has been unjustly denied, our Department will review your complaint to ensure the company is abiding by Illinois insurance laws and the policy language. If the denial involves a determination of medical necessity, we can ask the company to review it. However, our authority is limited.
Utilization Review
Although the Illinois Department of Insurance has limited jurisdiction over claim denials for medical necessity, we can ensure the payor or its delegated Utilization Review Firm handled the review process in accordance with the law. If you are having problems obtaining a utilization review decision or if you believe the review or appeal was not handled appropriately, please contact our Department.
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Understanding the Illinois External Review Process for Insurance Claims
The Health Carrier External Review Act provides standards for the establishment and maintenance of external review procedures to assure covered persons have the opportunity for an independent review of an adverse benefit determination or final adverse benefit determination.
Commonly Asked Questions
Is my denial eligible for external review? Denials that involve medical judgment, determination of experimental or investigational treatment, pre-existing conditions, or rescission of coverage for a reason other than nonpayment of premium or contributions are eligible for external review. The above includes, but is not limited to, medical necessity, appropriateness, effectiveness of a benefit, level of care, healthcare setting, length of treatment.
Why should I request an external review? When your health carrier denies medical care or treatment, they are required by law to provide a process to appeal the denial. If you complete your health carrier's internal appeal process and your request is still denied, you may be eligible for an external review. An external review is an independent medical review of a health carrier's decision conducted by an Independent Review Organization (IRO) that is approved by IDOI. In Illinois there is no cost to the consumer to file an external review. Note: Illinois Law Commonly Asked Questions 2 of 3.
When can I file an external review? You must file your external review within 4 months of receipt of your final adverse benefit determination (denial) from the health carrier.
What if my situation is urgent, or experimental or investigational? Your health care provider will need to complete the applicable certification form and submit to IDOI. Internal appeal and external review rights are exhausted at the same time in expedited circumstances.
What happens if I don't qualify? The Department will notify you that your request for external review has been denied, and when appropriate, information on how to file a complaint with the Department will be provided. If the Department's complaint investigation determines that clinical judgment was utilized, you will be notified of your right to file an external review.
Are all plans subject to the Illinois Health Carrier External Review Act? Not all health plans fall under the jurisdiction of the IDOI. Health plans that may be referred to a separate entity may include the following:
You are covered by a self-insured employer, union, church, or non-federal governmental plan. Refer to your benefit booklet for appeals process.
You are covered by a group plan issued in another state.
The coverage is through Medicare, Medicaid, Federal Employees Health Benefits Program, Tricare or other military coverage.
The coverage is for a specified disease (for example, "Cancer only"); specified accident or accident only coverage, credit, dental, disability income, hospital indemnity, long-term care insurance, vision care, or other limited supplemental benefits.
IDOI accepts external review requests: Send only copies. Keep your originals.
Online through IDOI Message Center
Email at DOI.externalreview@Illinois.gov
Fax at (217) 557-8495
Mail to 320 W. Washington Street, Springfield, IL 62767
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Disclaimer: The advice and information provided on this page and throughout this website are intended for informational purposes only and do not constitute legal advice. Please consult with a qualified legal professional for advice on any legal matters.