General Patient Forms
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, non-covered treatments, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the No Surprises Help Desk at 1-800-985-3059.
WE ACCEPT THE FOLLOWING INSURANCE PLANS AND FORMS OF PAYMENT:
- AARP MEDICARE COMPLETE
- ACPN NETWORK
- ADMINISTRATIVE ENTERPRISES (AEI)
- AETNA & AFFILIATES (out of network)
- AFFILIATED HEALTH FUNDS
- AMERICAN PPO
- AZ FOUNDATION FOR MEDICAL CARE
- BCBS OF AZ & AFFILIATES
- BEECH STREET
- CHAMP VA
- CHRISTIAN CARE MINISTRY
- CIGNA (out of network)
- CLARISPOINTE, INC
- EVOLUTIONS HEALTH CARE SYSTEMS, INC
- FIRST HEALTH/CCN ***verify plans***
- FOCUS HEALTHCARE MANAGEMENT
- FORTIFIED PROVIDER NETWORK (FPN)
- GALAXY HEALTH NETWORK
- GLOBAL MEDICAL MANAGEMENT
- HEALTH MANAGEMENT NETWORK
- HEALTH NETWORK AMERICA, INC/TRIVERIS
- INDEPENDENT MEDICAL SYSTEM
- NATIONAL CHOICECRE, INC (NCC PPO)
- NATIONAL PREFERRED PROVIDER NETWORK
- NATIONAL PROVIDER NETWORK, INC (NPN)
- PREFERRED QSP
- PRIME HEALTH SERVICES. INC
- PRIVATE HEALTHCARE SYSTEMS (PHCS SAVILITY)
- PROCURA MANAGEMENT, INC
- PROVIDER SELECT, INC
- RAN AMN
- ROCKPORT HEALTHCARE GROUP, INC
- RAILROAD MEDICARE (PALMETTO)
- SCHALLER ANDERSON OF AZ (AUTH)
- SOUTHWEST CARPENTERS TRUST
- THE RENY COMPANY
- THREE RIVERS NETWORK (TRPN)
- TLC ADVANTAGE, L.L.C.
- TRICARE WEST (HNFS)
- TRIWEST HEALTH CARE ALLIANCE (VA)
- UNITED HEALTH ONE
- UNITED HEALTH CARE (COMMERCIAL PLANS)
- UNITED HEALTH CARE DUAL COMPLETE
- UNITED HEALTH CARE LONG TERM CARE
- UNION PACIFIC RR EMPLOYEES HEALTH SYSTEMS
- UNIVERSITY CARE ADVANTAGE (MEDICARE REPLACEMENT)
- USA MANAGED CARE ORGANIZATION
- U.S. DEPARTMENT OF LABOR
- (W/C) WORKERS COMP (MOST REQUIRES AUTH)
- YAVAPAI COMB. TRUST (BCBS) (AEI)
WE ACCEPT CASH, CHECK, VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS, AND CARE CREDIT.
WE ACCEPT ALL INSURANCES SECONDARY TO THE PRIMARY INSURANCES LISTED ABOVE.
Hello, thank you for choosing Canyon Physical Therapy & Aquatic Rehabilitation. We are excited to serve you and look forward to providing you with “Uncompromising Care.” Please take a moment to review these frequently asked questions (FAQ)
Q. What should I bring to my first appointment?
A. Please complete the included packet and bring it in with you on your first visit.
Also please bring with you:
- Your picture ID
- Insurance card(s)
- Therapy prescription from your physician (if we do not already have it)
Please arrive 15 minutes early for the first appointment.
Q. What should I wear to my first appointment?
A. Please dress comfortably in loose fitting clothing that will allow access to the area of your body that will be evaluated by the Physical Therapist.
*If your physician has ordered Aquatic Physical Therapy you may bring your pool gear (i.e. swim clothes and towel, as we do not provide one) however, it may not be needed on the first visit.
Q. How long will my appointment last?
A. Your first visit (initial evaluation) will last approximately 1 hour and 30 minutes. Return visits will last 1-2 hours depending on your course of treatment.
*If you will be receiving Aquatic Physical Therapy your visits will tend to last closer to 2 hours.
Q. What should I do if I will be unable to make my appointment?
A. If you are unable to make your scheduled appointment, please call at least 24 hours before to reschedule. This will provide us ample time to schedule another patient. If you do not show for your visit or repeatedly cancel within 24 hours you will be removed from the schedule and a compliance record will be sent to your Dr. Please remember for Physical Therapy to be effective you must maintain a consistent schedule as prescribed by your Physical Therapist and Physician.
Q. Where is Canyon located?
A. Canyon Physical Therapy and Aquatic Rehabilitation is located at 2852 N. Navajo Dr. Ste. A. in Prescott Valley. We are on the Southside of Hwy 69 next to the drive-thru Wells Fargo Bank and adjacent to the Americas Best Value Inn.
Should you have any further questions please call (928) 772-9797 and someone will be happy to assist you. Again, thank you and we look forward to meeting your Physical Therapy needs.
Check out some of these links for additional resources:
- Referral FAQ
- Differences between Original Medicare and Medicare Advantage Plans
- Healthcare Key Terms
- American Physical Therapy Association
- Arizona Physical Therapy Association
- American College of Sports Medicine
- American Medical Association
- National Institute on Aging
- Centers for Medicare & Medicaid Services
- Web MD
- American Senior Fitness Association
- MEDLINE plus
- Physical Therapy Business Alliance
- Slips, Trips, and Falls – Powerpoint