Office Policies | Manhattan Physical Therapy & Pain Center

Important Company Policies for a successful relationship

We strive to provide you the best personalized care available. To make this possible we adhere to a set of very important guideline. Please read them carefully, initial all boxes and indicate your agreement by signing at the bottom.

Late Policy "10 minutes"
Being late by more than 10 minutes we require you either reschedule or wait for the next available opening. There are no guarantees since openings due to cancellations are unpredictable. We do not allow appointments overlap because this undeservedly compromises the care of another patient.

24-Hour Advance notice fee
If you wish to change or cancel an appointment we require a minimum 24-Hour advanced notice. Anything else will result in a $60 fee charged to your account. It costs us money to make appointments available to you. Whether you attend or not we still accrue the expenses (for staff wages, rent, etc). We do not charge you the actual cost for that appointment but rather a mere $60 fee. We do NOT make money with this charge; its only to act as a deterrent from making last minute charges. Advance notice allows someone else (who needs it) time to reserve in place of you.
Please be courteous and responsible. Thank you.

Copays are due on arrival
If you happen to forget your wallet or checkbook we may still be able to see you upon completion of an "Extension Request" form. This is a "promise-to-pay" form and carries a minimal fee that allows you to keep your appointment bottom.

No-shows are bad
If you fail to show for an appointment without notice all future appointments will be removed and a $60 fee assessed to your account. You may re-schedule appointments again on a "first come, first serve basis".

Cell phones must be shut OFF or silent.
We realize emergencies may arise and therefore allow you to carry your cell phone during sessions, however, please be courteous and set to silent mode or turn off. Thank you.

Children requiring supervision are NOT allowed to attend sessions with you.
Unless your facility offers child care services, you may not bring children who require supervision with you to your appointment. If your child does not require supervision and is capable of waiting for you quietly then you may bring them. If any disturbance is caused to other patients or staff member you may be asked to terminate your session early and attend your child.

Financial hardship
If you are experiencing financial difficulties and are unable to afford the cost of our service we have a "Financial hardship" which may be filled-out. If you qualify for financial assistance according to federal guidelines, we may legally assist you by waiving or discounting your (patient responsibility) portion of the bill. Ask the front desk person for assistance.

Important Notice from the Federal Government:
"It is unlawful to routinely avoid paying your copay, deductible or coinsurance payment...even if your doctor allows it. Unless you complete a "Financial hardship" form and qualify for financial assistance under Federal Standards, you may NOT routinely evade paying your responsibility portion for medical care as outlined in your insurance plan even if doctor allows it. You both may be charged for breaking the law. This includes services deemed as "professional courtest" and "TWIP's" - Take what insurance pays". Failure to comply place you in violation of the following laws; Federal False claims act, Federal Anti-Kickback statue, Federal Insurance Fraud laws, State insurance Fraud laws. Failure to comply may result in civil money penalties (CMP) in accordance with the new provision of section 1128 A(a)(5) of the Health Insurance Portability and Accountability Act of 1996 [section 231(h) of HIPAA]. Exceptional case do apply. Please see contact info for more information. Office of Inspector General, Department of Health and Human services. Contact by phone: 202-260-8512, by email: paffairs@oig.hhs.gov, by Office of Inspector General, Office of Public Affairs, Department of Health and Human services, Room 5541 Cohen Building, 333 Independence Avenue, S.W., Washington, D.C. 20201, Joel Schear, Office of Counsel to the Inspector general, 202-619-0089."

We look forward to building a successful relationship with you that lasts a lifetime!

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