Patient Forms & Insurance Accepted at Premier Physical Therapy
New Patient Forms

Thank you for selecting
Premier Physical Therapy for one-on-one physical therapy.
Request an appointment online or
call to schedule your preferred appointment at one of our physical therapy centers of excellence located in Manhattan (New York City), Westchester County (Eastchester, Hartsdale & Katonah), and Norwalk, CT.
Once you have made your initial appointment, you can pre-register by clicking on the links for New Patient Forms below. Simply download, print, and complete the forms prior to your arrival. Doing so will help speed up the new patient registration process at your first visit.
Please note: It may take a few minutes to load the forms if you are using a dial-up Internet Connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the Adobe icon.
Billing and Insurance
Health Insurance
We accept Workers Compensation, No-Fault, Medicare, and are in-network with most local and national health plans. Prior to your appointment, our billing specialists will verify your health insurance’s physical therapy benefits and discuss your coverage with you.
Below is a list of some of the many health insurance plans which we accept. Please call us if you do not see your insurance listed because we are continually adding new health plans.
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21st Century
AARP
Administrators Concept
Aetna
Aetna Better Health
Alicare
Allied
America's Choice
AmeriChoice
Amerih-PHCS
Anthem Blue Cross Blue Shield
Beech Street
Blue Cross Blue Shield/ BlueCard
Charter Oak
Cigna
Cigna-MVP Health Care
Community Health Network
ConnectiCare
Corvel
Coventry Health Care
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Difinity
Empire Blue Cross Blue Shield
Empire Plan/ MPN (NYS Gov't)
Employee Benefit Service
First CenturyFirst Health
Fiserv Health
Fortified Provider
Galaxy Health Network
Gallagher Benefit Admin
Golden Rule
Great West
Group Benefit Service
Guardian
Hartford Trust
Health Net
Health Plus
Horizon Blue Cross Blue Shield
Hudson Health Plan
HUSKY
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Liberty Mutual
Local 812
Local 1199 SEIU
MagnaCare
Meritain Health
MultiPlan
Mutual of America
Mutual of Omaha
Nippon
Oxford
PHCS
POMCO
Principal Life Insurance
PTPN Network Insurances
Screen Actors Guild
Sterling & Sterling
Teamster Benefit Trust
TRICARE (Military)
UniCare
UnitedHealthcare
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Questions To Ask Your Insurance Company
While we pride ourselves in providing excellent customer service, and will handle all of your insurance verification and authorization, it is important for you to understand your benefits. We encourage you to contact your insurance carrier in advance. When contacting your insurance company, there are several questions that you may want to ask them.
- Does my plan cover Outpatient Physical Therapy?
- What is my deductible and/ or co-pay?
- Has my deductible been met? If not, how much of the deductible has been met?
- Are there any visit limits or restrictions?
- Are my visit limits based on calendar year, benefit year, or other time frame?
- Do I need to obtain prior authorization for physical therapy?
- Do I need a referral from my physician?
Medicare
We accept Medicare at all of our locations. Please inform us if you have a secondary insurance at the time of appointment, and remember to bring your physician’s referral to your first appointment.
Workers Compensation & Auto No-Fault
We accept both Worker’s Compensation and Auto No-Fault at all Premier Physical Therapy locations. You will need to provide us with the insurance company’s name, address, phone number, the adjuster’s name, and your claim number in order for us to schedule your appointment. Authorization from your Worker’s Compensation carrier is required before the initial appointment. Our insurance and billing specialists will assist you in sorting out what your benefits are, and work closely with you throughout the billing process. You may be responsible for any portions of your bill not paid by Worker’s Compensation.
Private Pay Plans
At Premier, we understand that not everyone has a health insurance plan, and those that do are sometimes denied coverage or have their authorization expire. To help you with this, we offer a number of money-saving private pay packages. Please speak to one of the knowledgeable members of our office staff at any location regarding our private payment plans. They will be able to assist you in choosing the proper package to best suit your rehabilitation needs.
Billing/ Payment
We have a team of insurance specialists who are available to assist you through the authorization, verification and billing process. Our goal is to make the entire billing process as easy on you as possible. While we currently accept cash, health savings accounts, and credit cards (Mastercard & Visa) as payment, we do not accept checks. In addition, we offer flexible payment plans on an “as-needed” basis to help ease your co-payment/ deductible/co-insurance financial responsibilities while receiving physical therapy services at Premier Physical Therapy.
Direct Access to Physical Therapy Without A Prescription
New York State & Connecticut both have “Direct Access” laws which allow you to go straight to a physical therapist without first obtaining a prescription from a physician. Each of these laws has their own regulations and restrictions, and they are not intended to defer patient care by a physician, but rather give you the ability to gain access directly to a physical therapist to start treatment sooner. Additionally, some health insurance companies still require a referral from a physician before they will reimburse for services, so it is important that you contact your health insurer to find out their requirements before seeking physical therapy treatment through direct access. Please feel free to call any of our offices if you have further questions regarding direct access.
Request an appointment online or call to schedule your preferred appointment at one of our physical therapy centers of excellence located in Manhattan (New York City), Westchester County, NY (Eastchester, Hartsdale & Katonah), and Fairfield County, CT (Darien & Norwalk).