FAQ's

PHYSICAL THERAPY FAQ's

Why come to Biokinetics Rehab for my therapy?

We are fortunate to have many very talented clinicians, therapists, physicians, and trainers in our area.  But oftentimes, insurance regulations and facility policies may adversely influence the optimal delivery of care.  Many times, practitioners must see multiple patients at once or may be restricted in the amount of time spent during assessments and treatments.  Clients may be seen by different therapists or trainers each session, and care may be driven by generic protocols.  And unfortunately, visits may be limited and a person is discharged before they fully return to their desired levels.

We deliver care that is individually tailored to the specific needs and desires of our clients.  We are an out-of-network provider, which means we don’t have to satisfy insurance requirements.  We can see you directly, meaning you do not need to have a referral from your physician, saving you time and money.  We work one-on-one with our clients instead of having 1-2 other clients overlapping your session.  Your sessions will always be for a 60-minute duration with the same physical therapist.  We will make every attempt to get you seen within 24-48 hours instead of having to wait weeks for an appointment.  We have the ability to spend the time needed to address your concerns and have the knowledge and experience to restore you to your highest level of function.  And most importantly, we will ensure that you have the necessary tools and confidence to carry on in life, being able to recognize when we are needed but not dependent upon us to “fix” you.

Do I need a referral from my physician for physical therapy?

A referral for physical therapy is not required for you to be seen in our practice; you can call us to make an appointment right now.  

In North Carolina, physical therapists work under Direct Access, which allows you to see your physical therapist directly, without having to wait for a physician appointment and have extra costs for co-payments and tests. This will allow you to obtain treatment for your condition immediately, getting you back to living the life you desire at a faster time while spending less money.

What if my physician refers me to another clinic but I want to see you instead?

Although you should trust your primary healthcare provider, and it’s generally good to follow a doctor’s advice, it remains a patient’s right to choose who provides your physical therapy. After all, it’s your body and your health. Ultimately, your health is your responsibility.

“The Patient’s Bill of Rights”, adopted from the US Advisory Commission on Consumer Protection and Quality in the Health Care Industry, states that a patient has the right to choose a healthcare provider.  In addition to your primary healthcare provider, this also covers specialists, including physical therapists, who are generally physician-referred.

When your physician refers you to a therapy clinic, you should ideally receive a list of options. If the physician has any tie to a therapy clinic on the list, that information must be disclosed. Because you have the right to choose a physical therapist and the right to make decisions, it is up to you to decide which referral you will follow up with or whether you will follow-up at all.

Biokinetics Rehab is an out of network provider. What does this mean?

This simply means that we have not entered into a contract with individual insurance companies to receive reimbursement based on their contracted rates, nor subject to their influence on how to best serve your needs and desires.   There are many insurance companies, each with their own contracted rates and regulations, and our energy is best spent working with patients.

Will my insurance pay for physical therapy?

Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide payment for services received "out of network".  Going out of network means that you can choose to see a physical therapist who is not a participating provider with your insurance company. Many patients choose to receive services out of network in order to see the physical therapist of their choice and often without long wait.  

What steps are involved in submitting a claim to my insurance company?

The process is actually quite simple:  We will provide you with an invoice (or superbill) at the time of service, and you may submit that invoice and receipt to your insurance company for reimbursement. The invoice has all of the necessary  information (business name and address, tax ID, national provider identification, license numbers, etc.) as well as the patient’s ICD-10 (diagnosis) and CPT (billing) codes.

The invoice contains a statement that the patient has paid in full for the visit and that reimbursement should go directly to the patient.

Can I use my FSA or HSA for therapy services?

Yes, since physical therapy is a qualified medical expense, Biokinetics Rehab accepts Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) for physical therapy services.

RECOVERY ROOM FAQ's

How long do cold water immersion sessions take?

We recommend users submerge to their neck line for 2-5 minutes, never more than 10 minutes.  However, users can also complete 2-3 cycles in our cold plunge tub in between their infrared sauna session for a highly effective contrast therapy session.

What to bring to your Recovery Session:

• A towel for after your cold plunge and a towel to sit on when in the infrared sauna
• Whatever you are comfortable getting wet in the cold plunge (bathing suit, shorts and sports bra, etc.)
• A change of dry clothes for after your session (if you desire)
• Take off any jewelry or accessories that could rust/tarnish when exposed to cold water

Why does cold water immersion boost your mood and energy?

Research shows that cold-water immersion may help with stress by slowing your heart rate and directing blood flow to your brain by stimulating the vagus nerve, causing the body to return to a parasympathetic mode.  In addition to lowering your blood pressure, this will also assist with regulating your emotions. Exposing yourself to extreme cold causes your body to release certain mood and energy-boosting hormones, including endorphins and norepinephrine.

Can cold therapy improve skin health?

Cold exposure reduces inflammation while improving antioxidant levels. Studies have shown that the combination of these factors can improve skin health, especially in patients who suffer from chronic inflammatory skin diseases such as atopic dermatitis.

Can cold treatment reduce muscle soreness and improve muscle recovery?

Exposing sore muscles to ice water after an intense workout can help transport more nutrients to the affected areas, thus reducing soreness and speeding up recovery times. That’s why ice baths are a popular recovery method for elite athletes and fitness enthusiasts alike.

How long do the effects of cold therapy last?

How long the effects of cryotherapy last depends on the benefit you’re looking at. The initial boost in mood and energy lasts several hours, and so does the increased metabolic rate as your body tries to warm back up to normal temperatures.

What is the difference between cold water immersion and cryo chambers?

Both approaches are very effective at reducing inflammation, decreasing pain, promoting tissue healing, and stimulating an immune response.  Cryo chambers involve sitting or standing in an enclosed chamber while liquid nitrogen is used to cool the air.  Cold water immersion requires the user to submerge themselves into cold water, which gives a stronger and more immediate response, as well as a deeper level of vasoconstriction (followed by vasodilation once you get out of the tub) inside the muscle tissue, thus helping the cardiovascular system more effectively pump nutrients into the affected areas.  Additionally, cold water immersion transfers heat away from the body more effectively than air which increases norepinephrine in your body 6x faster than cryo chambers. Norepinephrine is a hormone and neurotransmitter responsible for increased mood, alertness, reaction time, thermogenesis, fat loss, pain relief and anti-inflammatories.

Is cold water immersion, infrared saunas, and compression therapy safe for me?

For the average person, cold, heat, and compression therapies are very safe.  However, there are contraindications and precautions one must be aware of to be sure you practice these treatments safely. Talk with your doctor before starting any new wellness regime. 

Cold water immersion is contraindicated to people suffering from: severe hypertension; recent myocardial infarction; unstable angina pectoralis; arrhythmia; chronic cardiovascular disease; peripheral arterial occlusive disease; venous thrombosis; recent cerebrovascular accident; impaired circulation such as Raynaud disease; impaired sensation diseases such as diabetic neuropathy or other types of neuropathies; behavioral disorders and impaired abilities to communicate.

Infrared sauna is contraindicated to: pregnant women; patients with severe cardiovascular conditions; anyone suffering from dehydration, weakness, trauma, or difficulty breathing; people using drugs, alcohol, and particular prescription medicines; people who have recently undergone serious trauma or surgery.

Normatec compression is contraindicated in people with: acute pulmonary edema; acute thrombophlebitis; acute congestive cardiac failure; deep vein thrombosis (DVT); episodes of pulmonary embolism; bone fractures or dislocations at or near the site of application.

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HIPPA Notice of Privacy

Effective Date: 2/12/24

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW THIS NOTICE CAREFULLY.

If you have any questions about this notice, please contact our privacy officer:

 Jeffrey M Smith

837 13^th Street NE, Hickory, NC 28601

(828) 528-1222

1.         Summary of Rights and Obligations Concerning Health Information.  Biokinetics Rehab is committed to preserving the privacy and confidentiality of your health information, which is required both by federal and state law.  We are required by law to provide you with this notice of our legal duties, your rights, and our privacy practices, with respect to using and disclosing your health information that is created or retained by Biokinetics Rehab. Each time you visit us, we make a record of your visit. Typically, this record contains your symptoms, examination and test results, our assessment of your condition, a record of your treatment interventions, and a plan for future care or treatment. We have an ethical and legal obligation to protect the privacy of your health information, and we will only use or disclose this information in limited circumstances. In general, we may use and disclose your health information to: 

• plan your care and treatment;

• provide treatment by us or others;

• communicate with other providers such as referring physicians;

• receive payment from you, your health plan, or your health insurer;

• make quality assessments and work to improve the care we render and the outcomes we achieve, known as health care operations;

• make you aware of services and treatments that may be of interest to you; and

• comply with state and federal laws that require us to disclose your health information.

 We may also use or disclose your health information where you have authorized us to do so.

 Although your health record belongs to Biokinetics Rehab, the information in your record belongs to you. You have the right to:

 • ensure the accuracy of your health record;

• request confidential communications between you and your physician and request limits on the use and disclosure of your health information; and

• request an accounting of certain uses and disclosures of health information we have made about you.

 We are required to: 

• maintain the privacy of your health information;

• provide you with notice, such as this Notice of Privacy Practices, as to our legal duties and privacy practices with respect to information we collect and maintain about you;

• abide by the terms of our most current Notice of Privacy Practices;

• notify you if we are unable to agree to a requested restriction; and

• accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

 We reserve the right to change our practices and to make the new provisions effective for all your health information that we maintain.

 Should our information practices change, a revised Notice of Privacy Practices will be available upon request. If there is a material change, a revised Notice of Privacy Practices will be distributed to the extent required by law.  We will not use or disclose your health information without your authorization, except as described in our most current Notice of Privacy Practices. In the following pages, we explain our privacy practices and your rights to your health information in more detail.

2.         We may use or disclose your medical information in the following ways: 

·       Treatment. We may use and disclose your protected health information to provide, coordinate and manage your rehab care.  That may include consulting with other health care providers about your health care or referring you to another health care provider for treatment including physicians, nurses, and other health care providers involved in your care.  For example, we may we will release your protected health information to a specialist to whom you have been referred to ensure that the specialist has the necessary information he or she needs to diagnose and/or treat you.  

·       Payment. We may use and disclose your health information so that we may bill and collect payment for the services that we provided to you. For example, we may contact your health insurer to verify your eligibility for benefits, and may need to disclose to it some details of your medical condition or expected course of treatment. We may use or disclose your information so that a bill may be sent to you, your health insurer, or a family member. The information on or accompanying the bill may include information that identifies you and your diagnosis, as well as services rendered, any procedures performed, and supplies used. If, however, you pay cash at the time of service, we will not disclose your protected health information to your health plan or any other responsible payer unless you sign an authorization for us to do so.  If we agree to await payment from your health plan or put you on a payment plan, we may provide health information to a collection agency, small claims court or other court of competent jurisdiction in the event your claims for our services are not paid within 90 days and you have not made alternative payment arrangements with us.  

·       Health Care Operations.  We may use and disclose your health information to assist in the operation of our   

practice. For example, we may use information in your health record to assess the care and outcomes in your   case and others like it as part of a continuous effort to improve the quality and effectiveness of the healthcare and services we provide. We may use and disclose your health information to conduct cost-management and business planning activities for our practice. 

·       Business Associates. Biokinetics Rehab sometimes contracts with third-party business associates for services. Examples include answering services, transcriptionists, billing services, consultants, and legal counsel. We may disclose your health information to our business associates so that they can perform the job we have asked them to do. To protect your health information, however, we require our business associates to appropriately safeguard your information.

·       Appointment Reminders. We may use and disclose Information in your medical record to contact you as a reminder that you have an appointment.   We usually will call you at home the day before your appointment and leave a message for you on your answering machine or with an individual who responds to our telephone call. However, you may request that we call you only at a certain number or that we refrain from leaving messages and we will endeavor to accommodate all reasonable requests.

·       Treatment Options. We may use and disclose your health information in order to inform you of alternative treatments.  

 ·       Release to Family/Friends. Our staff, using their professional judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, your health information to the extent it is relevant to that person’s involvement in your care or for payment related to your care. We will provide you with an opportunity to object to such a disclosure whenever we practicably can do so. We may disclose the health information of minor children to their parents or guardians unless such disclosure is otherwise prohibited by law.  However, please note that state law may prohibit us from disclosing medical information to a parent or guardian at the child’s request if the child is of a certain age.   

·       Health-Related Benefits and Services.  We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you. In face- to-face communications, such as appointments with your provider, we may tell you about other products and services that may be of interest you. 

·       Newsletters and Other Communications. We may use your personal information in order to communicate to you via newsletters (including electronic newsletters – subject to applicable anti-spam laws), mailings, or other means regarding treatment options, health related information, disease management programs, wellness programs, or other community based initiatives or activities in which our practice is participating. 

·       Disaster Relief. We may disclose your health information in disaster relief situations where disaster relief organizations seek your health information to coordinate your care, or notify family and friends of your location and condition. We will provide you with an opportunity to agree or object to such a disclosure whenever we practicably can do so. 

·       Marketing.  In most circumstances, we are required by law to receive your written authorization before we use or disclose your health information for marketing purposes. However, we may provide you with promotional gifts of nominal value and market services or products to you in face-to-face communications. Under no circumstances will we sell our patient lists or your health information to a third party without your written authorization.    

·       Public Health Activities. We may disclose medical information about you for public health activities. These activities generally include the following: 

•   licensing and certification carried out by public health authorities;

•   prevention or control of disease, injury, or disability;

•   reports of births and deaths;

•   reports of child abuse or neglect;

•   notifications to people who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;

       •   organ or tissue donation; and

       •   notifications to appropriate government authorities if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will make this disclosure when required by law, or if you agree to the disclosure, or when authorized by law and in our professional judgment disclosure is required to prevent serious harm. 

·       Food and Drug Administration (FDA). We may disclose to the FDA and other regulatory agencies of the federal and state government health information relating to adverse events with respect to food, supplements, products and product defects, or post-marketing monitoring information to enable product recalls, repairs, or replacement. 

·       Workers Compensation. We may disclose your health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.  

·       Law Enforcement. We may release your health information: 

• in response to a court order, subpoena, warrant, summons, or similar process of authorized under state or federal law;

• to identify or locate a suspect, fugitive, material witness, or similar person; 

• about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;

• about a death we believe may be the result of criminal conduct;

• about criminal conduct at [name of provider];

• to coroners or medical examiners;

• in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime;

• to authorized federal officials for intelligence, counterintelligence, and other national security authorized by law; and

• to authorized federal officials so they may conduct special investigations or provide protection to the President, other authorized persons, or foreign heads of state. 

·       De-identified Information. We may use your health information to create "de-identified" information or we may disclose your information to a business associate so that the business associate can create de-identified information on our behalf. When we "de-identify" health information, we remove information that identifies you as the source of the information. Health information is considered "de-identified" only if there is no reasonable basis to believe that the health information could be used to identify you. 

·       Personal Representative. If you have a personal representative, such as a legal guardian, we will treat that person as if that person is you with respect to disclosures of your health information. If you become deceased, we may disclose health information to an executor or administrator of your estate to the extent that person is acting as your personal representative. 

·       Limited Data Set. We may use and disclose a limited data set that does not contain specific readily identifiable information about you for research, public health, and health care operations. We may not disseminate the limited data set unless we enter into a data use agreement with the recipient in which the recipient agrees to limit the use of that data set to the purposes for which it was provided, ensure the security of the data, and not identify the information or use it to contact any individual.

 3. Authorization for Other Uses of Medical Information.  Uses of medical information not covered by our most current Notice of Privacy Practices or the laws that apply to us will be made only with your written authorization.  You should be aware that we are not responsible for any further disclosures made by the party you authorize us to release information to.  If you provide us with authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except to the extent that we have already taken action in reliance on your authorization or, if the authorization was obtained as a condition of obtaining insurance coverage and the insurer has the right to contest a claim or the insurance coverage itself. We are unable to take back any disclosures we have already made with your authorization, and we are required to retain our records of the care that we provided to you.

 4. Your Health Information Rights.  You have the following rights regarding medical information we gather about you: 

A. Right to Obtain a Paper Copy of This Notice. You have the right to a paper copy of this Notice of Privacy Practices at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy. 

B. Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care.  This includes medical and billing records.   

To inspect and copy medical information, you must submit a written request to our privacy officer. We will supply you with a form for such a request. If you request a copy of your medical information, we may charge a reasonable fee for the costs of labor, postage, and supplies associated with your request. We may not charge you a fee if you require your medical information for a claim for benefits under the Social Security Act (such as claims for Social Security, Supplemental Security Income, and any other state or federal needs-based benefit program.

 If your medical information is maintained in an electronic health record, you also have the right to request that an electronic copy of your record be sent to you or to another individual or entity. We may charge you a reasonable cost based fee limited to the labor costs associated with transmitting the electronic health record.

 C. Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as we retain the information.   

To request an amendment, your request must be made in writing and submitted to our privacy officer. In addition, you must provide a reason that supports your request.  We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: 

• was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

• is not part of the medical information kept by or for [name of provider];

• is not part of the information which you would be permitted to inspect and copy; or

• is accurate and complete.

 If we deny your request for amendment, you may submit a statement of disagreement.  We may reasonably limit the length of this statement. Your letter of disagreement will be included in your medical record, but we may also include a rebuttal statement.

 D. Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures of your health information made by us. In your accounting, we are not required to list certain disclosures, including: 

• disclosures made for treatment, payment, and health care operations purposes or disclosures made incidental to treatment, payment, and health care operations, however, if the disclosures were made through an electronic 

  health record, you have the right to request an accounting for such disclosures that were made during the previous 3 years;

• disclosures made pursuant to your authorization;

• disclosures made to create a limited data set;

• disclosures made directly to you.

 To request an accounting of disclosures, you must submit your request in writing to our privacy officer. Your request must state a time period which may not be longer than six years and may not include dates before December 1, 2023. Your request should indicate in what form you would like the accounting of disclosures (for example, on paper or electronically by e-mail). The first accounting of disclosures you request within any 12-month period will be free. For additional requests within the same period, we may charge you for the reasonable costs of providing the accounting of disclosures. We will notify you of the costs involved and you may choose to withdraw or modify your request at that time, before any costs are incurred. Under limited circumstances mandated by federal and state law, we may temporarily deny your request for an accounting of disclosures.

 E. Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. If you paid out-of-pocket for a specific item or service, you have the right to request that medical information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we are required to honor that request.  You also have the right to request a limit on the medical information we communicate about you to someone who is involved in your care or the payment for your care.

 Except as noted above, we are not required to agree to your request. If we do agree, we will comply with your request unless the restricted information is needed to provide you with emergency treatment.  To request restrictions, you must make your request in writing to our privacy officer. In your request, you must tell us: 

• what information you want to limit;

• whether you want to limit our use, disclosure, or both; and

• to whom you want the limits to apply.

F. Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by e-mail.  To request confidential communications, you must make your request in writing to your provider or our privacy officer. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

 G. Right to Receive Notice of a Breach. We are required to notify you by first class mail or by e-mail (if you have indicated a preference to receive information by e-mail), of any breaches of Unsecured Protected Health Information as soon as possible, but in any event, no later than 60 days following the discovery of the breach. “Unsecured Protected Health Information” is information that is not secured through the use of a technology or methodology identified by the Secretary of the U.S. Department of Health and Human Services to render the Protected Health Information unusable, unreadable, and undecipherable to unauthorized users. The notice is required to include the following information: 

• a brief description of the breach, including the date of the breach and the date of its discovery, if known;

• a description of the type of Unsecured Protected Health Information involved in the breach;

• steps you should take to protect yourself from potential harm resulting from the breach;

• a brief description of actions we are taking to investigate the breach, mitigate losses, and protect against further breaches;

• contact information, including a toll-free telephone number, e-mail address, Web site or postal address to permit you to ask questions or obtain additional information.  

In the event the breach involves 10 or more patients whose contact information is out of date we will post a notice of the breach on the home page of our Web site or in a major print or broadcast media. If the breach involves more than 500 patients in the state or jurisdiction, we will send notices to prominent media outlets. If the breach involves more than 500 patients, we are required to immediately notify the Secretary. We also are required to submit an annual report to the Secretary of a breach that involved less than 500 patients during the year and will maintain a written log of breaches involving less than 500 patients.

  5. Complaints.  If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services, 200 Independence Ave, S.W., Washington, D.C. 20201. To file a complaint with us, contact our privacy officer at the address listed above. All complaints must be submitted in writing and should be submitted within 180 days of when you knew or should have known that the alleged violation occurred. See the Office for Civil Rights website, www.hhs.gov/ocr/hipaa/ for more information.  You will not be penalized for filing a complaint.

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