Physical therapists (PT’s) and physical therapist assistants (PTA’s) are licensed by their respective states.

During your first visit you can expect the following:

♦ Arrive 10-15 minutes early to fill out patient information forms

♦ Provide us with your referral for physical therapy (if ordered by a physician)

♦ Provide your insurance card for verification of your physical therapy coverage limits

♦ You will be seen for the initial evaluation by the therapist

♦ The therapist will discuss the following:

1. Your medical history

2. Your current problems/complaints

3. Pain intensity, what aggravates and eases the problem

4. How your symptoms are impacting your daily activities, recreational pursuits and/or work ability

5. Your goals with physical therapy

6. Medications, tests, and procedures related to your health

♦ The therapist will then perform the objective examination which may include some of the following:

1. Palpation – touching around the area of the pain/problem. This is done to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.

2. Range of Motion (ROM) – the therapist will move the joint(s) to check for the quality of movement and any restrictions.

3. Muscle Testing – the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.

4. Neurological Screening – the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.

5. Special Tests – the therapist may perform special tests to confirm/rule out the presence of additional problems.

6. Posture Assessment – the positions of joints relative to ideal and each other may be assessed.

The therapist will then formulate a list of problems you are having, and how to treat those problems. A plan is subsequently developed with the patient’s input. This includes how many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created from input from you, your therapist, and your doctor.

Make sure to bring your physical therapy referral (provided by your doctor) if a physician has ordered the care, and your payment information. If your insurance is covering the cost of physical therapy, bring your insurance card. If you are covered by Worker’s Compensation or auto insurance, bring your claim number and your case manager’s contact information.

You should wear loose fitting clothing so you can expose the area that we will be examining and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose fitting shirt and pants, again so we can perform a thorough examination. To those who forget appropriate clothing we maintain a stock of gowns and athletic shorts for changing purposes.

Treatment sessions typically last 30 to 60 minutes per visit, with 45-60 minutes allotted for the initial examination. Treatment is always rendered on the initial examination visit.

This is highly variable. You may need one visit or you may need several weeks of care. It depends on your diagnosis, severity of impairments, past medical history, etc. You will be re-evaluated on an as needed basis, but no less than every 2 weeks. Additionally, you will be re-evaluated prior to returning to your referring physician. It is important that you know the date of your physician revisit so that we can provide the physician with a physical therapy progress report.

You have probably heard of the profession of physical therapy. Maybe you have had a conversation with a friend about how physical therapy helped get rid of his or her back pain, or you might know someone who needed physical therapy after an injury. You might even have been treated by a physical therapist yourself. But have you ever wondered about physical therapists – who they are and what they do? Many people are familiar with physical therapists’ work helping patients with orthopedic problems, such as low back pain or knee surgeries, to reduce pain and regain function. Others may be aware of the treatment that physical therapists provide to assist patients recovering from a stroke (e.g. assisting them with recovering use of their limbs and walking again).

The ability to maintain an upright posture and to involve your arms and legs in all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we are able to continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.

Because physical therapists are experts in movement and function, they do not confine their talents to treating people who are ill. A large part of a physical therapist’s program is directed at preventing injury, loss of movement, and even surgery. Physical therapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide services to athletes at all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, a number of physical therapists are engaged in consulting with recreational golfers and fitness clubs to develop workouts that are safe and effective, especially for people who already know that they have a problem with their joints or their backs.

The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to “hands-on” care, physical therapists also educate patients to take care of themselves and to perform certain exercises on their own. Depending on the particular needs of a patient, physical therapists may also “mobilize” a joint (that is, perform certain types of movements at the end of your range of motion) or massage a muscle to promote proper movement and function. Physical therapists also use methods such as ultrasound (which uses high frequency sound waves to produce heat), hot packs, and ice. Although other kinds of practitioners offer some of these treatments as ‘physical therapy”, it’s important for you to know that physical therapy can only be provided by a qualified physical therapist or physical therapist assistant under the direction of a physical therapist. Physical therapist assistants must complete a 2 year college education program and pass a state licensure examination.

Most forms of physical therapy treatment are covered by your insurance, but the coverage will vary with each plan. Most states do not require patients to see their physicians before seeing a physical therapist.

You and others may be referred to physical therapy because of a movement dysfunction associated with pain. Your difficulty with moving part(s) of your body (like bending at the low back or difficulty sleeping on your shoulder, etc.) very likely results in limitations with your daily activities (difficulty getting out of a chair, inability to play sports, or trouble with walking, etc.). Physical therapists treat these movement dysfunctions and associated pains and restore your body’s ability to move in a normal manner.

In most cases, health insurance will cover your treatment, apart from mandatory copays and deductibles. Make sure you talk to our receptionist so we can help you clarify the physical therapy benefit under your health plan.

Who is better to see, a PT who works for a physician or a PT that owns a private practice? We leave it up to you to draw your own conclusions but here are some facts. Studies indicate that more treatments are rendered (visits per patient are 39% to 45% higher in physician owned clinics) and greater costs are incurred for patients attending treatment in a physician owned, physical therapy practice (both gross and net revenue per patient are 30% to 40% higher) (1)

Another study indicates that licensed and non-licensed therapy providers spend less time with each patient in physician owned clinics, and that physical therapy assistants are substituted for physical therapists. (2)

We believe that we can provide you with the highest quality of care available and do it in a cost effective manner. (3) You will work closely with your physical therapist and in most instances, will be managed by the same physical therapist from beginning to end.

1. Mitchell, J., Scott, E., Physician Ownership of Physical Therapy Services: Effects on Charges, Utilization, Profits, and Service Characteristics, Journal of the American Medical Association, 1992.

2. “Joint Ventures Among Health Care Providers in Florida, “State of Florida Health Care Cost containment board, 1991.

3. Federal Office of the Inspector General May 1, 2006 – this report calls into question billing processes done by non-physical therapist owned practices.

You will be evaluated by one of our licensed physical therapists and he/she will also treat you during subsequent visits. Unlike some clinics, where you see someone different each visit, we feel it is very important for continuity of care to develop a one-on-one relationship.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques, modalities such as ultrasound, electrical stimulation, and/or heat or cold therapy. Movement often provides pain relief as well. Your physical therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.
In some cases, physical therapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be painful. Your physical therapist will utilize a variety of techniques to help maximize your treatment goals and help you differentiate “hurt” from “harm”. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

Flare-ups are not uncommon. If you have a flare up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

In most cases, you have the right to choose any physical therapy clinic. Our physical therapy clinics are participating providers for the vast majority of health benefit plans. The best thing to do is give us a call and we will verify our participation status with your plan.

The vast majority of states have some form of direct access whereby physician referral is not required to access the services of a physical therapist. In the case of New Jersey, patients have free access to services of a physical therapist without referral. One must be aware however that some health plans, particularly HMO’s, utilize the physician as the gatekeeper, thereby requiring a physician order to access our services.

In most states, physical therapists cannot make a medical diagnosis; rather therapists develop a functional diagnosis that defines your functional limitations related to your injury, illness, or condition. In most instances physical therapists treat the consequences of disease or injury, and not the disease itself.

Billing for physical therapy services is similar to what happens at your doctor’s office. When you are seen for treatment the following occurs:
1. The physical therapist bills your insurance company, Worker’s Comp, or charges you based on CPT (Current Procedural Terminology) codes.
2. Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
3. The payer processes this information and makes payments according to an agreed upon fee schedule.
4. An EOB (Explanation of Benefits) is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.
5. The patient is expected to pay the remaining balance, except in workers compensation and automobile insurance injury claims where balance billing of the patient is strictly forbidden.
It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example as well. At any time along the way, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as several months after the treatment date despite prompt payment laws to the contrary.

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program, or follow a prescribed step-down exercise program at our Wellness Center. Other patients upon completion of rehabilitation simply return to normal daily activities. It is important that you communicate your goals to your therapist, so he/she can develop a custom program for you.

The clients at the Wellness Center are diverse in age, life experience, and physical ability. Although the target audience is the baby boomer population (birth dates from 1946-1964) and older, the reality is that the ages range from the mid 20’s to the early 90’s. Regardless of age or ability, the goal is to design a fitness program appropriate to the level of the individual.

The genesis of the Wellness Center stems from a general observation made as a physical therapist treating patients. Twenty years ago it was uncommon for therapists to see older patients leading active lifestyles. Becoming a senior generally meant bingo, shuffleboard, and years of declining activity level. Today, older adults lead extremely active lifestyles and desire more life in their years. As an example, 10 years ago the Boston Marathon had 4,000 participants older than age 40. Last year, 10,000 out of the 20,000 runners were 40 or older. The biggest challenges we face today is moving older adults to an active lifestyle after having spent much of their lives being sedentary. Linked to this sedentary lifestyle are postural habits that cannot be altered due to bony changes and deformation over time.

Challenges aside, the biggest satisfaction with the Wellness Center is witnessing individuals discover exercise for the first time and realizing what a difference physical activity can make in their lives. The value of socialization and making new friends cannot be underestimated either.

Unique to the Stoneking Wellness Center (and entire area for that matter) are the revolutionary Keiser pneumatic strength and endurance exercise machines. According to U.S. Consumer Product Safety Commission reports recent increases in weight training injuries are not only due to age and technique, but also the shock loading of aging joints with weight stack machines. With Keiser’s Air Advantage equipment, the shock loading of joints and tissues are eliminated. Is it any wonder that successful professional sports teams, individual athletes, and research centers dedicated to exercise and aging utilize the Keiser brand?

Also unique to the Wellness Center are the Nu-Step brand recumbent cross trainers. From a comfortable sitting position clients simulate a natural walking motion while eliminating undesirable joint stress. The ergonomic design accommodates nearly every body type and size, utilizes a swivel seat for ease of transfer, and has been endorsed by the Arthritis Foundation for ease of use and joint safety.

Exercise and personalized training aside, the Stoneking Wellness Center is committed to the community through the provision of regularly scheduled free health awareness and prevention seminars. The subject matter is varied and includes Healthy Bones Osteoporosis lectures, nutritional label reading education, and first aid and cardiopulmonary resuscitation (CPR) classes for lay people to name just a few. Even when socializing our events have educational value as evidenced by the recent Cystic Fibrosis Benefit walk and our regular healthy cooking classes with gym member and chef Jim Hamilton of Hamilton’s Grill.