Insurance and Payments

J.A.W. Thearpy
  • Appointments
  • Hours
  • Insurance
  • Cancellation
  • Referrals
  • Payment
  • Patient Forms
  • Confidentiality

Request an Appointment

You will receive an electronic receipt of your appointment request within moments of submission, followed by an e-mail confirmation within 24 hours of your request. You may also call or e-mail for an appointment.

This form is a request only. It is not a guarantee or confirmation of the appointment time/date.

Fields marked with an * are required








    Insurance Information (optional)

    For faster insurance processing, fill out all of the optional fields. You can also call our office to give the information over the phone.




    Hours of Operation

    We pride ourselves on providing the highest level of care and convenience to our patients. Our appointment times flexible – let us know how we can best accommodate you.

    1. Monday – Thursday
      8:30 am – 5:00 pm
    2. Friday
      8:30 am – 6:00 pm
    3. Saturday
      By appointment
    4. Sunday
      Office closed

    We accept Medicare

    Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed tempus, ex vel ornare ornare, libero tortor aliquam sapien, sit amet interdum ligula felis venenatis odio. Nullam quis pharetra risus, ut elementum ligula. Fusce quis lacinia enim. Proin eros orci, tempus vel ante eget, rhoncus hendrerit ligula. Nam ullamcorper nulla quam. Vivamus quis ex commodo, consectetur nisi sed, vehicula dolor. Cras ac nisl sodales, semper ipsum et, sagittis nunc. Aliquam tristique velit sapien, ornare tincidunt arcu mollis eget.Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed tempus, ex vel ornare ornare, libero tortor aliquam sapien, sit amet interdum ligula felis venenatis odio. Nullam

    Insurance questions? Call our office to speak with a staff member who can help you determine and understand your benefits.

    Cancellation Policy

    If for any reason you are unable to make a therapy session, please provide notice at least 24 hours prior to your scheduled appointment time. Our staff will contact you to reschedule. Failure to provide 24-hour advance notice of cancellation will result in a $150.00 late cancellation fee.

    Cancellations can be made by e-mail or phone. If you reach our answering service or prefer to submit cancellation via e-mail, please be sure to provide:

    – Patient first and last name
    – Date and time of original appointment
    – Contact information for rescheduling

    Referrals

    Lorem ipsum dolor sit amet, consectetur adipiscing elit. Integer at felis semper, placerat metus quis, cursus mauris. Integer tristique rutrum urna, ut dapibus augue facilisis sit amet. Sed pharetra libero id magna maximus, at sollicitudin metus condimentum. Nulla enim felis, rutrum at neque semper, faucibus pharetra magna.

    Payment

    We require full payment when services are rendered for treatments covered by insurance, as well as those that are not. We accept HSA/FSA, MasterCard, Visa, Discover and American Express. Failure to provide payment at the time of services will automatically result in a cancellation of future appointments.

    Patient Forms

    Click the icon below to download and print patient forms. Be sure to bring the completed forms to your appointment.

    Confidentiality & Privacy

    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.

    The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires all health care records and other individually identifiable health information (protected health information) used or disclosed to us in any form, whether electronically, on paper, or orally, be kept confidential. This federal law gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information. As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

    Without specific written authorization, we are not permitted to use and disclose your health care records for the purposes of treatment, payment and health care operations.

    Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. Examples of treatment would include therapeutic exercise, neuromuscular reeducation, mobilization, etc.

    Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be billing your health insurance for your physical therapy services.

    Health Care Operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would include a periodic assessment of our documentation protocols, etc.

    We may also create and distribute de-identified health information by removing all references to individually identifiable information.

    We may contact you to provide information about treatment alternatives or other health related benefits and services that may be of interest to you.

    Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

    You have certain rights in regards to your protected health information, which you can exercise by presenting a written request to our Office Manager at 2134 L St NW, Washington, DC 20037.

    The right to request restrictions on certain uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.

    The right to request to receive confidential communications of protected health information from us by alternative means or at alternative locations.

    The right to access, inspect and copy your protected health information.

    The right to request an amendment to your protected health information.

    The right to receive an accounting of disclosures of protected health information outside of treatment, payment and health care operations.

    The right to obtain a paper copy of this notice from us upon request.

    [Download PDF version for printing]