- Do you accept insurance? If so, which ones?
- What’s the difference between in-network and out-of-network benefits?
- Why aren’t you part of my insurance network?
- Can I see a Physical Therapist without a referral from my healthcare provider?
- I don’t have insurance that covers Physical Therapy, what is your private pay policy?
- How much will it cost me and when will I need to pay?
- What are your office hours?
- What is your appointment policy?
- What information do I need to schedule an appointment?
- What can I expect during my first and ongoing visits?
Yes, we accept most medical insurance plans. Our Physical Therapists are preferred/in-network providers for the following insurance carriers:
- First Choice Health Network plans, including Group Health Options
- Group Health PPO plans
- DSHS/Medicaid , as secondary to Medicare only
- Labor & Industries (L&I)/workers comp claims
- Medicare (current patients only)
- Premera (most)
- Regence, including Blue Cross/Blue Shield, Uniform, and Boeing plans
We also bill many other medical insurance plans, including Aetna, Cigna, and UnitedHealthcare, and are happy to check your out-of-network benefit coverage.
We accept motor vehicle insurance with Personal Injury Protection (PIP) for injuries resulting from an auto accident. In some cases, we may also consider 3rd party billing with the filing of a lien.
In-network means that we have a contract with your insurance company, which includes an agreement that we will accept what they consider reasonable as full payment for our services. Typically, you can expect to pay less out-of-pocket when you see a healthcare provider that is part of your insurance network.
Out-of-network means that we do not have a contract with your insurance company. However, this does not necessarily mean that they won’t cover your Physical Therapy care. Many insurance plans offer “out-of-network” benefits. Typically these are reduced benefits compared to similar “in-network” benefits and may cost you more out-of-pocket. If we are outside of your network, contact us, since our Business Manager may be able to help you manage your out-of-pocket expenses, Deb, 860-3746 or email@example.com.
Reasons for us not belonging to an insurance network include:
- The network is not currently accepting new Physical Therapy providers in our area.
- The insurance provider is not common to the Seattle area.
- The insurance provider does not have contract terms that we find acceptable.
If you have questions about why we do not belong to your specific insurance network, feel free to call or email our Business Manager, Deb, 206-860-3746 or firstname.lastname@example.org.
Washington is a “direct access” state for Physical Therapy, meaning anyone can refer themselves to a physical therapist. However, your insurance plan may require you to have a referral or a prescription for Physical Therapy for the service to be covered (i.e. they won’t pay without it).
For those without insurance that covers Physical Therapy, we provide a limited number of sliding scale appointments. The sliding scale fee is based on your income. We ask that you bring a copy of your most recent tax return to your first appointment. Payment is expected at time of service unless otherwise arranged. Please contact our Business Manager, Deb, for more details, 206-860-3746 or email@example.com.
This is a great question, and we’re always glad to answer to the best of our ability. We know how unpleasant it is to get an unexpected bill, so we try our best to communicate estimated costs upfront. There are really two parts to this question: Paying Strictly Out of Pocket or Paying When an Insurance Company is Involved.
Paying Strictly Out of Pocket (or if you are filing your own insurance claims): In this case, we charge ~65% of our billed insurance charges. There is a fixed rate for evaluations and for subsequent visits. Please contact our Front Office for specifics at 206-860-3746 or firstname.lastname@example.org.
Paying When an Insurance Company is Involved: In this case, individual out-of-pocket costs vary widely depending on the insurance coverage you have. Some insurance plans have a per visit co-pay, to be paid at time of service. Co-pays typically range from $0 - $50. Some plans have a co-insurance, where they pay a percentage of the bill and you pay a percentage. Depending on your plan, your percentage may be 0% or up to 50%. Co-insurance portions are billed to you after we receive payment from your insurance company. Therefore, the timing of your bill is dependent on how fast your insurance company pays us (which again varies widely.) To add another layer of complexity, some insurance plans have BOTH a co-pay and co-insurance, with the co-pay expected at time of service and the co-insurance to be paid later. Our Business Manger, Deb, is happy to help interpret your insurance plan and come up with an estimate of your out-of-pocket costs, 206-860-3746 or email@example.com.
Note for those with unmet insurance deductibles greater than $500: If you have a large unmet deductible balance, we will collect a "deposit" towards meeting that deductible at each visit. We will collect a $125 deposit for the evaluation, then subsequently $100 for ongoing visits until your deductible is closer to being met. After your insurance processes the individual claims, we will bill you for any remainder due beyond the initial deposits collected.
NOTE: We accept cash, money orders, cashier's checks, personal checks, and most credit cards for payment. We also have a Paypal button on our website under Patient Info for those interested in making an online payment on their account.
Monday and Wednesdays, first appointment at 7:00am, last at 5:00pm.
Tuesdays, first 8:00am, last 5:00pm
Thursdays, first 7:00am, last 5:30pm
Fridays, first 7:00am, last 3:00pm.
We understand that situations arise that prevent you from attending your scheduled appointment. Please give us 24 hour notice, so that we can schedule someone that is waiting for an appointment in your place. You will be charged a $130 fee for the first missed appointment and a $65 fee for the first cancellation with less than 24 hour notice. A subsequent late cancellation is a $130 fee. If you have multiple missed appointments (with no notice,) we will ask you to make same day appointments only.
It’s helpful for us to know which healthcare provider, if any, is referring you and the diagnosis for the condition requiring physical therapy. It’s also helpful to know whether you’ve had any tests, like an MRI or x-rays, associated with your diagnosis.
If you’d like us to check your insurance benefits in advance, we will need information regarding your insurance (the insurance company name, subscriber ID#, and contact phone, if known) and your date of birth. If you’ve had a work-related injury, we’ll need the claim #, the date of injury, and place of employment when injured. If you’ve been in a car accident, we need the claim #, the date/place of the accident, the insurance company name, and name/contact information for the claims manager, as well as information about whether this claim is under your insurance or someone else’s.
Other than that, we just need your name and a contact phone number.
Your first Physical Therapy visit involves a thorough evaluation by the Physical Therapist. During the evaluation, the PT will ask you questions and conduct a series of tests and measurements to help determine their treatment diagnosis and the best plan of treatment for you. The first visit also incorporates treatment, which can range in scope depending on the severity of your problem, but will always include the assignment of a home program for you to complete between visits.
During ongoing visits, the PT will monitor both objective and subjective changes in your progress and may make changes in your program based on this information. Your input and participation in the process is key including consistency in appointments and following the home program prescribed by the PT.