PT Insurance FAQ’s
PT PRO, INC. will bill your insurance carrier directly as a convenience for you. However, you are ultimately responsible for payment for the services you receive.
Co-pays are always due at the time of service as described in your insurance policy.
You should find out exactly what physical therapy benefits are covered by your insurance company. There will be a number on the back of your insurance card that will connect you to your plans customer service department. PT PRO, INC. encourages all patients to verify their insurance benefits before the first session or just after to allow you and your therapist to plan accordingly. Below is a list of important questions that we suggest you ask your insurance company about your physical therapy benefits.
What is your outpatient physical therapy benefits?
Is there a dollar or visit max per year?
Do you need a prescription or referral for PT?
Do you have a deductible or co-pay?
Is PT PRO, INC an in-network provider with your insurance?
Our provider tax ID # is 205079345
If a written authorization from your doctor is required, please bring this information with you to your first appointment. It must be on file at this clinic.
Washington State Labor and Industries (L & I) Workman’s compensation requires a doctor’s prescription to begin physical therapy. You will need to provide a case number, name and number of your claims adjustor.
Personal Injury Protection (PIP) for auto accident injury coverage requires a doctor’s prescription. You will need to provide contact information.
PT PRO, Inc. does not accept United Healthcare patients, with backing of the APTA, due to said entity changing the agreed upon provider contract without negations.
We are currently contracted with:
- Blue Cross Premera: You do not need to see a doctor if you think you need physical therapy. You may come directly to us for evaluation. This group also covers a variety of insurance groups such as LifeWise and BlueCross/Blue Shield.
- Regence Blue Shield: You will need a physician’s prescription to be eligable for Physical Therapy benefits.
- First Choice Health PPO Network: This ecompasses a large group of insurance plans. Check your card to see if “First Choice Health Network” is on the front or back. You will NOT usually need a doctor’s prescription but this varies with each plan. You should check with your individual plan to find out. This group includes Pacific Life and Annuity, and many, many others.
- Cigna: You will NOT need a doctor’s prescription for a PPO plan. The amount of coverage is based on your type of plan.
- AETNA: You do NOT need a doctor’s prescription
- Washington State Labor and Industries (L&I) Workman’s Compensation: You will need a doctor’s prescription to begin physical therapy and your case number.
- UNIFORM: You will NOT need a doctor’s prescription, but you are limited in the number of visits per year. Check with your plan.
- Great West: We will be contracted with Great West as of March 1, 2008.You will NOT generally need a doctor’s prescription, although there are a few employers who will require it. If you are unsure, check with your plan administrator.
- PHCS/Multiplan: We are in network. Your coverage and benefits will be based on your individual plan.
- Personal Injury Protection (PIP): If you have been in a car accident and are using your auto insurance injury protection plan you will need a prescription from your doctor.
- Cash Pay: We also accept cash/check visa/mastercard payment at the time of service. You do not need a doctor’s prescription.
- Out of Network: If you are not part of these insurance groups you will still be able to receive partial reimbursement from your insurance company. Check with the company and ask for your “out of network benefits.” You will most likely need a doctor’s prescription.