Does My Insurance Cover Physical Therapy?

Complimentary Insurance Verification

Each insurance plan varies, so it’s important to check with your insurance provider to understand the specifics of your coverage, including any restrictions or requirements. We’ll do this for you. All you have to do is call our facility and our office or billing manager will contact your insurance company to see whether we’re in-network and whether your plan covers our services.

Which Insurance Companies Are In-Network?

The following insurance companies consider Physical Therapy Effect to be in-network:

• Anthem Blue Cross
• Blue Cross Blue Shield
• Blue Shield of CA
• Medicare
• Scripps Coastal and Scripps Clinical
• Tricare for Life
• Triwest/Veterans Affair
• United Tricare Select and Prime
• Workers Comp

Is Pre-Authorization Required for Physical Therapy?

Whether or not pre-authorization is required depends on the insurance company and the insurance plan. Sometimes, physical therapy requires a referral and sometimes it doesn’t. We’ll help determine what is needed in your specific case so that we can provide you with the treatment you need under the coverage of your insurance policy.

What If Physical Therapy Isn’t Covered?

If your insurance company won’t cover physical therapy, there are a few steps you can take:

• Verify Coverage and Appeal: Double-check your insurance policy’s details to confirm whether physical therapy is covered under certain conditions. If you believe there has been a misunderstanding or error, you can appeal the insurance company’s decision.
• Discuss With Your Therapist: Talk to us! We may offer a sliding scale fee based on income, payment plans, or discounts for uninsured patients or can apply the cost to your deductible.
• Seek a Referral or Prescription: Sometimes, insurance plans may cover physical therapy if it’s referred or prescribed by a physician. Consult your doctor to see if this is an option.
• Explore Alternative Insurance Options: If you have access to another insurance plan (like a spouse’s or parent’s plan), check if it offers better coverage for physical therapy.
• Use a Health Savings Account (HSA) or Flexible Spending Account (FSA): If you have an HSA or FSA, you can use these funds to pay for physical therapy.

Remember, it’s essential to communicate openly with us about your financial constraints. We may be able to provide or suggest more cost-effective treatment alternatives.