In-Network Preferred Providers for Blue Cross PPO, Blue Shield PPO and Medicare Insurances.
Out-of-Network Providers for the remainder of all PPO insurances, such as Aetna, UnitedHealthcare, Cigna and HealthNet.
When a clinic is “out of network,” we will bill your insurance provider for you and accept their out of net payments, but your co-insurance payment may be higher, and you may have a deductible that needs to be paid first.
Special Order Contracts: We hold special standing order contracts to treat pelvic health diagnoses from:
Axminster Medical Group
Torrance Memorial IPA
MemorialCare/Greater Newport Physicians
Triwest - Veterans Administration
Tricare
HMO Insurances: if you are an HMO member of a group other than those listed above, we can offer you our cash rate.
First Steps
When you call to schedule your first visit, our Patient Care Coordinator will take your insurance information, call your insurance company for verification of benefits, and then let you know your benefits and estimated financial commitment prior to coming in for your first visit.
We understand how confusing insurances can be, and our staff will work with you to make sure that all of your questions are answered. Our most important concern is that you are able to obtain treatment and can start working toward resolving your health concerns!
Direct Access (attending physical therapy without a referral):
Since January 2014, individuals in California can consult a Physical Therapist for an evaluation and treatment without the previously required physician referral/prescription.
Individuals are allowed 12 visits or 45 days of care before needing a signature from a physician (or other healthcare professional such as a CNP, CNM, PA, DC, etc). At that point, in order to continue treatment, we would need to obtain a referral to continue care.
In most cases of self referral to our clinic, we like to communicate with your health care provider toward the start of care. We prefer to have an open line of communication with your health care team in case we find any “red flags” that need other diagnostic testing. We are willing to contact your health care provider after your first visit to make sure everyone is in agreement with our plan of care.
Even with direct access laws in California, some health insurance plans still require a prescription before they pay for services. This is something we will also screen when we call to verify your insurance benefits. (HMO members do require an authorization to be seen.)
If you have any questions at all about whether your insurance will cover physical therapy, do not hesitate to call us!