Insurance
Following is a list of our most commonly accepted insurance plans. Physical/Occupational Therapy is a covered service depending on the contractual agreement between the employer and the insurance carrier. Verification is needed to determine the patient's eligibility. For specific terms of a member's coverage, please refer to the member's applicable "Certificate of Coverage". Please call the customer service # located on the insurance card or you can give us your information and we would be more than happy to verify your benefits.
If your plan is not listed, please contact us. We strive to accommodate all patients and plans.
AETNA
ELECT CHOICE
MANAGED CHOICE POS
AETNA CHOICE POS II
AETNA SELECT
OPEN CHOICE PPO
NATIONAL ADVANTAGE
We are a participating provider of Aetna EPO and PPO plans. These plans tend to have subscriber ID numbers that start with "W". We are NOT contracted with any Aetna HMO or QPOS plans. If your HMO or QPOS has out of network benefits you are welcome. We will submit the claims to Aetna, which may subject you to a deductible and coinsurance. Please be aware that some plans in-network are subject to co pays and/or deductibles.
OXFORD
OXFORD MEDICARE
OXFORD FREEDOM PLAN
OXFORD FREEDOM PLAN SELECT
OXFORD HMO
Most plans are covered at 100% after co-payment. Some plans require patients to meet their in-network deductible and can have co-insurance. If a referral is needed, you must obtain one from your Primary Care Physician or the Referring Physician in order for services to be covered. Most Oxford plans require pre-certification through OptumHealth. It is the patient's responsibility to fill out the required forms in order to obtain authorized visits. If you would like to fill out the forms, please complete the "Patient Summary Form" labeled "PATIENT COMPLETES THIS SECTION" and the "Functional Scales Form" that pertains to your diagnosis. Authorized visits are provided in increments; therefore, it is the patient's responsibility to fill out subsequent forms if continued treatment is needed.
Patient Summary Form (pdf)
Disabilities of the Arms, Shoulder and Hand (pdf)
Lower Extremity Functional Scale (pdf)
Back Index (pdf)
Neck Index (pdf)
UNITED HEALTHCARE
UNITED HEALTHCARE PPO
UNITED HEALTHCARE HMO
UNITED HEALTHCARE POS
Most patients are covered at 100%. Verification is needed to determine the patient's eligibility. Please call the customer service # located on the card.
EMPIRE BLUE CROSS BLUE SHIELD
Most patients are covered at 100%. Verification is needed to determine the patient's eligibility. Please call the customer service # located on the card. A pre-certification prior to initial evaluation might be required. HMO plans require authorization to be obtained through Orthonet in order for visits to be covered.
HIP
Only accepted for Occupational Therapy. Patient must obtain a referral from their Primary Care Physician or Referring Physician. Authorization is obtained from Palladian for certain members after their initial evaluation. Although our Physical Therapists do not participate with HIP, please call to discuss if we can accommodate you.
HEALTHNET
Most patients are covered at 100% after their co payment. Authorization is obtained from Orthonet Medical Management after the patient's initial evaluation is rendered.
MEDICARE
Medicare patients are covered at 80% after their deductible has been satisfied. Most supplementary/secondary insurance will pick up the remaining 20%. A supplementary insurance can be: AARP EMPIRE BLUE CROSS BLUE SHIELD GHI UNITED HEALTHCARE AETNA CIGNA
OTHER PLANS
We accept all insurance that has out of network benefits. The patient must meet his/her deductible before the insurance will cover any benefits. We commonly accept out of network benefits for other insurance companies such as: CIGNA PHCS Multiplan Great West.