Physical therapy is a covered medical benefit under insurance plans for medically necessary treatment. Gorge Spine & Sports Medicine is a preferred provider for most insurance plans throughout the Northwest, and as a courtesy to you, we are happy to verify physical therapy benefits prior to your first visit. You can be confident that we will educate you about your insurance benefits and help you understand your personal responsibility in advance of patient care.
Billing and Insurance Claims
As a courtesy, we will file and assist in obtaining payment for physical therapy services rendered directly with your insurance company.
Co-payments are due at the time of service. We will bill you for any co-insurance or deductible amount after your insurance has processed your claims. You may contact us if you have any questions about your account statements. You may also contact the clinic directly.
Gorge Spine & Sports Medicine
1627 Woods Court
Hood River, Oregon 97031
(541) 386-9511
Managed Care
Managed Care Health Plans vary in their restrictions and requirements. To assure the highest level of payment, we encourage patients to be aware of the limitations and requirements their plan offers. Some common requirements and limitations include:
- Co-pay required by patient at the time of service
- Referrals from primary care physician (PCP)
- Therapy visit limitations per calendar year
- Deductible obligations
Physical Therapy Direct
State laws provide direct access to licensed Physical Therapists without a physician’s referral or prescription. That means that as a consumer of healthcare, you can seek medical treatment for your musculoskeletal issues directly from the Physical Therapist of your choosing. This places physical therapy as a first line provider for your musculoskeletal health.
Insurance coverage for your physical therapy benefits are plan-specific. Most insurance companies do not require a referral from your physician, but some do.
Many third party payers will pay for Physical Therapy services rendered under direct access, however, the benefit is plan specific. Medicare does not pay for Direct Access Physical Therapy at this time, but Physical Therapists can perform an evaluation under direct access, and as long as a physician signs off on a treatment plan, we are able to bill Medicare.
Verifying your Physical Therapy Direct benefits with your insurance plan is simple:
- Contact your insurance company via phone
- Provide: Plan & Group Number
- Ask if you need a Doctor Referral for physical therapy to be covered under your plan
- Yes – if your plan requires a doctor referral then you will need to go see your physician prior to scheduling an appointment. Request a referral to Therapeutic Associates.
- No – call the Therapeutic Associates clinic most convenient for you and schedule an appointment directly.
We are happy to verify your physical therapy benefits for you prior to scheduling your first visit. Simply contact one of our clinics and we will outline your physical therapy benefits so you can make an informed decision. You will receive information on referral requirements, co-insurance, co-pay, and your total annual benefit. We do offer cash rates for your convenience and for services rendered outside insurance plan coverage, which can be very cost effective.
