INSURANCE

You don’t need another job. We help take the pain out of insurance. We submit claims on your behalf to maximize reimbursement.

We accept Medicare insurance. All other insurance is accepted as out-of-network. We do not accept Medicaid.

WHY OUT OF NETWORK ? ITS PUTTING YOUR HEALTH FIRST

Most patients utilize our services as an “out-of-network” provider.

We are a specialist care provider that only accepts doctorate therapists that have devoted their professional lives to pelvic physical therapy and a commitment to the highest level of training.

We focus on patient health first and have opted out of jumping through arbitrary insurance restrictions and hoops designed for general physical therapy clinics and assembly line patient volume mills.

We provide flexibility with follow-up treatment times of 45 or 60 minutes to assist with minimizing costs.

We are credentialed with most “out-of-network” health insurance companies. Your claims will be electronically submitted to your out-of-network provider on your behalf – making it hassle-free to utilize your available benefits.

While receiving care out-of-network may not seem ideal ideal on the surface, cutting corners on receiving specialized health care is often penny wise and pound foolish given we frequently get patients back to health faster and with fewer treatment sessions.

We can assist with helping you determine your insurance benefits to make informed decisions about your care.

WANT TO KEEP IT SIMPLE? USE REDUCED CASH PAY 

We do our best to keep cash pay rates affordable – as follows and effective July 15th, 2024.

• 45-minute treatment session $135
• 60-minute treatment session $160
• 60-minute evaluation $165

Yes – our patients regularly tell us we should charge more as the price is less than a regular massage or fancy haircut.

SELECTING YOUR HEALTHCARE TEAM

Colorado is a “DIRECT ACCESS” state and the vast majority of plans allow you to see a physical therapist directly – without first seeing a physician and needing a prescription.

HMO plans are the exception and require you to have a prescription from your physician in order for outpatient physical therapy services to be covered.

KEEPING THE COSTS DOWN

The current healthcare crisis, to put it bluntly, is in part due to a complete lack of understanding of how much it costs to deliver patient care. With all faults, the total treatment cost estimate above is our attempt to be clear and provide transparency.

​As an “out-patient” clinic we keep the costs down. Some clinics charge ill-informed patients under an “in-patient” setting (typically affiliated with a hospital that could be at a different location), where the total treatment cost to you and/or your health insurance company can be 2 – 3 times higher.

After Sally reaches her out-of-pocket limit

Sally has seen healthcare professionals often and her total costs have exceeded $5,000​.

Her plan pays full cost of covered health care services for the rest of the year.

Treatment Cost = $165
Sally Pays 0% = $0
Plan Pays = $165

OUR INSURANCE BILLING PROCESS

Out-of-Network Providers

​An out-of-network provider is a healthcare professional or facility that is credentialed with but has no contractual agreement to charge a specific rate with an insurance company. The insurance company recognizes the provider as being a legitimate medical professional—it knows things like the provider’s name, national provider identification (NPI) number, professional license number.

Uninsured

If you have no health insurance plan.

Co-Payment or “Co-Pay”

A fixed amount you pay for a covered health care service, usually when you receive the service. Your co-payment is counted towards the total cost of care.

Out-of-Pocket Limit

The most amount of money you will pay during a policy period before your health plan begins to pay 100% of the allowed amount.