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Thanks SPT for helping me regain my active lifestyle!
Is Sound Physical Therapy covered by my insurance?
Sound Physical Therapy has active contracts with most major insurance companies. We also bill first party auto insurance, worker’s compensation, and accept private payment. We are happy to bill insurance as a courtesy to our patients, and will assist you by attempting to determine before your first visit what your physical therapy benefits are at that time.
Sound Physical Therapy is an In-Network Provider for the following Insurance Companies:
First Choice Network
Kaiser Foundation Health Plan of Washington Options, Inc.
Labor and Industries
How do we help you?
After you make an appointment at our clinic, our billing specialist will contact your insurance company and prepare an Eligibility Verification Form. This form summarizes benefits quoted us by your insurance company. You will receive a copy of this information at your first Sound Physical Therapy appointment.
Should I contact my Insurance Company?
We strongly recommend that each client is familiar with their insurance contract coverage for Physical Therapy, and to contact your insurance company if you have any questions about your coverage.
How do I find out how many treatments insurance will pay for?
Physical Therapy benefits are usually considered part of Physical Medicine and Rehabilitation services. Your insurance may limit the number of treatments per year, and/or a specific dollar amount you can spend for these services. Massage Therapy, Chiropractic treatment, Occupational and Speech Therapy can also be included in this group. If this is the case, your Rehabilitation insurance dollars or number of visits allowed are spread among all of these services.
What do we need from you?
We strive to provide good customer service by communicating to you any insurance coverage issues that may arise. To do this we need your correct insurance info, address and phone numbers. We ask that you alert us with any concerns, problems and changes as they arise. We also appreciate your understanding that the patient portion of payment will be made promptly.
Why is Sound Physical Therapy not a preferred provider with every insurance company?
We are a small, independently owned clinic and strive to deliver high quality care at a reasonable cost. Each client receives 55 minutes of 1-1 care with the Physical Therapist at every treatment. In order to deliver this level of care, we need to be reimbursed by insurance companies at a reasonable rate. If an insurance company has lowered their rate of reimbursement to below the level required to cover the cost of delivering care, we have chosen to be out of network providers for that insurance company. In this case the patient would be expected to pay the out of network rate of reimbursement established by that insurance company, which is a higher fee.
What do the insurance terms mean?
Below are some of the more common insurance terms that you will encounter when using your Physical Therapy benefits. Please contact your insurance company for further clarification of these terms.
Co-Payment: This is the amount the insurance company has decided the patient will pay on the day of service.
Allowed Charges: An “allowed charge” is the amount an insurance company will pay for services received by their client that is provided by an in-network provider. The in-network contract we have with an insurance company requires us to accept the “allowed charge” for any services we provide.
Co-insurance: Your contract may state that you are required to pay a percentage of the allowed charges. For example, you may have an 80% - 20% plan, which means that the insurance company will pay 80% and you will pay 20% of the allowed charges.
In-Network benefits: This is the benefit your insurance company will pay if Sound Physical Therapy has a contract with them. After the insurance company receives our bill for services delivered, they will determine the allowed charges they will pay for this service. We are bound by our in-network contract with the insurance company to accept their determination of allowed charges.
Out of Network benefits: This is the benefit that your insurance Company will pay if we are not a preferred provider with that company. In this case, the patient is responsible for a higher portion of the total bill.
Incident Report/Questionnaire: This is a form your insurance company may send you during the course of care. You will need to complete and return this form to your insurance company for payment to be made.
How does billing work?
Monthly Statements: After your insurance determines what the allowed charges will be for the services you have received, we will provide you with a monthly statement of your account. If you have any questions, you may contact our billing specialist at (206) 200-6177.
Private Pay Discount: If you have no healthcare insurance or PIP/LNI claim or Sound PT is out of network for your insurance, Sound Physical Therapy offers a discount for services. This represents a 25% or larger discount from our usual charges, and represents the reduced administrative costs of managing your account without having to bill insurance. Private Pay will be collected the same day before the appointment. Initial Evaluations are $150.00 and subsequent appointments are $125.00. A form detailing the date, injury and treatment codes used can be filled out by your Physical Therapist for you to submit to your insurance company for reimbursement if you so desire.