Insurance Coverage for Physical Therapy
Serving Portland OR | Vancouver WA
New Heights Physical Therapy Plus accepts most insurance plans. Your coverage may vary based on your specific plan for outpatient physical therapy. As a courtesy to you, we are happy to verify your insurance benefits in advance of your first visit. We will review your benefits and help you understand your personal responsibility and answer any questions you may have regarding your physical therapy benefits. We will bill your insurance company for rendered services and bill you for any co-insurance or deductibles after your insurance has been processed. All co-payments are due at time of service. If you have any questions regarding your account statement please contact our billing specialist:
Major Insurances Accepted:
- REGENCE BCBS (ALL PLANS)
- BLUECROSS BLUESHIELD: REGENCE & PREMERA (BCBS)
- CARE OREGON
- FIRST CHOICE HEALTH
- HEALTH NET
- KAISER-ADDED CHOICE PLAN
- PROVIDENCE EPO, PPO PEBB, MEDICARE (Vancouver Only)
- PROVIDENCE MCO
- PACIFICSOURCE (excluding Legacy Employee plans)
- UNITED HEALTHCARE
- US DEPT OF LABOR
- WASHINGTON DEPT OF L&I
- WASHINGTON MEDICAID: APPLE HEALTH PLANS
- AND MANY OTHER INSURANCES
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Overview of Oregon’s Personal Injury Protection (PIP) Insurance
PIP, or Personal Injury Protection, is automobile insurance coverage that pays medical expenses for individuals injured in an auto accident, regardless of who is at fault. This coverage is also known as no-fault Personal Injury Protection.
Terms to Know
- PIP – Personal Injury Protection
- MVA – Motor Vehicle Accident
- IME – Insurance Medical Examiner
Who PIP Insurance Covers
PIP covers all occupants of the car, both driver and passengers, and pedestrians or cyclists hit by a car. Even if pedestrians and cyclists don’t carry PIP coverage themselves, the driver’s PIP insurance should pay medical bills resulting from the accident.
It is mandatory for drivers in the state of Oregon to carry PIP insurance. Medical bills are charged first to the PIP insurance carrier, and when that coverage is exhausted, to an individual’s healthcare plan. Washington drivers may elect to carry PIP insurance, although it is not mandatory to do so.
What PIP Insurance Covers
In Oregon, PIP pays for reasonable and necessary medical treatment for all injured occupants in auto accident for up to one year, or until a policy dollar limit is reached, typically a maximum of $15,000. This amount varies by individual policy. In Washington, there is a three year limit, but no set dollar limit.
Under PIP, injured patients are allowed to seek medical care from the practitioner of their choice, including physical therapists, while under the direction of a medical doctor (MD, DO, and sometimes DC, depending on the insurance plan.) This last point is important because insurance companies will sometimes deny payment of medical bills when a medical doctor does not oversee the treatment plan.
Although PIP insurance is required to pay for any reasonable and necessary treatment that you receive, by doctors of your choosing, the insurance company may require you to see a doctor of their choice, called an Insurance Medical Examiner, or IME. If you have any questions, call Tammy, the New Height’s billing manager.
An individual’s healthcare insurance policy typically will not begin paying medical expenses until the PIP coverage has been exhausted. If you do not have healthcare insurance, you are responsible for paying the amount billed in excess of your PIP coverage.
Disclaimer: This information is not to be construed as formal legal advice. If you have questions about your accident, injuries, and PIP insurance coverage, we recommend that you consult an attorney.
Understanding Your Physical Therapy
We know that understanding insurance benefits can be daunting, and that is why we are happy to verify your benefits and answer any of your questions. We highly encourage you to become informed about your own benefits.
Here is a list of questions to ask your insurance company about your physical therapy benefits.
- Is a doctor’s referral or prescription for physical therapy required under your plan?
- Is New Heights an in-network provider under your plan?
- Does your plan require authorization prior to receiving treatments?
- When did your eligibility in the plan begin?
- What is the amount of deductible?
- What is the amount of deductible paid to date?
- Is a Co-Pay required?
- What are my annual benefits for physical therapy? This can be explained in visits per year, or maximum dollar amount allowed per year.
- How many visits or how much money do I have left?
- Does my coverage run on a calendar year or plan year?
Insurance Coverage for Physical Therapy in Portland OR and Vancouver WA
Seeing Patients in the following Portland and Vancouver areas: