Insurance & Billing Information

Physical Therapy Access

It is important to us that we are able to provide physical therapy services to all members of our community. See the list below to see what networks are currently in-network. For those plans still pending, please check back regularly for updates. If opting to pay cash and you have out-of-network benefits, we can provide you a superbill to submit to your insurance company for reimbursement, which may go toward your annual out-of-network benefits allowance.

Insurances Accepted

Aetna (Commercial and Medicare Advantage Plans)

  • Click here for in-network Health Plans

Auto Insurance

Cigna

First Choice Health Network

Health Net of Oregon

Medicare (Traditional Part B and any Supplement Plans)

Multiplan PPO

MODA Health Plans

  • Affinity

  • Beacon

  • Connexus

  • Synergy Network

  • Summit Network

  • OEBB

  • OHSU PPO

  • Medicare Advantage

  • Community Care Network

  • **Excludes Santiam Affiliates, Salem Health Medicare, OHSU Tuality

Pacific Source Health Plans

  • Commercial

    • Smart Choice Voyager

    • Navigator​

    • Pathfinder 

    • Legacy Health Plan

    • **Excludes Legacy Plus Employee Plan**

  • Medicare Advantage

Regence Blue Cross Blue Shield

  • PPP (PPO)​

  • **Excludes Blue Distinct Total Care (BDTC), Capella plans, EPO Silver PeaceHealth Plan (Silver/Gold/Platinum), OHSU Plus plans***

OptumHealth (United Healthcare)

Private Pay / Cash Pay

Initial Evaluation

$220 flat rate

Follow Up Appointments

$160 per hour

Pending Plans

Prime Health Services PPO

Out-of-Network

CareOregon

Kaiser

Oregon Health Plan (OHP)

Pacific Source Medicaid

Providence

  • Some plans have excellent out of network benefits. We can verify your benefits and provide you with a cost of service estimate.

Triwest VA PC3 Program

Trillium Medicaid

Worker’s Compensation

Grants for Musicians or Music Industry Workers Experiencing Financial Hardship

We understand that many musicians and music industry workers may not have equal access to health services due to lack of insurance, limited access to preferred providers with expertise in treating musicians, high deductible plans, or myriad other reasons. Hampton Physiotherapy has partnered with MusiCares to bridge this gap. MusicCares provides a safety net of critical health and welfare services to the music community in three key areas:

  • Mental Health & Addiction Recovery Services: Support, referrals, and emergency financial assistance for counseling, psychiatric care, inpatient treatment, coaching, intensive outpatient care, sober living and more.

  • Health Services: Financial assistance during medical crises and preventive services such as dental and medical screenings, hearing clinics, vocal health workshops, and assistance obtaining low-cost health insurance.

  • Human Services: Support for basic living expenses like rent, utilities, car payments and insurance premiums in times of hardship, plus programs addressing affordable housing, career development, legal issues and senior services.

For musicians and music industry workers in need, MusicCares may offer grants for physical therapy services if certain criteria are met. Musicians may apply for these grants by going to the MusicCares website or by contacting Hampton Physiotherapy directly for more information.

**Application for this grant does not guarantee coverage.

Insurance Verification

We will gladly verify your insurance benefits prior to your first appointment. It is important that you feel confident in understanding your physical therapy coverage. We will review your benefits with you prior to your first appointment to help you plan for the financial cost of care.

When you contact us to schedule your first appointment, we will ask for your insurance information, including your company name, policy holder name, member ID, and group ID (if applicable). As a courtesy to you, we will contact your insurance company to verify your coverage and benefits. We will determine your per calendar year deductible, out-of-pocket maximum, allowed number of physical therapy visits, co-pay or co-insurance amount, and whether a referral or prior authorization is required.

We encourage you to contact your insurance company as well to confirm and better understand your benefits.

Ask your insurer:

  1. Is a doctor’s referral or prior authorization required?

  2. What is my deductible and how much has been met?

  3. What is my out-of-pocket maximum and how much has been met?

  4. Do I have a co-pay or co-insurance for physical therapy and what are these amounts?

  5. How many physical therapy visits are allowed per calendar year?

  6. Is the plan on a calendar year (January 1-December 31) or a contract year (other specified start/end dates)?

Our billing process

Have you ever received a massive medical bill 6-8 weeks after starting a medical treatment? It stings! A company quoted you an estimated cost of services and it ended up being much higher than you expected when the bill came in the mail. We do things differently for insurance companies that permit it. We want to eliminate large, unexpected bills by collecting estimated payment at time of service. We provide cost of service transparency to you so you are less likely to receive surprise bills with large balances in the mail 6-8 weeks into or after treatment. Billing this way allows you to better budget what you can afford for physical therapy services and gives you the ability to collaboratively alter your treatment plan with your provider to stay within your financial means.

What this means

We collect payment at time of service at each appointment regardless of whether or not we bill your insurance. Payment will be discussed and collected directly by your provider. This means that co-payments, coinsurance amounts, and deductibles will be collected at time of service. Cash, check, or card payments are accepted.

**We will let you know before your first appointment if your insurance doesn’t allow us to bill at time of service.

It is important for you to understand that you may still receive a bill after physical therapy services have been during and/or after your physical therapy has been completed. Our billing method prevents you from receiving a large, unexpected bill 6-8 weeks into treatment, but it does not guarantee the elimination of a bill altogether. Your bill should be much less than if we had not collected payment at time of service and sent you a bill after your insurance company reimbursed us. You will pay the same amount for physical therapy services as you would have if we requested your payment after we billed your insurance company. You are simply paying smaller amounts at more regular intervals. Your provider will work with you to help you stay within your financial means. Transparency is everything.

Cancellation Policy

If you need to cancel or reschedule an appointment, we require a minimum of 24-hour notice if you need to cancel an appointment. Because we choose to schedule in one hour blocks to optimize the care we provide you, cancellations significantly affect our ability to stay afloat. Giving us advanced notice allows us to fill your slot with someone from our waitlist and allows someone else to receive much needed care. Cancellations can be made by call (please leave a voicemail), text, or email.

You will be granted one Late Cancellation. You will be verbally informed by your provider and reminded of our cancellation policy. Each Late cancellations will be charged $100 per incident. Exceptions include sudden onset illness, emergency, or inclement weather.

You will be be granted one No-call No-show. You will be verbally informed by your provider and reminded of our cancellation policy. Every No-Call No-Show after this will be charged the full $160 cash rate for each incident. A maximum of two No-Call No-Shows will be allowed. More than two will result in discharge of your care.

Payment for late cancellations and No-Call No-Shows will be collected at the end of your next appointment. Failure or refusal to pay your cancellation fee may result in the discharge of your care.