"Do You Take My Insurance?" #1 Pelvic Floor Physical Therapy Question, Answered

 
 

Navigating this system is confusing and time consuming—after all, you're a patient, not an insurance expert.

We aim to help our patients get the best possible benefits from their insurance company and will advocate on behalf of the patient to get the coverage they pay for and deserve. We will not only submit a patient’s claim, but also assist them in obtaining the required authorizations so patients can focus solely on healing. Read more about our Billing Policy.

In recent years, insurance policies and billing requirements have become more complex. Insurance companies are requiring more and more documentation, and even PPOs may require pre-authorization for physical therapy services. That's why we aim to go above and beyond to help you get the best possible benefits from your insurance company and will advocate on your behalf to get the coverage you pay for and deserve. 

We routinely surveys other physical therapy clinics to ensure that the claims submitted to your insurance are on par with the other providers in our area and specialty, and to put you in the best position to meet your deductible quickly, without any additonal out-of-pocket expense. We will not only submit your claim, but also assist you in obtaining the required authorizations. Patients who self-submit claims or authorization requests are more likely to be denied for benefits, especially out of network. This could result in an appeals process which is complex and often lengthy with no guarantees.

When you choose to receive treatment from us, we provide all of these services at no cost to you to make your experience as hassle-free and stress-free as possible, so that your focus is solely on healing.

This video covers:

  • The difference between in-network and our out-of-network care - this is the Sarton Difference (0:27)

    • Unmatched experience

    • Longer treatment times (no more getting passed off to a physical therapy aide)

    • Innovative treatment

    • Complex case treatment

    • Patient education

  • Our billing process (2:21)

  • Superbilling (3:35)

  • "What if I have an HMO provider?" (4:57)

  • "What if I have Medicare?" (5:33)

    • Please note: We unfortunately are not contracted with Medicare for the simple reason that reimbursement is so low that we could not maintain our model of care, which is to spend one full hour with each of our patients, delivering treatment from a highly specialized pelvic floor physical therapist.

    • It saddens us greatly that we are also not allowed to accept cash payments for patients with Medicare as federal law prohibits this. We are hoping the law changes soon as there’s nothing more that we love than to deliver treatment to our senior population. It upsets us to no end that this law exists, and we have tried writing letters to our Congress women and men to get this changed.

    • We have fantastic ancillary services and classes starting this month as we have been working behind the scenes to build a wellness program for patients, particularly the Medicare population, so that you can still get help via this avenue.

  • "What does this mean for me as a patient?" (5:46)

More information is available at pelvichealing.com/my-first-visit. If you still have questions, we would be happy to answer them. Please contact us here.


We want to encourage you to get evaluated by one of our outstanding physical therapists, and regain control of your life. Pelvic pain, pelvic floor dysfunction, back pain, tailbone pain—you name it—these conditions do not have to control your life. There is hope. Call us today to book an appointment for 1 of our 3 Southern California locations, or inquire about a virtual, online treatment session.


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Sarton Physical Therapy and its affiliates recommend that you contact your physician before participating in any physical therapy, exercise or fitness related programs. Learn More.