Physical Therapy Benefits
Physical therapy is a covered medical benefit under insurance plans for medically necessary treatment. We are preferred providers for most insurance plans throughout western Montana, and as a courtesy to you, we are happy to verify physical therapy benefits prior to your first visit. You can be confident that we will inform you about your insurance benefits and help you understand your personal responsibility in advance of patient care.
Billing and Insurance Claims
As a courtesy, we will file and assist in obtaining payment for physical therapy services rendered directly with your insurance company.
Co-payments are collected at the time of service. Please contact us whenever you have any questions about your account, we are here to help.
Sapphire Physical Therapy
2207 S. Third St. W
Missoula, MT 59801
phone (406) 549-5283
fax (406) 549-5392
Health Care Plans
Health care plans vary greatly. To assure the highest level of benefit, we encourage patients to be aware of their plan's coverage. To this end, we will call your insurance company and obtain an outline of your benefits, which we will share with you. Some common healthcare plan items are:
- Co-pay required by patient at the time of service
- Deductibles, often waived for participating/preferred providers. We
participate with many plans.
- Direct Access or Referrals from primary care physician (PCP); see next section
- Therapy visit or monetary limitations per coverage year
Physical Therapy Direct
State laws provide direct access to licensed Physical Therapists without a physician’s referral or prescription. That means that as a consumer of healthcare, you can seek medical treatment for your musculoskeletal issues directly from the Physical Therapist of your choosing. This places physical therapy as a first line provider for your musculoskeletal health.
Insurance coverage for your physical therapy benefits are plan-specific. Most insurance companies do not require a referral from your physician, but some do.
Many third party payers will pay for Physical Therapy services rendered under direct access, however, the benefit is plan specific. Medicare does not pay for Direct Access Physical Therapy at this time, but Physical Therapists can perform an evaluation under direct access, and as long as a physician signs off on a treatment plan, we are able to bill Medicare.
Verifying your Physical Therapy Direct benefits with your insurance plan is simple:
- Contact your insurance company via phone
- Provide: Plan & Group Number
- Ask if you need a Doctor Referral for physical therapy to be covered under your plan
- Yes – if your plan requires a doctor referral then we will need to obtain a referral from your physician. We can often do this for you or you can call your physician and request a referral to Sapphire Physical Therapy.
- No – call Sapphire Physical Therapy and schedule an appointment directly.
We are happy to verify your physical therapy benefits for you. Simply contact our clinic and we will outline your physical therapy benefits so you can make an informed decision. You will receive information on referral requirements, co-insurance, co-pay, and your total annual benefit. We do offer cash rates for your convenience and for services rendered outside insurance plan coverage, which can be very cost effective.
Patient convenience:
- Insurance Verification and Billing
- Convenient Location & Hours
- Professional, Friendly Service
We are Preferred Providers
Clinic participation varies by insurance contract. Sapphire Physical Therapy participates with many insurance plans. Please contact our clinic directly if you have any questions.