Do you take my insurance?

By |2022-04-20T21:32:35+00:00September 3rd, 2020|About MovementX|0 Comments

Insurance can be complicated, we're here to make it simple.

MovementX Physical Therapy Portland

Payment for healthcare services could not be more confusing. Not to mention, most healthcare bills are entirely unpredictable.

At MovementX, our goal is to simplify the payment and overall experience of receiving high quality healthcare. Before ever booking a session with us, you will have full transparency in how much a session costs and how much you can expect insurance to reimburse you. Are we the cheapest option in town? Not always, but we are the highest quality, most effective, and most convenient choice on the market.

What insurance plans do you work with?

We work with all major insurance plans on an out-of-network basis. Keep reading to learn more about what that means and what you have to do to get started! In some cases, we can submit directly to the insurance company including Providence Health Plans, United Healthcare, Regence BCBS, Personal Injury, Motor Vehicle Accident, and Worker’s Compensation Plans.

Verify My Benefits
  • At this time, we do not work with Medicare Part B or Supplemental plans for physical therapy care. We do work with select Medicare Advantage plans and are happy to offer wellness services on an out of pocket basis.

What does it mean that MovementX is “Out of Network?”

The term “in-network” refers to health care providers who are a part of your insurance plan’s network of providers. Usually, your insurance plan has negotiated a discount with these providers.

This means that providers who are in-network provide services at a lower cost to your insurance company. While this is very effective at controlling the cost of care, it can come with unforeseen consequences to the patient such as shorter appointment times and your doctor managing a higher patient volume.

The term “out-of-network” refers to health care providers who do not participate in your insurance provider’s network. This does not mean these providers are not covered by insurance.

Most insurance companies provide you with out-of-network benefits which allows you to see providers in and/or out of your plan, but the provider is not bound by the insurance company’s rules and regulations.

How does MovementX operate out-of-network?

  • Step 1 Verify Your Benefits: Submit your insurance information via this secure form and a member of our insurance team will verify your out of network coverage for physical therapy, including your accumulations towards your deductible. You should receive a summary of this information via email within 48 hours.

  • Step 2 Pay for Your Session: In most cases, your physical therapist will collect the cost of the session in full after the session is complete. You will then immediately receive an email with a link to your receipt, which has been fully itemized with all the information the insurance needs to process your claim.

  • Step 3 Submit for Reimbursement: In most cases you can submit for reimbursement on your insurance web portal. If you do not have web portal access, you can call your insurance and request a “Member Claim Form” which you will attach to your MovementX receipt and mail to the insurance company.

  • Step 4 Get Paid: Your insurance will write you a check and mail it directly to you for the portion of the session that is reimbursable to you.

More insurance FAQs

Why do you need my payment information prior to my first session?

Providing your payment information prior to care ensures that you are 100% ready to be evaluated and treated by your expert provider, leaving your provider to focus solely on what matters most- you and your care. Not only does this streamline our operations, it makes receiving care more convenient for you.

When will my card be charged?
The only time we process a charge on our system is after you receive services with us and have agreed upon a set price with your provider. After a charge occurs, you will always receive an email from MovementX with a link to your receipt.

Where do you house payment information?
Our priority is keeping your credit card secure. That is why we utilize a widely used third party payment processor to anonymously store your credit card information. No credit card information is stored on our website or platform and no one, except for you, has access to its data.

Can I speak to someone before entering my card information?
Absolutely! We are happy to discuss processes further or set you up with a free consultation with one of our expert providers. Please call us at 971-361-9442 or email us at info@movement-x.com so we can provide further assistance.

As soon as your session is processed by your physical therapist, your card on file will be charged and you will receive a link to your session receipt via email. You can also access your receipts by logging into your patient dashboard and clicking “sessions” in the upper right hand drop down menu.

Every insurance company has a slightly different process for submitting for reimbursement. If you have access to an online portal through your insurance company, this is likely the easiest way to submit your claim. If you do not have online portal access, call the member services number on the back of your insurance card and ask for a “Member Claim Form” and a claims mailing address. Attach your receipts from MovementX to your Member Claim Form and put them in mail!

Because we are considered out of network with all insurers, we do not sign a contract binding us to a certain reimbursement rate. This means that often times your insurance will value our time less than our hourly rate. The difference between what we charge and the insurance company reimburses is called a “balance bill.” Every insurance company has a different amount that they reimburse, therefore MovementX cannot guarantee a certain level of reimbursement and will not refund you for the balance.

Please know our intentions are good and we are working to change this from within! If insurance valued our contribution to our patients’ health as much as we do, we would be happy to go in-network with them. However, current reimbursement rates are unsustainable and don’t allow us the ability to deliver the quality, one on one, care that you deserve.

Most insurance plans do not require a referral to be seen by a physical therapist. When we verify your insurance information, we will confirm whether or not your specific plan requires a physician script.

If you are using your workers compensation or car accident coverage, you will need a script from your managing physician. Physician scripts and medical charts can be faxed to (888) 645-6068.

Yes! Some plans require prior-authorization to be obtained prior to starting care. As long as you submit an insurance verification form prior to starting physical therapy, we will take care of securing your authorization. Please note that not all of our providers work with prior-authorizations, so we will match you with someone who does!

MovementX often receives notifications from the insurance company asking for more information on a claim. We will handle all inquiries and make sure that your claim is corrected and payment is directed to you. If you receive any notification about an issue with a claim, please forward it to our insurance office at accounts@movement-x.com.

After we verify your insurance, our insurance office will email you with your out of network physical therapy coverage, which can be full of words that even the highest scholar doesn’t understand. So what do all these insurance words mean?

  • Deductible: the amount you pay for health care services before your insurance plan starts to pay
  • Co-pay: The fixed upfront costs associated with an office visit
  • Co-Insurance: The percentage of costs of a health care service that your insurance will pay after you’ve met your deductible.
  • Out of Pocket Maximum: The maximum amount you pay out of pocket until insurance starts to cover 100%

Yes! We gladly accept Health Savings Accounts and Flex Spending Accounts for physical therapy care. When setting up your profile, input your HSA or FSA debit card as your payment method or submit your invoices directly to your employer or HSA/FSA provider for reimbursement. FSAs often expire at the end of the year, so don’t let it go to waste!

We wish we could! MovementX is considered “non-enrolled” in Medicare, which means we have no relationship or contract with Medicare.  While third party Medicare Advantage plans do have out of network coverage, traditional Medicare Part B and Medicare Supplemental plans do not. This means that we do not bill and our clients cannot submit for reimbursement to Medicare Part B.

Unfortunately, due to Medicare regulations, PTs are not allowed to accept cash for restorative physical therapy sessions focused on pain relief, recovery of function, and post surgical rehabilitation.

We are, however, allowed to see you for the following reasons:

  • Wellness and Optimize Sessions aimed at helping you move better, perform at a higher capacity, and become more resilient to injury. (Medicare does not care if you pay out of pocket for this because services are not considered medically necessary!)

  • Physical therapy services after Medicare has denied further visits at an insurance based PT clinic.

  • Our AgeProofYourBody exercise class series.

Every insurance company pays a different amount for an hour of physical therapy. At MovementX, we have set our hourly rate at $150-$200.  Your out of network reimbursement will be based on what the insurance determines as their hourly rate, and not based off of MovementX’s hourly rate. If the reimbursement rates of the insurance company are less than our hourly rate, you will not be reimbursed for the balance by MovementX.

Every day our profession is fighting to prove our value to insurance companies so they can increase our reimbursement rate, and therefore save you money. Help us advocate for our value by writing to your insurance company about the value you have found out of PT.

Physical therapist stretching patient with hypermobility syndrome in Portland, OR

Why is MovementX out-of-network?

At MovementX, we have a vision of a world healed by movement. We want to deliver the highest quality physical therapy and personal training to anyone in need. To do so, we have gone outside the world of insurance to help provide a better quality physical therapy experience, while maintaining a relationship with insurance to offload costs to you. Being out-of-network allows MovementX the autonomy to provide physical therapy where you need it most (at work, in home, outdoors, at your gym) and not be limited by the administrative burden and arbitrary limitations placed on in-network clinics.

In the following circumstances, going to an out of network physical therapy clinic can actually be the same cost or cheaper than going in network!

  • If you have a high deductible plan and will be paying cash towards your deductible, our rates and bundle packages are often lower than in-network rates. Some deductibles even cross accumulate in and out of network!

  • If you have met your out of pocket maximum for the year and your insurance is paying 100% of your healthcare bill, in and out of network clinics may be covered at the exact same rate.

  • If you don’t have health insurance at all and are looking to pay cash, our rates and bundle packages are often lower than a traditional clinic.

Don’t forget, MovementX does accept coverage in full for motor vehicle accidents and workers compensation claims!

We’re Here to Help!

We know the insurance lingo can be confusing, which is why we are happy to help you figure it out. Getting excellent physical therapy care shouldn’t be complicated. At MovementX, we make sure to verify your out-of-network benefits with your insurance provider and make sure there are no surprise costs.

Check My Benefits
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