Insurance

Health Insurance & Payment Options

Almost all insurance carriers cover physical therapy at OrthoRehab Specialists. We partner with most private plans, Medicare, Worker’s Compensation, and auto insurance carriers to help you access the care you need. To avoid unexpected costs, we recommend that you verify your benefits before your first visit. You remain responsible for any balance not covered by your insurance plan. While our administrative team can assist with benefit verification, we cannot interpret every policy. Please call our billing office at 612-355-2254 or email staff@orthorehabpt.com for personalized assistance. You can also view our full list of accepted carriers on the Insurance & Payment Options page.

Why Verify Your Coverage?

Verifying your insurance coverage has several key benefits:

• Avoid Unexpected Charges: Knowing your copays, coinsurance amounts, and deductibles helps prevent surprise bills.
• Plan Your Budget: Understanding your out-of-pocket maximum and visit limits lets you plan for ongoing care.
• Expedite Treatment: Direct access to physical therapy can begin without waiting for a physician referral, as long as your plan allows. Learn more on our Direct Access page.
• Simplify Administration: When benefits are confirmed, paperwork is minimized for you and your provider.

Common Insurance Terms Explained

Familiarizing yourself with these terms will help you make informed decisions about your care:

Copay

The fixed amount you pay at each visit. For example, you may have a $20 copay for physical therapy sessions.

Coinsurance

The percentage of the allowed service cost you pay after meeting your deductible. For example, if your coinsurance is 20% and the service costs $100, you would pay $20.

Deductible

The amount you pay out of pocket before your insurance begins to cover services. If your deductible is $500, you pay the first $500 of allowed charges each year.

Out-of-Pocket Maximum

The most you will pay in copays, coinsurance, and deductibles in a plan year. Once reached, your insurance covers 100% of allowed services.

Visit Limit

The maximum number of therapy visits your plan covers in a calendar year. Some plans cap visits at 20 or 30 per year.

Prior Authorization

Approval your insurer requires before covering certain treatments or a specific number of visits. We help you obtain prior authorization when needed.

Steps to Verify Your Benefits

Follow these steps to confirm your coverage:

1. Contact Your Insurance Carrier
   Use the customer service number on the back of your insurance card. Provide your member ID and plan details to inquire about physical therapy benefits.
2. Review Your Online Member Portal
   Many insurers offer an online portal where you can check copays, deductibles, out-of-pocket maximums, and visit limits.
3. Call Our Billing Office
   Reach us at 612-355-2254 or email staff@orthorehabpt.com. We will confirm your in-network status, coverage details, and any required authorizations.
4. View Accepted Carriers
   Visit our Insurance & Payment Options page to see all plans we accept, including private, Medicare, Worker’s Compensation, and auto policies.

Accepted Insurance Carriers

We contract with a comprehensive list of carriers to ensure you receive in-network benefits whenever possible:

• Medicare
• Humana
• Blue Cross Blue Shield
• Medica
• Patient Choice
• PreferredOne
• MN Health Care Programs
• UCare
• UnitedHealthcare
• Aetna
• PHCS / MultiPlan
• Ameritas PPO
• Auto Insurance
• Worker’s Compensation

Self-Pay & Financial Assistance

If you are uninsured or your plan does not cover the full cost of services, we offer:

• Transparent Cash Rates on all physical therapy services
• Payment Plans to spread out costs over time
• Health Savings Account (HSA) & Flexible Spending Account (FSA) friendly billing
• Financial Counseling to discuss options and address concerns

For more details, visit our Financial Assistance page or speak directly with our billing coordinator.

Special Considerations for Medicare Beneficiaries

Medicare patients must still obtain a physician referral prior to starting physical therapy. Under Medicare Part B, you are responsible for a 20 percent coinsurance after meeting your Part B deductible. We will help coordinate any necessary referrals and submit claims on your behalf. For details on Medicare coverage, see our Medicare Services page.

Direct Access vs. Medicare Requirements

Direct access under Minnesota law allows evaluation and treatment by a physical therapist for up to 90 days without a physician referral for new conditions or chronic conditions already diagnosed. However, Medicare requires a valid referral. If you are covered by Medicare, we will guide you through the referral process to ensure uninterrupted care.

Frequently Asked Questions

What if my plan has a high deductible?

We offer self-pay rates and payment plans to help you manage costs while you meet your deductible. HSA and FSA contributions can also be applied to physical therapy services.

How do I know if I need prior authorization?

Most private plans require prior authorization for more than a set number of visits. We will check your plan requirements and help initiate the authorization process if needed.

Can I switch from direct access to a referral-based plan?

Yes. If you prefer to obtain a referral or if your insurance requires it, we will coordinate with your physician and manage the paperwork to transition you smoothly.

What if my insurance changes?

Notify us as soon as possible of any insurance changes so we can update your information and verify new benefits before your next visit.

Next Steps to Get Started

Ready to verify your benefits and begin treatment? Here’s how to move forward:

1. Call Your Carrier: Confirm your physical therapy benefits using the number on the back of your card.
2. Contact Us: Call Edina at 952-922-0330 or Minneapolis at 612-339-2041, or book online.
3. Submit Referrals: If you have Medicare, ask your physician to send a referral directly to our clinic.
4. Attend Your Visit: Bring your insurance card and ID to your first appointment. We will handle the billing details so you can focus on your recovery.

Why Choose OrthoRehab Specialists?

• Therapist-Owned & Operated – We prioritize patient outcomes over quotas.
• One-on-One Care – Consistency from the same therapist each session.
• Evidence-Based Practice – We follow APTA guidelines and current research.
• Comprehensive Services – From manual therapy to Pilates and blood flow restriction training.
• Convenient Scheduling – Early morning, evening, and weekend slots available.
• Trusted by Physicians – Over 600 local providers refer their patients to us.

To learn more about our overall approach, visit our Why OrthoRehab Specialists page or explore detailed treatment descriptions on our Physical Therapy Services page.

Take Control of Your Care Today

Verifying your insurance and understanding payment options is the first step toward a successful recovery. Contact us now to schedule your free benefits check and direct access evaluation. Our team is ready to support you on your path to improved health and function.