We are in nearly every provider network in the state of Texas
Over the years, we have taken great pains to be as inclusive as possible. Therefore, it’s very likely that we are in the provider network for your insurance plan. That means that no matter where you go, you won’t get terms that are any better!
Insurance Plans/Networks That Don’t Require Pre-Verification
If you have any non-HMO plan, we do not need your information in advance. We’re in network and after your first visit, we will check online or call to obtain full benefit information if you have Aetna (all plans except for Aetna Medicare/Medicaid/CHP Plans), Cigna (all plans except HealthSpring), Blue Cross Blue Shield, United, Humana, Medicare, Medicaid, and Tricare, and many other insurance plans.
Insurance Plans/Networks That Require Pre-Verification
Pre-Verification means that we will need to obtain your insurance information up-front to determine the extent and timing of your care. In most cases, we can start care within 24 to 72 hours, depending on the cooperativeness of your plan.
Health Maintenance Organization (HMO) Plans
These often require that a referral be sent to your insurance company and logged before you can see a physical therapist. If your plan has “HMO” anywhere on the card, or you are aware that your plan is an HMO plan, we will need to obtain your information in advance.
Commercial Children’s Health Plans (CHP) or Medicaid Plans: Cook Children’s, Amerigroup
Some of these plans permit the patient to come directly to therapy with a physical therapy prescription and be evaluated, then authorize care based on that evaluation. Others require the primary pediatrician’s pre-authorization before any visit.
School Athletic or Activity Insurance
This is insurance that covers students in case of injury on school grounds or during school activities. Some of these plans are considered primary to any health insurance plan, while others are not, depending on the type of health insurance plan and type of school insurance.
AARP Medicare Complete by United Healthcare or Secure Horizons
This card could represent coverage by any number of insurance companies, and each plan under this program has different details and procedures. We will need to contact the insurance plan directly to determine benefits and coverage policies. Refer to this blog post on this specific type of insurance coverage.
Department of Veterans Affairs through Tri-West Healthcare Alliance
If you already have authorization to see a civilian provider outside of the VA, you can contact the VA or contact us to get your authorization changed to our facility.
Workers’ Compensation Plans
Virtually all Workers’ Compensation Plans require pre-authorization of therapy visits. “Subscriber” plans are those offered through a workers’ compensation health care network (HCN) giving you a choice of network providers. These allow you to attend your first appointment for evaluation, then a plan of care is submitted for the rest of your care, within state guidelines. “Non-Subscriber” plans are offered directly through the employer, although they may be administered by a 3rd party. You may be able to transfer your therapy to our clinic, so call us to find out!
Information Needed for Pre-Verification
If you will be using any of the insurance plans listed below for your therapy visit, we will need to obtain your insurance information prior to your appointment, to ensure that the visit (and subsequent therapy) will be covered. The information we’ll need will be:
- Your Legal Name and Date of Birth
- Insurance ID Number and Group Number
- The Plan Subscriber’s Name and Date of Birth
- The Customer Service Number on the back of the card
- Plan Identification Information (we’ll let you know if we need that) from the card