Moving Into Harmony will work with you if you are choosing to utilize your medical health care insurance benefits. We provide physical therapy services througuh your out-of-network rehabilitation benefits. With the ever changing environment of health insurance, and growing confusion around coverage, we highly recommend the following to know your coverage and responsibilities:
- Call your health insurance carriers customer service line twice over a 2-3 day period,
- Write down the representative’s name and if availalble id# (they record your calls, so you have the right to also ask who you are speaking with). Write down name, id# if available, date and time of your call.
- Ask to have your plan’s benefit reviewed for out-of-network rehabilitation, or Physical Therapy, coverage.
- Ask about any uncovered rehabilitation service under your benefits.
- Ask them to send you a copy via email of those benefits you just reviewed with them.
- Ask about your current out-of-pocket out-of network balance – this includes what deductibles and/or co-insurance payments that you either already paid or owe to an out-of-network provider for services in the calendar year, not insurance company.
- Ask about what you may still owe when recieving services from an out-of-network provider based on #6.
- Please know they will pursuade you to seek Physical Therapy from one of their contracted in-network providers. This is their job to convince you and get you to save money. Please know, not all Physical Therapy services are the same, and this is similar to being a consumer of other goods and services for what you want in your health. We encourage you to come in if you have been referred by a practitioner, physician, friend, or family member it is because they understand and have experienced the highest quality of care that gets results beyond the baseline level of being pain-free. We encourage you to inquire, search this website to get a feel of the perspectives and philosophy of our model of care, and at the minimum come in for a inquiry session to see how we can help you with what you want. Thank you.
It is very important you understand your health is your priority; that your clarity and understanding about your health care coverage and financial responsibilities before receiving care is part of being healthy.
If I choose to utilize my health insurance benefits for your services, do you bill my insurance?
- BILLING: we have changed our policy to submission. We are happy to provide a paid invoice receipt (known as a “super-bill”) that you can submit to your health insurance company for your payments toward your out-of-network out-of-pocket balanced expense, or any reimbursement they will send you based on your co-insurance responsibilities. It is ultimately your responsibility to follow-up with your insurance company to obtain information about your account. Help us by ensuring we have all of your updated insurance information to put on a paid invoice receipt. If you received an email about your phone call inquiry you are welcome to bring it and we will do our best to decifer and interpret what you were given. This is not absolute as insurance companies have rights to change their responsiblities wihtout notice.
- At each visit, you will be required to pay for services. Our policy regarding overpayment if your insurance company sends a check to our office, we will write a check for over-balance payment to you with 15 days or receiving, or credit your account based on your decision.
- We realize that temporary financial problems may affect timely payment of your account. If such problems do arise, please contact us promptly so we can assist you the best we can.
Do you take Medicare or Medicaid (Oregon Health Plan-OHP)?
Moving Into Harmony does not contract with Federal or State sponsored medical health insurance programs. These often require specific and restrictive contracts that limit the services provided. We are committed to offering the best practice services in the field of Manual Therapy and Functional Movement that often exceeds the level of services provided by practitioners who contract with these programs. We invite you to experience our valuable best practice services and make your own decisions about what you want for your health.
Addendum – Moving Into Harmony will provide you with a detailed form explaining your services and specific cost of care, to provide clarity and assurance there are not extra or hidden costs to receive the care you want. An ABN Advance Beneficiary Notice of Non-coverage (ABN Form CMS-R-131) will be provided during your first visit specific to your care for this purpose.
Do you accept insurance for a Motor Vehicle Accident?
Under Oregon laws, you are covered for two years from date of incident for your Personal Injury Protection policy. We require that you know your coverage, your maximum benefit, how much has been billed (estimates based on your knowledge of care and cost provided to you) and provide us with written information, including:
- date of accident,
- physician for your care,
- your available coverage,
- insurance company and claim representative names.
- phone number and fax numbers for communication with your insurance company’s representative.
We recommend you review your policy benefit descriptions and call your health insurance agent that assisted you with your policy, or a representative through the insurance company you have representing your claim to answer your specific question about your benefits, and monies available for continued care (i.e. in Oregon the minimum benefit is $25,000 per incident, with more monies allowed based on your policy you contracted with). All services related to injuries and lack of function from an MVA, are financially your responsibility and the company you have contracted with; meaning, if the monies allowed are exhausted, you are responsible for reimbursing any practitioner for the services provided once benefits are exhausted.
We also require a recent (1-3 weeks) prescription from a medical doctor (MD), an osteopathic physician (DO), a naturopath (ND), or a dentist (DMD). Referrals from a chiropractor (DC) per Oregon law, can not be accepted. The prescription must indicate the date of accident, the proper diagnostic coding for areas requiring treatment, frequency and duration of care.
If you are involved in a litigation or suit for continued care or support of the care you already received, it is important to inform us of your current situation including any legal representative (including name and contact information) and medical personal supporting you.
A release of medical information is required to communicate with any individual supporting your care.
What are the benefits of me participating in a cash-pay option?
You recieve the care you want and progress toward the results you desire.
Bottom line – You are in charge of your health and well-being.
You have a direct relationship without the triangulated relationship in which someone else controls what you receive for best practice solutions and how well you get.
Cash pay, or Private pay, is that; often discounted through packages and also becasue there is no extra time and resources required to be in three way relationship to the health you want to achieve – no involvement with a third party managing your care. Care is tailored to your specific needs and goals.
Further progressive care may be available as a continuum of your health and wellness goals, suited to your individual needs for the outcome(s) you want. This is a benefit because you are in control of your well-being; AND you have developed a relationship with a therapist who understands your tendencies, your strengths and flexibility, your efforts, your interests and goals from the time spent assisting you in your recovery. Why not have the same therapist who can consistently assist you into greater realms of health and well-being?
There are no diagnosis that you carry as a label to who you are, and your care will not impact how you will be covered in the future based on what was addressed and we helped you with. No health information is requried to be shared unless you direct us to do so.
It’s also important to recognize that using your insurance can impact your ability to have a say in your wants and desires for therapy, as your insurer may limit the number of sessions or what you work on in sessions. Managed care through health insurance companies dictate your care and override what a professional has assessed and given recommendations for your best solutions. We will provide the best practice solutions under their guidelines, and in our experience is limited to what can be accomplished. You also relinquish your rights to any current and future insurance company to have access to your therapy records.
How much is a visit?
Initial Consultation – $300-$350 (see Your First Visit)
Initial Consultations are typically a 1&1/2 hour session, which includes the interview – history & review of systems, evaluation and assessment, treatment, movement education and initiating a home-self care program. A follow up email reviewing key points of your visit and references/resources is included in the fee for this session.
Physical Therapy sessions – $200 – $250 (see description of service)
These sessions are time and service based. Per insurance codes (CPT codes), there are specific charges (reasonable and customary fees set by the Oregon Health Authority, per 15minute interval) for the type of skilled service provided, such as:
- Gait (walking) Training,
- Manual Therapy,
- Kinetic Activity (1:1 functional movement),
- Neuromuscular Re-Education (balance, coordinative activities), and
- Therapeutic Exercise (instruction in exercise program including home programs).
Sessions can be scheduled for 45, 60 or 75 minutes depending on your needs and treatment provided.
Please inquire with any questions you may have.
Packages & Discounts
We do not want finances to get in the way of you getting better. Packages are available to support consistency and continuity of care, and for those choosing NOT to use their health care benefits for services offered.
Discounts are available for services paid at time of visit, cash-pay/private-pay (no medical insurance billing or submission), students of the Hatha Yoga classes with Moving Into Harmony, and Federal Poverty sliding scale applicants.
Please inquire with any questions you may have.
Federal Poverty Guideline Sliding Fee Application
For those who may be experiencing financial hardship, sliding fees may be available to private pay patients who have no health insurance coverage and have an annual combined household income that falls within the Federal Poverty Guidelines.
Please inquire with your questions or interest with this program.