Understanding the Referral Process
Washington state allows individuals to refer themselves to physical therapy, however many health insurance plans will only cover physical therapy services when the process includes a referral or prescription for physical therapy from an approved health care practitioner. These practitioners include medical doctors, chiropractors, physician’s assistants, nurse practitioners, naturopathic physicians and podiatrists.
- Regence Blue Shield
- Blue Cross/Blue Shield
- First Choice
- Labor and Industries
- Workers Compensation carriers
If you have health insurance you may contact your provider to determine the requirements of your benefits and whether or not you need a prescription to have the services covered.
If your insurance requires a prescription, contact us once you have obtained one from your health care practitioner by calling us at 1-206-624-7602 or click here to request an appointment online.
If you do not need a prescription or do not have insurance and would like to self refer in a self payment situation please call us here at 1-206-624-7602 or click here to request an appointment online. Please ask about our self payment arrangements.
What to Expect on Your First Visit
The evaluation will last approximately one hour and comfortable clothing is the best option, including shorts and a sports bra if this is appropriate. Also please bring in your walking, running or athletic footwear as we may want to evaluate your walking and /or running. The evaluation will focus on your medical history and your current issues. We will examine your flexibility, strength and ability to complete your functional activities.
Depending on the prescription and your situation we will develop a treatment plan with you and decide on the appropriate frequency and duration for your future visits. Most commonly we will see you 1-2 times per week, or as your health care practitioner recommends, for one hour sessions.
Amazon Employee Benefits
Since more than half of the patients we see here at GO PT are Amazon Employees, we thought it would be beneficial to give a brief breakdown of insurance benefits we typically see for Amazon Employees. Most Amazon patients have a deductible between $300-$1500, 10% co-insurances, 60 visits allowed annually, and no prescription required. If they haven’t met their deductible, the initial evaluation will typically cost $200 and follow-ups $120 until the deductible is met. If the deductible has been met, the initial evaluation will generally cost $20-25 and follow-ups $10-15. That means even if you have the higher deductible of $1,500, and if you use all 60 of your PT visits for the year, it would break down to only $38 a session (including the evaluation). So make the most out of your benefits, you worked hard for them!
New Patient Forms
- I have a referral from my doctor doesn’t that mean that my insurance will pay for my physical therapy?
GO PT: Some insurance companies require that you have a referral from your doctor to use your PT benefits, while most in the state of Washington do not. Premera, Aetna, Regence and others typically do not require you to have a doctor’s referral to use your PT benefits. Please review our “Patient Guide to understanding Insurance” to see how insurances pay for your physical therapy services.
- I heard that if I get a referral from my doctor each physical therapy session will be less than if I didn’t have a referral.
GO PT: Having a referral will not change the amount that you and your insurance companies have to pay. We are contracted with your insurance company and we have come to an agreement on how much your insurance will reimburse us for our physical therapy services. A referral does not change that agreement.
- “I only paid the office copay at my doctor’s appointment; shouldn’t I only have to pay a co-pay for physical therapy as well?”
GO PT: Your office copay at your doctor’s appointment may not apply to physical therapy because we are considered a specialist and not part of general medical.
- I have insurance so doesn’t that mean that all my physical therapy services are paid for?
GO PT: Having insurance does not mean that your physical therapy is paid for. Insurance will pay a portion of your total cost of physical therapy. How much you pay out of pocket will be substantially less than without insurance. Please review our “Patient Guide to understanding Insurance” to see how insurances pay for your physical therapy services.