Insurance Information

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Christine & Mario Farfan, Clinic Owners, firmly believe that everyone deserves an opportunity to Discover Balance and learn how to recover by finding their Healing Zone. We are happy to extend steep discounts for cash paying patients that are unable to receive subsidizing from their insurance company for the comprehensive Perfect Balance Physical Therapy Services. You and your family deserve to Discover Balance and find healing and wellness. Please note we will not be providing SuperBills for insurance reimbursements for this cash rate.

**Perfect Balance PT IS NOT In Network with any Insurance Carriers currently.

Out of pocket cost of PT visit as low as $50, Really! *Pending on your Out of Network Insurance Benefits

For Out of Network Insurance Plans: We provide SuperBills for Fast & Easy Insurance submission to speed the reimbursement payments coming directly to you from your insurance company.

For Clients Using Insurance:

First Visit Includes: 

Evaluation & 60 min Treatment with PT only :  $275 Amount Paid by you at visit

Amount Insurance Approved Check to Patient  -$55-220 Received from Insurance

Your Actual Co-Insurance/ Out of Pocket Cost:  $55-220 Pending your Insurance

Subsequent Visits Includes:

60 min Comprehensive Treatment with PT:  $250 Amount Paid by you at visit

Amount Insurance Approved Check to Patient -$50-200 Received from Insurance

Your Actual Co-Insurance/ Out of Pocket Cost:   $50-200 Pending your Insurance

For Clients Not Using Insurance/Paying Cash:

First Visit Includes: 

Evaluation & 60 min Treatment with PT only:  $225 Amount Paid at first visit

Subsequent Visits Include:

60 min Comprehensive Treatment with PT:  $200 Amount Paid subsequent visits

Understanding your out-of-network benefits for physical therapy and how to get reimbursed by your insurance company can help alleviate some of the financial burden associated with seeking treatment outside your insurance network. By following these steps and staying informed about your coverage, you can make the most of your healthcare benefits while receiving the care you need. If you have any questions or need assistance with the reimbursement process, don't hesitate to reach out to us. We're here to help!

** We Can Help Check Your Coverage:** Before starting physical therapy, we can help you obtain details about your specific insurance plan to understand your out-of-network benefits, including any deductibles, co-pays, or coinsurance you may be responsible for. If you’d like us to call for insurance benefit details,

Text the following to (408) 444-1177 or Email to PerfectBalPT@gmail.com:

• a photo of the front of your insurance card
• a photo of the back of your insurance card
• Patient’s Date Of Birth
• Date of birth of the Primary Insured Person, if it isn’t self;
• Your personal Email for us to send you a Health Hx Questionnaire to be sent and completed PRE Evaluation visit, to provide Christine the most accurate information on what’s going on with your mind body system.

2. **Receive your Perfect Balance Customized Treatment:** The majority of our patients experience pain relief within even the first visit. Beyond that, they learn to manage their situation and how to maximize their own Healing, reducing their need for physical therapy visits. Schedule your physical therapy sessions with a provider high quality and with vast experience, even if they are out-of-network. The quality of Care matters. You and your family deserve to Heal quickly.

3. **Pay Full Fee Just Prior to your visit:** 

This is where our insurance companies try to manipulate us by making it uncomfortable to pay upfront and wait for reimbursement from them. If you calculate your payment after your reimbursement, you will see it is well worth it. It works as follows. You pay the appropriate Fee described below, at the time of service.We appreciate checks but take a variety of payment forms. Keep all receipts and documentation provided by your physical therapist.

4. **Request Super Bills:** Ask Mario at the front desk for super bills for each session. He can also email them to you in an electronic version. Make sure they include all necessary information required by your insurance company.

5. **Submit Claims:** Submit the super bills along with any other required documents to your insurance company for reimbursement. This can usually be done online, by mail, or through a mobile app.

6. **Wait for Processing:** Your insurance company will review your claim and determine the amount they will reimburse you based on your out-of-network benefits. This process can take as little as 5 days, or up to 45 days. Call your carrier to check on status.

7. **Receive Reimbursement:** Once your claim is processed, your insurance company will send you a reimbursement check or deposit the funds directly into your bank account.

For Out of Network Insurance Plans: We provide SuperBills for Fast & Easy Insurance submission to speed the reimbursement payments coming directly to you from your insurance company.

A super bill is a detailed invoice provided by your physical therapist that includes information such as the services rendered, dates of service, diagnosis codes, and fees charged. This document serves as proof of the treatment received and the associated costs. We can provide this for you.

In network health care is a volume driven business. This forces busy PT clinics to schedule their PT’s to see up to 24 patients in an 8 hour shift at a typical In-network PTs schedule. In busy in network clinics, most of your treatment is spent with support staff that is unlicensed.. How could any clinician bring their best self to 24 patients in 24 twenty minute treatments, per DAY, scheduled back to back? That’s just not viable. 

At Perfect Balance, it is important to us to provide high quality, one on one care.

In order to maintain quality of care and allow our patients a full treatment with their licensed Physical Therapist, we prioritize a clinical quality model of care. 100% of every clients time in treatment is DIRECTLY with Christine, the PT. This would not be possible if we stayed in-network.

Every clinician desires and should have a healing oasis to work in, but most don’t. Do not despair, we do here at Perfect Balance. (Sorry to brag, not really sorry to brag!) Come check out the unique healing enclave that is Perfect Balance Physical Therapy. It’s quiet, serene, free from distraction and full of clinical tools for full recovery and optimal healing. As a bonus, you get to actually know your PT. Let’s do this!

At Perfect Balance PT you get more bang for the buck in every way. The customized one on one treatment style is able to deliver a very comprehensive and full treatment, which decreases the amount of visits necessary significantly, saving you time, money and frustration with slow healing progress. Be assured that all of the advanced high tech & state of the art modalities, biofeedback, specialized equipment or advanced manual techniques that are offered at Perfect Balance PT are available to you at no additional cost. Your treatments are tailored around a clinical model with the full attention of your PT, every time. We do not employ support clinical staff, which is why we are an out of network specialty service. The volume driven model of the in network clinics does not allow us adequate time to provide you a full and effective treatment or the therapeutic space to help you heal. We believe you will notice extreme benefits with a customized Perfect Balance Program. Please know that you’ve chosen the path of quality treatment without constraints by choosing out of network care. You deserve the best customized care available. Come to Perfect Balance PT.

We do take Worker’s Compensation cases, pending specific authorization to attend PT at Perfect Balance Physical Therapy. Ask your worker’s Comp assigned MD to request authorization to come here for your PT. It is your right to request the care of choice. We are happy to coordinate with the MD office to facilitate the referral and authorization process.

You DO NOT need permission from a doctor, or anyone else to come to physical therapy! California is a Direct access state, and does not require an MD prescription. No Rx is required to attend PT, but we’re always interested in seeing one if you have it. 

A referral serves a valuable role as communication between the physician and your PT. This is helpful information, but not necessary, as we have excellent evaluation skills and capacities. So text, email or bring it with you if you do have a prescription or referral from your doctor. We will happily connect with your MD and can provide them reports about your ongoing PT recovery journey. We can fax an initial evaluation and progress reports to any of your doctors, upon request. For an optimal recovery it's important to have ongoing communication between all of your caregivers. A health & wellness team, working together, can provide you an integrated medicine approach which science has shown to result in complete healing and recovery.