Billing and Insurance
We try to simplify the billing and insurance process for you. If you have questions about your insurance coverage or payment obligations, please contact our office manager at (408) 540-7622.
- Prior to scheduling, we will verify your coverage for outpatient physical therapy and provide you with an estimate of what insurance may cover and your financial responsibility.
- We collect patient payments at each visit. Payments can be made using Visa, Mastercard, AMEX, personal check or cash.
- We submit claims directly to your insurance company for processing. You will receive EOBs from your insurance company in the mail; processing often takes 30-45 days.
- If you have a balance due or refund, we will mail you a statement once claims have processed.
Our therapists are all contracted Medicare providers. We accept PPO plans with out-of-network coverage, including Blue Cross/Blue Shield, Aetna, CIGNA, HealthNet, and UHC. We also accept Worker’s Compensation cases under the CA Worker’s Comp Fee Schedule.
Blue Cross/Blue Shield: These insurance companies send payment for out-of-network services to the patient/subscriber. Therefore, we collect the payment at each visit and submit the claims to insurance. This allows you to deposit/cash the insurance checks as they arrive and helps us keeps your balance up-to-date with Vortex.
If you have additional questions about your insurance after receiving our estimate, we encourage you to call the insurance company prior to treatment. You are responsible for knowing what your insurance plan covers and paying us for our services.
If your insurance does not offer out-of-network coverage or has a high deductible, we offer a 25% discount for paying privately. This includes those with HMO plans, such as Kaiser, certain PPO plans, and those without any health insurance.Please contact our office for more information.
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our number on our website for more information.
Vortex accepts and bills Medicare, PPO plans with out-of-network benefits, and Worker's Comp plans. We also offer a discounted private pay rate to those without insurance coverage.
Please call if you would like our office manager to verify your insurance coverage.
Patient payments for deductibles, co-insurance, and supplies are collected at each visit.
Cancellations & No Shows
We have a 24 hour cancellation policy. If you late cancel, we cannot offer the appointment to a waiting patient and your therapist has a hole in their schedule.
Vortex charges $75 for late cancellations; $100 for no shows. These fees are owed by the patient and are collected at the next scheduled appointment. Insurance does not pay for missed appointments.
Need to cancel? Call us now.
For your convenience, our New Patient paperwork is available to download as a PDF form. Please download and complete these forms in preparation for your first appointment. You can email them ahead of time or bring them to your evaluation.