Insurance coverage

Vortex is a contracted Medicare provider. We also bill PPO plans with out-of-network benefits. Worker’s Compensation cases are considered on a case-by-case basis.

Prior to scheduling, we will verify your insurance coverage for outpatient physical therapy and provide you with an estimate of what insurance may cover and your financial responsibility. If your insurance plan falls into any of the following categories, we offer a 25% discount for paying privately. Please contact our office for details.

  • High deductible plans
  • HMO plans, such as Kaiser
  • PPO plans with no therapy coverage out-of-network
  • No health insurance

Medicare coverage details

Medicare has certain restrictions regarding payment for outpatient physical therapy. Please review the following information to make sure your visits will be covered by insurance.

We do not want you to encounter any issues which would result in you being billed for physical therapy services.

  • If you plan to receive physical therapy at another clinic for a separate issue, please schedule your visits on different days of the week. Medicare will not pay for more than one outpatient physical therapy visit on the same day.
  • If you are receiving home health services, you must be completely discharged before starting outpatient physical therapy. Medicare will not pay for home health services and outpatient physical therapy during the same timeframe.
  • If you are receiving physical therapy at separate clinics, it needs to be for distinctly different issues/body parts. For example, shoulder therapy and vestibular therapy would be considered separate issues by Medicare. However, balance therapy and leg strengthening should not be done concurrently, as they are related.

Billing and payments

We will collect your portion of the payment (co-insurance, deductibles) at each visit. We accept all major credit cards, checks and cash.

Blue Cross/Blue Shield: These insurance companies send payment for our services to the patient/subscriber. Therefore, we collect the payment in full at each visit and submit the claims to insurance. This allows you to deposit/cash the insurance checks as they arrive and keeps your balance up-to-date with Vortex. (Alternately, you can choose to pay our discounted private rate and submit the receipts to insurance for reimbursement.)

If you have questions about your coverage, we encourage you to call your insurance company prior to treatment. You are responsible for knowing what your insurance plan covers and paying us your portion of the cost for our services. If you have questions about your insurance coverage or payment obligations, please contact our office manager at (408) 540-7622.

ATTENTION: As of January 1, 2014, you no longer need a prescription to see a physical therapist in California. Patients can directly access physical therapy treatment for 45 calendar days or 12 visits after which time the patient must have a physician approve the plan of care developed by the physical therapist. Read more about Direct Access.

Insurance Coverage

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.

Read More About Our Insurance and Billing Policy

New Patient?

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.

Download Your New Patient Form

Cancellations & No Shows

We require 24 hours notice to cancel or reschedule an appointment. If you do not provide enough notice, we are unable to offer the time to another patient, leaving a hole in your therapist's schedule. This creates a financial burden because if you don't come for your appointment, we do not get paid by insurance. Physical therapists are paid for time spent with a patient.

Therefore, Vortex may charge you $50 for late cancellations; $75 for no shows. These fees are NOT paid by insurance; they are owed by the patient and are collected at the next scheduled appointment.

Need to cancel? Call us now.

Learn More About Our Policy