Orthopedic and TMJ Physical Therapy Center is contracted with the following insurance networks:
- Regence Blue Cross/BCBSO/Out of state Blue Cross (excluding Silver PeaceHealth
- CareMark for Workmans Comp. SAIF - Auth generally required
- HMA out of WA
- First Choice Health
- Health Net- No ND Rx’s, has to be MD Auth, Centene Corporation Emp. Premier PPO, Basic PPO and High deductible Health Plan PPO, Community Care
- MHN PPO
- MODA – Beacon & Connexus Networks, Medicare Advantage, Synergy Network – SEE LIST BELOW
- Multiplan (Private Health Care Systems)AKA PHCS, OHUS PPO
- PacificSource Health Plans, EBMS, No TMJ coverage, Legacy Health Plan–Call to check benefits
- Prime Health Services PPO
- ProAmerica (Multiplan)
- Providence Health Plans – TMJ ONLY and PPO Network
- Providence Workman's Comp any body part
We are “non-participating” with the following. However, out-of-network may be available:
- First Health (Healthcare Direct, Coventry)
- Great West
- Integrated Health Plan
- Kaiser Added Choice
- Medicare or Medicare Advantage
- MODA – OHSU Employees. Rose City, Affinity, and Cornerstone Networks
- Oregon Health Systems
- Pacific Source - Legacy plus employee only out-of-network
- Principle Financial Group
- PHA (Pacific Health Association)
- Providence – Connective care plan
- Three Rivers
- United Health Care
We do not accept the following insurance at all:
- DHS (OMAP, Oregon Health Plan, Care Oregon, Family Health, Family Care, Medicaid)
- Champ VA/Tricare/Triwest
- Providence Medicare
Please note that insurances accepted are subject to change. We also have a flat fee price available for uninsured patients.
Checking your insurance benefits in advance of your appointment can save you from financial surprises down the road. The following questions below can provide important information about your coverage:
1. Is the Orthopedic & TMJ Physical Therapy Center considered an in-network provider under my plan? If not, what are my out-of-network physical therapy benefits?
2. Do I have a deductible to meet before insurance covers? If so, how much have I met so far?
3. Do I have a copay or coinsurance for visits?
4. Is pre-certification required for outpatient physical therapy?
5. Is a doctor’s referral required for physical therapy?
6. Is there a limit on the number of visits allowed?
7. Is there a TMJ exclusion on my policy (if applicable)
8. Can I get a reference # for the call?