One Nine and Health Insurance

Our Therapy and Insurance

One Nine Physical Therapy is an out-of-network provider for all insurances. We operate a curtesy billing procedures, which means that we handle all insurance claims and paperwork and will stay in contact with the insurances through the process to take the hassle out of dealing with the complications of insurance. If this gives you pause, you may want to read on and learn more about how your care may be negatively impacted by insurance reimbursement to in-network therapy. Visiting an in-network therapist is often the cheaper option, but there are a few things to consider before you make your choice based on price alone. At One Nine, we guarantee the highest quality Physical Therapy and Performance services in San Diego and will work to get you the most from your insurance.

Health Insurance Plans we submit claims

 

  • All Major commercial PPO insurance we submit claims to

    • Blue Shield CA

    • Anthem Blue Cross CA

    • Blue Cross/Blue Shield (all states)

    • United Healthcare

    • Aetna

    • Cigna

    • Scripps PPO

  • Medicare (contracted)

  • College Secondary plans (contracted)

  • TriCare

  • Cash-pay

    • Kaiser Physical Therapy

    • UCSD HMO

    • All other HMO

  • Worker’s Compensation

Comparison: One Nine versus in-network physical therapy

About in-network therapy

  1. In-network therapy clinics often treat 2-3 patients/hour and a patient regularly sees the therapist for less than 20 minutes. They do this because they have contracted with your insurance to take less reimbursement for your care. This contract directly dictates the quality of care that you receive, because they must see more patients to stay in business.

  2. In-network therapy requires prior authorization, meaning it can take over a week to see a therapist. A lot can change in a week.

  3. You still have to pay your deductible. That really low number on your card, the co-pay, only applies after you have paid off your deductible - in the same way car insurance does.

  4. You get the treatment that is paid for, not the treatment that you need. Your in-network therapists will do what the insurance will pay for - nothing more. This means they probably won’t check in with you or answer questions outside of treatment time like we do at One Nine.

About One Nine therapy

  1. We do not contracts with the insurance company - we work only for you. You have a contract with the insurance company for them to cover a portion of your healthcare costs.

  2. You pay the same flat, agreed upon rate for every physical therapy visit. No surprise bills.

  3. We handle all the claims paperwork to your insurance on your behalf. Our team will follow up on any claims and deal with insurance when issues arise.

  4. More attention and education means you require less visits, resulting in similar or reduced overall costs to you. Our primary goal is to teach you independence and provide support outside of treatment to get you lasting results. 

Physical Therapy Health Insurance Recap

  • No matter where you go, you pay everything until your deductible is met.

  • The amount you pay elsewhere may be more than expected if your deductible is not met

  • In-network providers cannot discount services. We set our rates competitively and have packages that save you money.

  • Many insurances pay on a per diem basis. This means that no matter how short your appointment is, you pay the same. Our visits are the full time with a therapist 100% of the time.

  • Treatment methods and visits may be limited by insurance for in-network physical therapy

What to ask your insurance when making your decision

We recommend you ask your insurance company the following questions:

  1. Do I have out-of-network benefits?

  2. What is my out-of-network deductible?

  3. How much do you reimburse for out-of-network physical therapy services? (termed co-insurance)