Catalyst Sports Performance & Rehabilitation Guide To Determining Out of Network (OON) Physical Therapy Benefits

1. Contact Your Insurer to Determine Benefits- Significant differences exist between various insurers and plans.  Please contact a customer service representative at the number listed on the back of your insurance card to ask if they offer out of network outpatient physical therapy benefits. 
2. Obtain a confirmed quote for outpatient physical therapy out of network benefits.  Things to ask:
   • Do I have OON benefits for outpatient physical therapy?
   • Do I have a deductible and if so how much is it?
   • How much of the deductible has been met already?
   • What % of my coverage is my responsibility for seeing an OON or non-preferred provider?
   • Does my policy require a referral or prescription from my primary care physician (PCP)?
   • Does my policy require pre-authorization or a referral on file for outpatient physical therapy services?
   • How can I submit claims and reimbursement forms and what is the process?
3. Submit the provided “superbill”/invoice for services to the insurer for reimbursement.