OPTM Therapy | General FAQ
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General FAQ

Do I need a doctor’s referral before going to physical therapy?

 

  • There is direct access for a limited number of visits to physical therapy without seeing a doctor.
  • A doctor’s referral is required for Medicare coverage.
  • Insurance payment is based on medical necessity as determined by your medical insurance.
  • A referral from your physician supports medical necessity.
  • Most insurance companies require a referral from an MD that contains a diagnosis, frequency and duration.

 

 

What should I bring to my first visit?

 

Please come 15 minutes early to allow time to complete the paperwork.

 

  • Your insurance card.
  • If you have Medicare, please bring your secondary or supplemental insurance card.
  • Your signed MD referral.
  • If a patient is a minor, a parent or guardian must accompany the patient for the first visit.
  • A payment towards your co-pay, co-insurance, and/or deductible will be collected.  We accept MC, VISA, personal check, or cash.

 

 

What are your hours and how soon can I be seen for an appointment?

 

  • Our Los Gatos facility takes their first appointment at 7:00 am and their last appointment at 6:00 pm.
  • Our Willow Glen facility takes their first appointment at 7:30 am and their last appointment at 5:30 pm.
  • Both are Monday through Friday.
  • Will depend on the day, time and/or therapist desired.

 

 

Will you bill my insurance company?

 

  • We are PPO providers with most major insurance companies and will bill them daily electronically.
  • We are out of network providers for United Healthcare, but will bill them if you have out of network benefits.
  • If you have Medicare, we will bill both Medicare and your supplemental/secondary insurance.
  • We bill Works Compensation insurances directly.
  • We do not bill any HMO plans.
  • We do not bill 3rd party payers.  You would be responsible for the full amount at each visit.  Upon discharge, we will provide you with an itemized statement to submit for reimbursement.
  • We do not accept attorney liens.

 

 

 

Do I need to pay at each visit?

 

  • Yes, a payment towards your co-pay, co-insurance, and/or deductible will be collected.  We accept MC, VISA, personal check or cash.

 

 

What if I don’t have insurance?

 

  • The cost of your visit will vary depending on the treatment received at each appointment.
  • Visits vary from $80-$180.
  • To discuss financial consideration, please contact our business office at (408) 979-2300.

 

 

 

How long are the appointments?

 

  • Treatment time varies depending on the procedures and your strengthening program.
  • 30 minutes will be directly with your therapist and you will be performing therapeutic activities for 30-45 minutes.
  • You should allow about an hour to complete your appointment.