Billing & Payment Information
At Stride Physio, some services may be covered by insurance while others are considered wellness, performance, or specialty services and are typically not covered by health insurance plans.
Insurance coverage varies by plan and service. Our team can help verify benefits and discuss payment options prior to your appointment; however, patients are ultimately responsible for any costs not covered by their insurance.
For services that are not covered by insurance, payment is due at the time of service unless a prepaid package has been purchased.
If you are choosing not to use insurance, discounted self-pay rates and package options may be available. A Good Faith Estimate is available upon request for uninsured or self-pay patients.
We are fully committed to providing you with the highest quality physical therapy and want to foster a lifelong patient/provider relationship regardless of your insurance coverage.
Please contact our office at 206-547-7445 or admin@strideseattle.com for current pricing, package options, and insurance coverage questions.
Pay Your Bill Online
Click the button below to make payment towards your invoice. The "bill ID" number will be on the top right hand of invoice. If you have any issues, please contact us at 206-547-7445
Cash Pay Physical Therapy
Patients who choose not to use insurance may be eligible for discounted self-pay rates when payment is made at the time of service.
If you are uninsured or electing to self-pay, a Good Faith Estimate is available upon request in accordance with federal regulations.
Please note:
- Self-pay discounts cannot be applied retroactively after insurance has been billed.
- Self-pay package discounts cannot be applied to previously completed visits.
- To receive package pricing, packages must be purchased before or at the time of the first visit included in the package.
- Self-pay packages are non-transferable and may not be shared with family members or friends.
- Self-pay packages expire 12 months from the date of purchase.
Specialty Services
Many of our specialty services focus on wellness, injury prevention, performance enhancement, and lifestyle optimization. Because these services are often not considered medically necessary by insurance companies, they are typically self-pay services and are not billed to insurance.
Bike Fits
Available services include:
- Road and touring bike fits
- Spin bike fits
- House-call bike fits (King County only)
- Couples spin bike fits
- Virtual/telehealth bike fits
Ergonomic Assessments
Available services include:
- Workplace ergonomic assessments
- Home office ergonomic evaluations
- House-call visits (King County only)
- Virtual home office evaluations
- Virtual follow-up sessions
Custom Orthotics
Services include:
- Evaluation
- Casting
- Fabrication
- Fitting
- Adjustments
Insurance coverage varies by plan. Many health insurance plans may cover portions of the evaluation, casting, and fitting process but may not cover the fabrication cost of the orthotic device itself. We recommend verifying benefits with your insurance carrier prior to treatment.
Golf Well
Services include:
- Initial Biomechanical Analysis
- Follow-Up Golf Visit
Run Well
Services include:
- Initial Video Gait Analysis and Running Assessment
- Follow-Up Progressive Running Program
- Follow-Up Progressive Running Program (Off-Site Track Visit; King County only)
Weight Lift Well
Services include:
- Evaluation
- Follow-Up Visits
- Package of 6 Visits (12-month expiration)
Health & Wellness Coaching
Services include:
- Annual Wellness Review
- Follow-Up Wellness Planning
- 12-Month Package (12 Sessions Total)
Return to Sport Screen
- 45-Minute Assessment
Blood Flow Restriction Training
- 45-Minute Session
Myofascial Decompression (Cupping)
- 45-Minute Session
Dry Needling
Dry needling is an advanced treatment technique used to reduce pain, improve muscle function, and support recovery. Our physical therapists complete extensive post-doctoral training to safely incorporate dry needling into individualized treatment plans.
Although dry needling may be performed during a physical therapy visit, most insurance plans do not provide reimbursement for this service. If dry needling is recommended as part of your care, an additional out-of-pocket fee may apply.
Many patients choose dry needling because it can:
- Reduce pain
- Improve mobility
- Accelerate recovery
- Decrease the number of visits needed to achieve their goals
Your therapist will discuss whether dry needling is appropriate for your condition and answer any questions about costs before treatment.
Health Insurance Billing
Because we know how frustrating and confusing insurance can be, our customer support team at Stride Physio is here to help you navigate this process with ease. Here’s how billing works:
- Stride will look up your insurance plan, verify your benefit and explain it to you so that you can have a general understanding of your financial obligations prior to the start of treatment.
- For each date of service, Stride will collect your co-pay at the time of service if applicable and apply it to your account.
- Stride then files a claim to your insurance. In turn, your insurance will process this within 45 days (unless other information is required) and will let both you and Stride know what you are financially responsible for in their “explanation of benefits”, (this includes your co-pay, deductible and/or co-insurance).
- Stride will send you an invoice for the remainder you may owe which will be due within 30 days of receipt and you can either pay online, in person, over the phone, via text, or through the mail. Invoices are sent around the beginning of each month, via email from jennifer@strideseattle.com so be sure to add this to your contacts list so it does not get lost in spam. If there is no payment received in 30 days an invoice may be mailed to the address we have on file along with a follow up past due text message. If you have any questions about your bill, please call us at (206) 547-7445 or email jennifer@strideseattle.com.
When you are ready for us to check benefits please call our front desk at (206) 547-7445 or email admin@strideseattle.com . To look up your insurance benefits you will need to provide the following information: name of plan, member ID, and the name and birth date of the plan subscriber.
In-Network Plans
These are the plans that Stride Physio is contracted with and is considered a preferred provider for. These plans set the amount that we get paid. You in turn are responsible for paying for your contracted out of pocket expenses, which include the deductible, co-pays and/or co-insurance*.
- Aetna Medicare Advantage
- Regence (PPO, Boeing, FEP, UMP, Group Administrators)
- Regence Medicare Advantage
- Premera Blue Cross
- Premera Medicare Advantage
- LifeWise
- Medicare
- Auto accident claims (no 3rd party)
- Labor and Industries
Out of network plans
Many insurance companies will reimburse even if Stride is not contracted with them. However, this means that the out-of-pocket cost to you may be higher.
- Aetna
- Kaiser PPO
- First Choice
- Cigna
- United Health Care
- Some HMO plan (Kaiser)
- Veterans Affairs – Tricare (requires referral and prior authorization)
Superbill
A superbill is a detailed receipt that outlines the physical therapy services you received. If you self pay for physical therapy and have out of network insurance benefits, you may request a superbill from us.
Courtesy Billing
Courtesy billing is when the provider submits a claim to your insurance company on your behalf, as a convenience to you.
In this case, you have already paid the provider directly. The provider submits the claim as a courtesy. If Stride receives any reimbursement from the insurance company, the patient will be refunded that amount.
Please note that insurance companies only reimburse amounts allowed under your specific plan. This means you may receive partial reimbursement or no reimbursement, depending on your coverage.
Plans not accepted
Unfortunately, some plans do not allow small businesses like Stride to participate and some plans pay so little that they do not cover our costs. However, this should not be a barrier to you getting good care. Research is clear that getting physical therapy early saves time, money and unnecessary treatment down the road, including MRIs, medications and surgeries. Don’t let insurance interfere with your good health. Stride will work with you via flexible repayment options, HSA plans and shorter or less frequent visits to make sure you get the care you need. Below are plans we can not accept:
- Apple Health
- Medicaid
- Molina
- Some Affordable Care Act (ACA) plans - please give us a call 206-547-7445 to confirm if your plan is accepted
Understanding Health Insurance
Health insurance can be used for physical therapy services that are deemed medically necessary.
Washington is a “direct access” state, which means you can go directly to a physical therapist without the need of a prescription or referral from another provider. However, each insurance carrier has its own rules and may require a current prescription, referral or prior authorization. Stride will identify whether or not your plan requires this and if so, may ask for more information from you.
Insurance Demystification
Understanding insurance and the real cost of health care is often confusing and frustrating. At Stride Physio, we want to be as transparent and clear around what we charge for our services and what you see on your bill. The more you understand how insurance works and how providers bill for their work the more empowered you can be in making choices around your care. We believe the services we provide are of high value at a low cost in both the short and long run. Physical therapy keeps you out of pain, reduces your reliance on medications, prevents the need for and/or improves the outcome of surgeries, minimizes lost days at work and staves off long term disability. Don’t let insurance be the barrier to you getting the best care for your movement system.
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- Billing Insurance: The amount insurance will reimburse and/or release to the patient differs per visit and insurance plan. Since we are a small business, each insurance determines the allowable amounts per our contract with them. This means the insurance company determines how much they will reimburse and how much they will request the patient to pay. Stride Physio has no control over how much your insurance company will leave as patient responsibility. We suggest you contact your insurance company to find out more about your plan benefits.
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- Self pay rates: Because of contractual language with insurance providers, we cannot charge a different rate to people who pay out of pocket versus those who pay with insurance for the same services (despite insurers paying substantially lower than what we charge). However, we can give a discounted rate if you pay out of pocket the day of the service because we are not contracted with your insurance or your insurance deems your visit not medically necessary. See self pay rates above.
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- Understanding your bill: Most insurance policies have deductibles, co-pays and co-insurance (see below for these definitions). You will get an EOB from your insurance carrier, which is NOT a bill. You will then get an invoice from Stride Physio for any amounts owing for deductible, co-pay or co-insurance. In general, Stride asks that you pay your co-pays at each date of service. Should you not understand or agree with the bill we sent, we are more than happy to go over it with you for further clarification.
Glossary of health insurance terms
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- Deductible: this is a set amount that each individual must pay before their insurance benefit will start covering the cost of healthcare services. For PT, if we bill your insurance $240.00 for your visit, and your insurance states the allowable (set rate by insurance company) amount is $120.00, then you will pay $120.00 toward your deductible. Once your contracted deductible is paid, then your insurance covers the bulk of the service and you cover the co-pay and/or any co-insurance which is going to be a percentage of the allowable on the visit. Stride is happy to look up your plan for you to find out your particular deductible.
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- Co-pay: this is a set amount you are required to pay every time you have an appointment with your provider. Many plans consider physical therapy a “specialty” service so they require you to pay a higher amount. Stride asks that you pay your co-pay on the day of your appointment.
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- Co-insurance: once you have paid your deductible, many insurers require that you pay a percentage of the service amount, up to a set maximum out-of-pocket amount. For example, if you have 20% coinsurance on an adjusted bill of $120.00, and your deductible is met, Stride will bill you a total of $24 for coinsurance.
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- Visit Limit: Most insurance plans have a set number of visits for all “rehab” services, including physical therapy, chiropractic, occupational therapy and massage therapy. Once you have reached the visit limit number, then all future visits will have to be paid in full by the client.
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- Prior authorizations: Many plans now require a separate authorization process in order for you to receive services. These prior authorizations have an expiration date and/or a visit limit. These authorizations pre-determine the amount of care you can receive, regardless of the stated number of visits (or dollar amount) in your plan.
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- Medically necessary: This term is used to either accept or deny an insurance claim billed by a provider. It is defined as healthcare services and supplies that are justifiably reasonable, necessary and/or appropriate to diagnose or treat an illness, injury, disease or its symptoms. Your practitioner AND your insurance provider determine what is medically necessary. If you are denied coverage based on lack of medical necessity, your therapist at Stride will appeal this if that does not comport with our clinical judgment.
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- HMO: This is a term for health maintenance organization. These plans keep their costs down by keeping all the work in house. With many of these plans you can still see a provider out of their network, if you are willing to incur greater out of pocket expense.
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- PIP: this stands for “personal injury protection” and is part of auto insurance coverage. In the event of an auto accident, your auto policy will cover your medical bills, up to a specified dollar limit, if you chose to have PIP as part of your policy. PIP claims require a referral for physical therapy. Once the PIP amount is used up, then the claim becomes “3rd party. Stride does not accept 3rd party claims. However, once the PIP is used up you are able to use your health insurance for further services needed and/or pay self pay.
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- L & I: Labor and Industry claims is employer insurance for on-the-job injuries. These claims require referral from another provider in order to receive physical therapy. You will also be asked to provide a claim number, the date of the injury and a case manager name and number.