Out Of Network Insurance

What does Out of Network really mean?

OUT OF NETWORK does not mean we do not take that insurance, it means you will get reimbursed at a different rate.  That rate differs depending on what the clinic or hospital charges.  Here is how it works.

  • You pay Oceanside PT at the time of service. See the chart below.
  • We will bill your insurance through our software system.
  • You will be reimbursed by the insurance company at a rate they feel is reasonable. This amount will be less than you pay and will vary depending on your insurance and the clinic you go to.

The Oceanside PT rate allows us to cover expenses.  Current contracted rates are below this amount and we will not be able to remain in business if we continue to agree to the current contracts. If physical therapy is an important aspect of your health care, we urge you to opt for a plan that pays providers a respectable rate.

 How does this differ from out-of-pocket of cashed based PT?

The reimbursement amount may be the same.  However, because we are In-Network with many insurance companies and have a software system designed to bill efficiently, we will submit the claim for you.  Many clinics will give you an invoice to submit to the insurance company by yourself.  We take this headache away from you.

Always check your benefits, plans vary greatly.