How to Get Reimbursed for Physical Therapy: A Guide to Out-of-Network Benefits
Quality Care, Without the Red Tape: A Guide to Out-of-Network Reimbursement
At Zimmer Physical Therapy, we do things differently. You may have noticed that we operate as an out-of-network provider. While that might sound like extra paperwork, it is actually the secret to why our patients get better, faster.
By stepping outside the traditional insurance "factory" model, we aren't limited by "pre-approved" visit counts or narrow treatment lists dictated by an insurance adjuster. You get 100% of our focus, which leads to faster results in fewer visits.
The best part? You can still get paid back by your insurance company. Here is how it works.
What is a Superbill?
A Superbill is a specialized, detailed receipt that we provide after every session. It contains all the specific clinical codes (ICD-10 and CPT codes) that your insurance company needs to process a claim.
3 Simple Steps to Get Reimbursed
Pay at the time of service: We accept all major credit cards, as well as HSA (Health Savings Account) and FSA (Flexible Spending Account) cards.
Submit your Superbill: We’ll email you your Superbill. You can then upload it to your insurance provider’s member portal or use a streamlined app like Reimbursify.
Receive your check: Depending on your specific PPO plan, your insurance company will mail a reimbursement check directly to you. Many of our patients receive 50–80% reimbursement after meeting their out-of-network deductible.
What should I ask my insurance provider?
Before your first visit, we recommend calling your insurance company to confirm your benefits. Ask these three questions:
"Does my plan provide 'out-of-network' benefits for physical therapy?"
"What is my out-of-network deductible, and has it been met?"
"What is my 'co-insurance' percentage for out-of-network care?"
Focus on Healing, Not Billing
Our goal is to provide a transparent experience with no hidden "facility fees" or surprise bills arriving months later. By choosing an out-of-network model, you are investing in high-quality, human-centered care that puts your goals—not an insurance company’s bottom line—first.
Have questions about your specific plan? Contact us today and we can help you navigate the process so you can get back to doing what you love in Tahoe City, Truckee, or Incline Village.