Costs & Insurance

Experience Momentum

Thank you for choosing Experience Momentum for your care. As a patient at Experience Momentum, you will assigned a Patient Advocate who will guide you through the financial process of clinical care.

 

Please review our pricing and insurance guide to better understand how we accept payment and how we advocate for you and your care to your insurance carrier. All insurance paying customers will receive a complimentary Patient Advocate who will assist in obtaining the best coverage for your care from your insurance carrier. 

 

Cash Pay Pricing

Visits are 50 minutes in length.

 

Doctor of Physical Therapy

$125 per visit, including evaluations & follow-ups.
Contact us for additional service pricing.

Licensed Massage Therapist

$100 per visit, including evaluations  & follow-ups.
See our Wellness Plan for multiple visit plans.

Registered Dietitians

$110 per visit, including initial consults & follow-ups.
Return to the Nutrition page for multiple visit plans.

 

*You may pay cash for your services and then submit for insurance reimbursement.
**Patients who are under Medicare or Medicaid are not permitted to pay cash for services and then later submit for reimbursement per federal law.

 

Insurance

We proudly accept the vast majority of insurance carriers. As a portion of your service, we will bill and communicate with your insurance carrier for you. To improve the insurance process, Experience Momentum will provide you with a Patient Advocate who is a trained member of our Billing Team to review the specifics of your insurance plan at your first appointment. This information is quoted to us by your insurance company. Our goal is for you to feel educated and empowered in regards to what your insurance does and does not cover. If you have further questions, you will be able to contact your Advocate. Not a fan of your insurance? Read our Blog post on "How to Choose Health Insurance."

The following is intended to help you understand the process of how we bill your insurance and receive payment for Physical Therapist, Massage Therapist, and Registered Dietitian rendered services. Any services that are not covered by your insurance company will be billed to you. 

Billing in a nut shell: Based on your benefits check/quote by your insurance company, we will collect your co-pay and payments at each appointment. This is a requirement by your insurance carrier. At the end of your appointment, we submit a bill to your insurance carrier. We then wait up to 90 days for your insurance carrier to respond and process your bills. This can result in unpaid or overpaid balances due to incorrect quotes initially provided by your insurance. Our billing team will immediately contact you should this be the case. For more information about billing, payment, and an introduction to "Prior-Authorization" continue to read below.

 

Accepted Insurance Payers 

 

We accept payment from the following insurance carriers for Physical Therapist, Massage Therapist, and Registered Dietitian rendered services. Actual coverage is plan dependent, NOT carrier dependent. If your insurance provider is not listed, please contact us so our Billing Team can call them to better understand your insurance plan. 

  • Regence

  • Premera

  • Aetna

  • Blue Cross

  • Blue Shield

  • TriCare

  • MVA-Motor Vehicle Accidents

  • GreatWest

  • First Choice

  • Labor & Industries

  • United Health Care

  • Health Partners (certain plans) 

  • Kaiser Permanente (certain plans) 

Note: we are currently unable to accept Medicare or Medicaid as sources of payment. You may not pay cash for your service and then submit for reimbursement per federal law.

 

Everything Insurance

 

Verification of Insurance Coverage

Our Billing Team will call your insurance company to request verification of your insurance plan and coverage of services. Information that is quoted to our Billing Team by your insurance company is recorded, along with the representative spoken to and a call reference number. However, verification by our Billing Team does not guarantee service coverage, as that is ultimately determined by your insurance company. 

Billing of Insurance

Our Billing Team submits claims for each appointment to your insurance company within one business day of the actual service date. Depending on the insurance company, it can take anywhere from 14 to 90 business days to process claims. Once a claim is processed, our Billing Team will notify you of any remaining amount owed (if any) for the service dates that were billed.  

Prior Authorization

In July 2016, prior authorization became a universal strategy used by insurance carriers to reduce overuse of care. What this means is that a third-party company (I.e. Optum, CareCore, etc.) reviews the evaluation or re-evaluation notes from your provider and decides whether to authorize insurance coverage for future visits. Neither Experience Momentum nor your provider has control over their decision to authorize more visits or not. If you would like to appeal a prior authorization decision, we strongly encourage you to call your insurance company. We understand this process prevents us from providing the optimum level of care you deserve, so if you (the patient) have complaints about this process please contact your insurance company and the Insurance Commissioner. 

Deductibles, Co-Pays, Out-of-Pocket Max

Each insurance plan is unique, but most have a deductible, a co-pay, and an out-of-pocket maximum. These amounts are determined by your insurance company based on your purchased insurance plan. Your insurance company reports these amounts to your medical providers. Experience Momentum cannot change these amounts. 

Deductibles
Your deductible is the total amount you must pay out-of-pocket for medical services before your insurance will cover all services at 100% of the cost. Your insurance company may not cover the full amount of services at Experience Momentum until you have met this deductible. Check your individual plan for details. 

Co-Pays

Your co-pay is the amount you must pay each time you receive a service and is determined by your specific insurance plan. Your co-pay does not count towards your deductible but will sometimes count towards your out-of-pocket maximum. Co-pays are due at the time of service. 

Out-Of-Pocket Maximum
This amount is the most you will spend out-of-pocket each plan year. Out-of-pocket costs include your deductible and your co-pay. Once you have paid the out-of-pocket maximum, your insurance company may change your costs owed for services. 

Insurance Plan Renewal Date
This is the renewal date of your insurance plan. It is different for each plan and does not necessarily follow the calendar year. Please be aware of the renewal date of your insurance plan, as this is when your deductible, out-of-pocket max and benefits will reset. 

Maximum Visit Allowance

Each insurance plan has a maximum visit allowance for specific services and specialties. Some service specialties are combined to count towards your total maximum visit allowance (I.e. your insurance company may count visits with a Physical Therapist, Massage Therapist, and a Chiropractor all towards your maximum visit allowance). Our Billing Team will help you determine how many total visits you have left to utilize but cannot guarantee accuracy of quotes from your insurance company. Please be aware of your maximum visit allowance, and what services count towards that total.  

Cash Pay Payment

If your insurance plan does not provide coverage for services or you choose not to bill through insurance, Experience Momentum offers cash pay options for all services. Payment is due at the time of service.