Insurance

Diagnostic Edge PT is an out-of-network provider with all major insurance providers. This provides both the practitioner and the patients with a number of benefits that will directly enhance the treatment that is provided:

  • Freedom of treatment:

    Being able to decide which area of the body the practitioner will work on the patient should be decided between three people: the practitioner, the patient and the physician, not insurance. Taking insurance out of the decision making equation results in faster and more effective results for the patient.

  • No hidden fees or additional costs:

    All forms of treatment that are provided come with the purchase of a session or package.

  • Appointment Availability:

    More accessibility with less wait directly results in faster healing times. Unlike other clinics where you may have to wait weeks or months before being seen, we will have availability within one week. Weekend appointments may be available, call to find out.

Depending on your health insurance plan, you may have out-of-network benefits that will help to cover the cost of treatment. A special invoice called a Superbill can be provided to each patient for services rendered that may be covered by your insurance or go towards your deductible.

How to Use Your Superbill

A superbill is an itemized document that records the services provided during your appointment. It serves as the primary data source for creating insurance claims, allowing you to get reimbursed for out-of-network services when your provider isn’t directly billed by your insurance.

Review the Document:

Check that all your personal information, appointment dates are correct. If you notice any inaccuracies, contact your provider immediately.

Submit Your Claim:

  • Online Submission:
    Many insurance companies offer online portals where you can upload your superbill along with any required claim forms.

  • Fax or Mail:
    Some insurers prefer that you send your superbill via fax or mail. Be sure to keep copies for your records.

  • Claim Forms:
    Verify if your insurer requires you to complete a specific claim form along with your superbill. These forms are often available on the insurer’s website or by calling their customer service.

Follow Up: Track the status of your claim by contacting your insurance company. Keep copies of all documents and any confirmation receipts from your submission.

Additional Tips for a Smooth Reimbursement Process

  • Know Your Benefits:
    Call your insurance company’s member services to confirm:

    • If you have out-of-network coverage

    • The specific documentation they require

    • The deadlines for claim submissions (often 90–180 days)

  • Keep Records:
    Retain copies of your superbill, any claim forms, and correspondence with your insurer.

Address Denials:
If your claim is denied or only partially reimbursed, contact your insurer to understand why. Ask about the possibility of resubmitting or appealing the decision.

FAQ

    • Government issued ID (ex. Driver’s license)

    • Prescription for physical therapy (if applicable)

    • If under 18, the minor must be accompanied by a parent or guardian

    • Patients should wear clothing that they are comfortable performing exercises in such as shorts, T-shirt and tennis shoes.

    • During your first session, our therapist will conduct a comprehensive evaluation of the affected area. This assessment includes reviewing your medical history, discussing the details of your injury, and examining the area of concern. Based on this thorough evaluation, the therapist will outline an initial treatment strategy tailored to your needs. When appropriate, initial interventions—such as manual therapy, stretching, or strengthening exercises—may also be incorporated during this session.

    • Sessions are 45 minutes long, however an entire hour will be blocked off for each patient to ensure that the session will start on time and allow for unexpected delays.

    • If you cancel at least 24 hours before your scheduled time, you can easily do so through our online portal.

    • For cancellations made within 24 hours of your appointment, please call our office at 650-704-2004.

    • In-network physical therapy clinics often operate under financial constraints due to lower reimbursement rates from insurers. To maintain profitability, these clinics may schedule therapists to treat a high volume of patients—sometimes exceeding 16 appointments per day—or utilize group treatment sessions. Although physical therapy assistants can be valuable in supporting care delivery, it is not uncommon for the clinician who performed the initial evaluation to differ from the provider administering subsequent sessions, potentially impacting the continuity and effectiveness of treatment.

    • Conversely, out-of-network clinics typically offer more individualized care. These settings generally allocate longer, one-on-one treatment sessions consistently delivered by a licensed physical therapist, which may contribute to more personalized care and improved clinical outcomes.

    • Unfortunately, Diagnostic Edge PT does not take Medicare at this time.

    • At the cross street of El Camino Way and James St, travel down James street about 100ft and there will be an entrance to an underground parking garage on the right-hand side. When entering the underground parking, patient parking will be available on the right side where the gate is open.

    • Street parking is also available along El Camino Way and James St for patient use.