1. What is Mesa Physical Therapy’s Tax ID number?
2. What is the protocol to refer a worker’s compensation patient to Mesa PT for therapy?
3. Can Mesa Physical Therapy request pre-authorization on worker’s compensation patients?
6. What insurances is Mesa Physical Therapy contracted with?
7. What is the protocol to refer a private insurance patient to Mesa PT for physical therapy?
8. What is the protocol to refer an HMO insurance patient to Mesa PT for physical therapy?
9. How can I refer a cash patient to Mesa PT for physical therapy?
10. Can Mesa Physical Therapy accommodate splinting for your patient the same day?
11. What is the protocol for referring a Work Comp patient to Mesa PT for splinting?
13. What is the protocol for referring a HMO insurance patient to Mesa PT for splinting?
14. Can I refer a Medicare patient for splinting to Mesa Physical Therapy?
1. What is Mesa Physical Therapy’s Tax ID number?
Insurance claims are submitted under the Mesa Physical Therapy name and Tax ID number.
Name: Mesa Physical Therapy
Tax ID #: 27-4418547
2. What is the protocol to refer a worker’s compensation patient to Mesa PT for therapy?
Pre-authorization is always required for work comp patients needing treatment and/or any splints and materials. In order for the authorization to be processed as quickly as possible and have the patient scheduled, please fax the following to Mesa Physical Therapy at (805) 823-6525.
- A prescription referring the patient for therapy and/or splint.
- The patient demographics including insurance carrier, claim number, date of injury (DOI), and if available, name and phone number of the adjuster. With this information we will be able to follow up on the status of the patient to ensure treatment and approval.
- The PR2 * from the patient’s last visit with the doctor
- Signed RFA form from the referring doctor
*The PR2 is the doctor’s report
3. Can Mesa Physical Therapy request pre-authorization on worker’s compensation patients?
Yes, we are able to request pre-authorization. Doctor’s offices have the option of either requesting authorization directly or sending us the information listed below for us to initiate the authorization process. Either way, Mesa Physical Therapy is prepared to accommodate each doctor’s specific needs.
In order for Mesa Physical Therapy to request pre-authorization and get the work comp patient scheduled as soon as possible, please fax the following to Mesa Physical Therapy at (805) 823-6525.
- Claim Number
- Adjuster Information (name and phone number)
- Date of Injury
- Name of Employer
- Worker’s Compensation Company
- Signed RFA form from the referring doctor
- Rx Form
4. What is an RFA form?
The RFA form is a new form required by work compensation claims. It accompanies the Rx and PR2 in the authorization request form and the doctor must sign it. Please let us know if you need one and we will be happy to accommodate by filling one out and send it over to you and obtain the doctor’s signature. Once we receive an RFA form signed by the doctor we will then request authorization.
Please do not hesitate to contact us at 1(858) 277-2277 if you have any questions.
5. What is a PR2?
PR2 stands for Physician’s Progress Report. This is the treating physician’s primary report for the patients visit. A PR2 is one of the documents required when referring a worker’s compensation patient to physical or hand therapy.
6. What insurances is Mesa Physical Therapy contracted with?
Through our network affiliations, Mesa Physical Therapy has the most comprehensive contracted list of payers. We are contracted with:
- Most private/PPO insurances
- Medicare & Medicare Advantage
- Worker’s Compensation
- TriCare/TriWest, VA & Military
- HMOs such as Healthnet. We are also a contracted provider with SCRIPPS Employee.
- Currently accepting all Covered California plans
Mesa Physical Therapy is NOT contracted with:
- Any Senior Plans through SCRIPPS, including: Secure Horizon, Senior Plus plans or Scan.
- Any SHARP HMOs
- Kaiser HMO
If you would like to confirm whether we are a contracted provider of the patient’s insurance please do not hesitate to call us at (858) 277-2277 or fax the patient’s information to (805) 823-6525.
Our front desk will be happy to confirm whether we are contracted with that specific insurance and will let your office know right away. If you prefer, you can always easily search through the alphabetized insurance list on our website.
Click here to view list of insurance accepted
7. What is the protocol to refer a private insurance patient to Mesa PT for physical therapy?
In order to expedite the referral process of a private insurance/PPO patient and have the patient scheduled as soon as possible, please fax the following to Mesa Physical Therapy at (805) 823-6525.
- A prescription referring the patient for therapy and/or splint.
- The patient’s contact information enabling us to follow up directly to set up an initial evaluation appointment.
8. What is the protocol to refer an HMO insurance patient to Mesa PT for physical therapy?
Mesa Physical Therapy is contracted with Healthnet HMO. We are also a contracted provider with SCRIPPS Employee.
In order to expedite the referral process of an HMO patient and have the patient scheduled as soon as possible, please fax the following to Mesa Physical Therapy at (805) 823-6525.
- A prescription referring the patient for therapy and/or splint.
- The patient’s contact information enabling us to follow up directly to set up an initial evaluation appointment.
- Authorization, if you have it.
(Special Notes for Specialist Offices: Fee for service insurances have to be submitted by the specialists office, but, once you get the tracking number you can fax it over to us at (805) 823-6525 and we can schedule the patient. Additionally, if you are a Specialist Office referring a patient with United Healthcare through Scripps insurance, we are able to submit for authorization.)
9. How can I refer a cash patient to Mesa PT for physical therapy? Mesa Physical Therapy offers patients that would like to pay cash, a flat rate of $85 dollars per visit. The treatment will include an evaluation, a full-specialized plan of care including any indicated modalities, manual therapy, therapeutic exercise and a personalized home exercise program. If the patient requires splinting with a Certified Hand Specialists (CHTs), the cost will be a flat cash rate plus the cost of supplies.
In order to expedite the referral process of a cash patient and have the patient scheduled as soon as possible, please fax the following to Mesa Physical Therapy at (805) 823-6525.
- A prescription referring the patient for therapy and/or splint.
Protocols to refer a patient to Hand / Occupational Therapy for custom made splinting
10. Can Mesa Physical Therapy accommodate splinting for your patient the same day?
Mesa Physical Therapy is committed to avoiding delay in patient care. If your patient needs a splint ASAP, we will do our best to work them into our schedule that same day! You can ALWAYS call us at (858) 277-2277 even before the patient leaves your office to see if we can get them in immediately and then proceed to fax us the patient’s insurance information.
Upon receiving the patient’s insurance information we will submit for authorization directly to the insurance, and verify coverage.
11. What is the protocol for referring a Work Comp patient to Mesa PT for splinting?
Time is crucial when it comes to getting authorization for splints for work comp patients.
Please make sure to fax the following patient information as soon as possible to (805) 823-6525 in order to start the authorization process right away.
- A prescription referring the patient for therapy and/or splint.
- The patient demographics including insurance carrier, claim number, date of injury (DOI), and if available, name and phone number of the adjuster. With this information we will be able to follow up on the status of the patient to ensure treatment and approval.
- The PR2 * from the patient’s last visit with the doctor and/or the details of the visit matching the date of the Rx when the patient was referred for therapy or splinting.
- Signed RFA form from the referring doctor.
*The PR2 is the doctor’s report
(ATTENTION SURGEON OFFICES: We strongly recommend faxing the information listed above to Mesa Physical Therapy as soon as you know the patient is scheduled for surgery. This will enable us to begin the request for authorization and avoid delay in patient care. Please be advised that worker’s compensation authorization for splinting after surgery has a tendency to have a longer wait time.)
12. What is the procedure followed internally when a worker’s compensation patient is referred to Mesa PT for splinting?
In order to expedite the referral process of a private insurance/PPO patient and have the patient scheduled as soon as possible, please fax the following to Mesa Physical Therapy at (805) 823-6525.
- A prescription referring the patient for therapy and/or splint.
- The patient’s contact information enabling us to follow up directly to set up a splinting appointment.
Once we receive the information listed above we will verify the coverage of the requested item and let the patient know if they have a share of cost, as soon as possible.
13. What is the protocol for referring a HMO insurance patient to Mesa PT for splinting?
HMOs always need authorization prior to service.
In order for us to submit for authorization and expedite the referral process of an HMO patient, please fax the following to Mesa PT at (805) 823-6525.
- A prescription referring the patient for therapy and/or splint.
- The patient’s contact information enabling us to follow up directly to set up a splinting appointment.
It is important to note that some HMOs do not cover splints. When this happens we try to work with the patient as much as we possibly can. If the patient’s HMO insurance does not cover the splint recommended by the doctor: we will bill the insurance for the time required to fabricate the splint and offer the patient a discounted cash rate on the supplies used. Dependent on when we receive the patient’s insurance information, we do our best to notify patients of any expected expenses prior to service. We do recommend, however, that the patients take initiative to check directly with their HMO insurance to see what is covered in their benefits plan prior to their splinting appointment.
14. Can I refer a Medicare patient for splinting to Mesa Physical Therapy?
Medicare does not pay for splints or other supplies. With that being said, Mesa PT will go above and beyond to try and accommodate Medicare patients that need splinting.
When a Medicare patient is sent to Mesa PT for a splinting, we will:
- Bill Medicare for the evaluation
- Bill the patient for the cost of the supplies to make the splint
Medicare requires an Rx form from the referring doctor to initiate therapy. Every Rx has a 30-day expiration date after which, if needed, we will submit an updated Rx and a Progress Note back to the patient’s doctor for signature and approval. Please fax both the signed RX and Progress Note back to Mesa Physical Therapy at (805) 823-6525 in order for the patient to be able to continue therapy.
