OccuSport Physical Therapy

Billing & Insurance Information

Filing Your Insurance

1. We will submit your services directly to your insurance company.
2. We will work with you and your insurance company to receive payment for services.
3. Deductibles, coinsurance, and co-pays are due at the time of services.
4. We will file third-party claims (auto, personal injury).  If claims are denied, the patient will be responsible for the balance.

Managed Care Contracts

OccuSport Physical Therapy is affiliated with various Managed Care Health Plans.

1. Patients should be aware of the requirements of their insurance policy. 
2. Prior authorization / PCP referral may be needed for treatment to begin.  

We participate in the following managed care contracts:

• Admar Corporatins
• Atena
• BC/BS PPO POS Workers Choice
• BCEEmergis
• Beech Street PPO
• Cigna PPO, POS HMA
• Health Marketing (HMI Super PPO)
• National Provider Network, Inc. (NPN)
• United Payors and United Providers PPO
• All United HealthCare
• Corvel Corp. W/C, Core-Care PPO
• First Health PPO, W/C
• Galaxy Health Network PPO, W/C
• Great-West Healthcare PPO, POS, HMO
• Health Dynamics PPO
• Medicare Part B
• Private Health Care Systems (PHCS)
• Union Pacific Railroads Employees Health Systems
• USA Managed Care Organization
• Health Marketing Inc (HMI Super PPO
• Health Network
• HFN/PPO, WC
• HMO/IL, BC/BS (Southland, DuPage and Kane County IPA only)
• Humana PPO, POS, HMO/ Medicare Gold Plus
• MultiPlan PPO, WC
• Railroad Medicare
• Unicare/Wellpoint HMO,PPO, POS

Registration Forms

Below are the forms that need to be completed by new patients. For your convenience, click on the forms you need, fill them out, and bring them with you to your first appointment.

Patient Information Form

Consent to Treat Form

Patient Medical History Form

MediCare Form

Job Demands Employee Version