Patient Info

Patient Referral Program

  • Refer a friend, get a gift!
  • Click HERE to find out how.

Patients may be seen at Midwest Physical Therapy with or without a written referral for physical therapy. Many insurance companies, however, require a written referral and/or pre-authorization for payment of physical therapy services.

On your first visit:

  • Arrive 10 minutes early to complete the necessary paperwork.
  • Bring a list of your medications and/or surgeries.
  • Bring your insurance card(s).
  • Bring a recent photo ID.
  • Bring information with the written physician order for physical therapy treatment if you have one.
  • Plan for the session to be 45 minutes, your medical and current injury history will be taken and a physical examination will be performed to determine the nature and severity of the injury.

To save time, please download and complete the following two forms and bring them to your first visit. Click on each one to open.

  1. Patient Information
  2. Patient Medical History

Midwest Physical Therapy Services is dedicated to maintaining the privacy of your identifiable health information. Please carefully review our Notice of Privacy Practices describing how we may use and disclose your identifiable health information, your privacy rights in your identifiable health information, and our obligations concerning the use and disclosure of your identifiable health information

After review of our policy, please sign an acknowledgment of its receipt, Privacy Notice Acknowledgment.

Billing and Insurance Information

Midwest Physical Therapy submits to all major insurance companies. We are providers for the following companies:

  • Blue Cross & Blue Shield: Tier 1 providers (select In-Network Provider) for Select Blue Choice Plans (patients pay the lowest cost-sharing option available on their plans).
  • Tricare
  • Medicare
  • Medicaid
  • Midland’s Choice
  • Cigna
  • First Health
  • Humana

We can work with any PPO plan that has out of network benefits. We would be happy to verify your out of network benefits. Please contact our office should you have any questions regarding insurance coverage or billing.

Verify insurance coverage by:

  • Contacting your insurance company to confirm physical therapy coverage.
  • Determine your insurance company’s:
    • Yearly dollar limit.
    • Number of approved treatment visits for therapy.
    • Need for pre-authorization of physical therapy treatment sessions.
  • Recording the name of the insurance company’s representative.
  • Recording any pre-authorization numbers as provided by the insurance company.