New Client Paperwork
At Back On Track and Pleasanton Physical Therapy, our goal is to help make your recovery with physical therapy quick and seamless. Here you can find downloadable intake forms.
Please download, print and fill out to bring into your first appointment. Bring your insurance card and a valid form of ID. We advise arriving about 15-20 minutes prior to your appointment so we can submit your paper work and go over your insurance plan verification.
You will ONLY need to print out the forms that best pertain to you. If you have any questions, feel free to give any of our locations and we will be happy to help.
When you schedule a physical therapy appointment (and you wish to bill your treatments through your insurance) our admin staff will work to verify your insurance benefits and inform you before beginning treatment.
We accept patients without a physician referral.
We accept most insurance plans
including but not limited to the following:
- Anthem/ Blue Cross
- Blue Shield of California
- Contra Costa Health Plan
- John Muir Physician Network
- Worker Compensation
- Health Net
- & more
Insurance Terms 101
We understand that your insurance eligibility may be difficult to understand. As a courtesy, our front admin staff will verify your eligibility and benefits for physical therapy prior to your first visit. Here are some terms that represent the portion of the medical bills that you are responsible for.
Your copay is the fixed amount that you pay for when you come to physical therapy. Copays are significantly less than your deductible amount and vary from patient to patient depending on your insurance plan. Back on Track and Pleasanton Physical Therapy will collect your copay prior to each visit.
A deductible is a fixed amount that you must pay out of pocket before your insurance can cover the remaining medical expenses. Depending on the insurance plan, a deductible can range from $0 to thousands of dollars.
A coinsurance is the percentage amount of the medical bill that you are responsible for and the percentage that your insurance will cover. For example, somebody with a 80/20 plan is responsible for 20% of the bill and their insurance will cover the remainder of the amount which is 80%. The coinsurance is paid after meeting the deductible.
Saturday & Sunday: Closed