FAQ

Please use either the Appointments Page or this link to access the Secure Client Portal. This is where you are able to fill out electronic intake forms, request scheduling, and communicate with us. We have all clients fill out our registration & intake packet before scheduling so that we are able to get more done during the initial session with less time spent on 'office forms'. We also have a clearer picture of what is going on with each person since we have had a chance to review your information. You'll get more out of your initial appointment and have more direct contact time with us! Due to the varied needs of our clients we will work with you to make a tailored treatment plan. We do not do 'cattle farm' rehabilitation and aim to really work on what each individual needs within their abilities. It is advised that 3-4 follow ups are booked after the initial appointment, because it can sometimes be challenging to find available appointments if we wait until the week ahead. Follow-up packages with discounts are available (please see below for that information). Initial appointments are not discounted due to the time we spend formulating a treatment or training plan as well as report writing.

Evaluations range from 60 minutes to 120 minutes depending on the clinician and the issue; follow-ups are usually 60 minutes, though we can arrange for longer if it makes sense for your needs. Sometimes this is because it is easier to be seen for longer sessions less often due to childcare, driving time, or your time off from work. We do try to follow what is called a 'therapy hour' where the last 5-10 minutes of most sessions are not direct contact with the client which leaves the practitioner with a few minutes to clean-up equipment & manage documentation or exercise plans related to your session. The practicioner will make every effort reasonable possible to stay on time. If you are running late to your appointment, please let us know in the portal (for us this is easier for someone to see than the phone) but you can also call & leave a message if that's better in an urgent situation. We never double or triple book you with other clients in the same session.

There is no pressure to buy a follow-up package, you can always book one-by-one visits at the usual $175/hour rate. Follow-up Packages purchased for 60 minute sessions of either 1:1 fitness or 1:1 rehabilitation are found below. They are good for 9 months from purchase date. There are no refunds. Due to how the billing software functions, we are not able to apply prior visits, or same-day visits, to a package. 6 sessions $900 ($150/session) 5 sessions $775 ($155/session) 4 sessions $640 ($160/session) 3 sessions $495 ($165/session) 2 sessions $340 ($170/session) FollowUp Packages are not applicable to any Initial Evaluation or ReEvaluation type visits, which we are periodically legally required to do. (Evaluative type appointments involve much more time outside of the visit for the clinician to complete documentation.) Clients are able to view in their portal how many visits within a package they have remaining. We do not keep track of expiring packages or package visits. However, the software will send an automatic reminder if there are any unused visits on a package 30 days before it expires, which is 9 months from purchase. Clients may self-purchase additional packages by clicking “BOOK” in the portal & scrolling down to "All Follow Up Packages". *ORIGINAL MEDICARE patients: packages do not apply to you as that is the only insurance we do bill directly. We are unable to see Medicare clients for longer than 60' visits due to complications with insurance billing.*

We are considered an ‘out of network provider’ for all commercial insurances. We do provide Superbills and all medical documentation needed. Additionally, Pondera Rehabilitation & Fitness PC provides a service/free app for our patients called Reimbursify so you do not have to deal with submitting claims, forms or faxing your insurance company. Pondera Rehabilitation & Fitness PC is a registered (traditional) Medicare Provider for InHome (Part B/outpatient) visits only so we do bill them directly. Sliding Fee Scale cases: we update on social media when we are accepting applications for such cases. Please see our other FAQs for more details on related topics such as reimbursement and rates for visits or packages for follow-ups.

In general, our rate is $175/hour. There are no additional costs associated for use of imaging ultrasound, documentation or Superbills. There is a price reduction for follow-up appointment packages for rehabilitation or performance fitness (see related question for details). There are some concussion baseline testing appointments (ie before one has sustained a concussion) that are shorter duration, hence the rate is lower. If you are seeing someone for any type of InHome/mobile visits (pelvic health, musculo-skeletal, neurological), there are different rates for those visits & they are only done within a small radius for certain cases. Please inquire when you register for our secure portal in the messaging thread. Follow-up Packages purchased for 60 minute sessions of either 1:1 fitness or 1:1 rehabilitation are found below. There is no pressure to buy a follow-up package, you can always book 1 by 1 visits at the usual $175/hour rate. 6 sessions $900 ($150/session) 5 sessions $775 ($155/session) 4 sessions $640 ($160/session) 3 sessions $495 ($165/session) 2 sessions $340 ($170/session) *Medicare clients: none of this applies to you as that is the only insurance we do bill directly. We are unable to see Medicare clients for longer than 60' visits at any time.*

Pondera Rehabilitation & Fitness provides a service called “Reimbursify;” they will do the necessary work for any additional forms & submissions to your insurance company so that you may receive reimbursement according to your plan’s benefits. There are two main ways to access Reimbursify, either through their free downloadable app, or through this web-based link below called File Fast. Download Reimbursify App

Please use this worksheet when contacting your insurance:

FOR FITNESS PERFORMANCE: You do not need a referral if we are not treating a specific diagnosis or condition. For example, if you are being seen with a focus on staying healthy, improving your physical fitness, movement assessment &/or injury prevention (cross-training, running, cycling, overall health & wellness goals). FOR REHABILITATION: In the state of California, occupational therapists (OTs) do not need a referral to treat patients. Physical therapists (PTs) are able to see patients without a referral for 45 days or up to 10 visits with no referral under ‘Direct Access’ laws. We will send your initial evaluation to your provider for signature hence why we ask for their contact information on your registration forms. To find out about your own insurance’s plan-specific financial coverage for out of network reimbursement, you may use following insurance worksheet and see related questions on this page about reimbursement via Reimbursify: Insurance Reimbursement Worksheet

In general, yes. Obviously the ability to attend to your own session might be impacted but it is better to have some time to address your needs than to not have any time at all! We love to get kids moving with us when the space, safety and attention allows! In the clinic, younger children can sometimes be incorporated into our session and we can pause as needed for nursing etc. Children who are able to be secured in a carseat or can sit on a bench in the gym are welcome to be in there as long as they are safely staying there, and not disturbing others in sessions. We do have a front waiting area with a sofa but it is not visible from the gym, hence we cannot allow children under 8 years of age to be alone while you are in your session as per insurance regulations. Additionally, there is a front entrance door in that waiting area, so know that your child would be potentially able to leave. If possible, one suggestion would be to try to have childcare help set up for at least your initial evaluation. Additionally, in some cases we are able to do follow-ups via telehealth or mobile visits if that is preferred & helpful for you. Please reach out if you have questions about this. We really want to help you get what you need but will also be mindful of what is safe, and balanced for other clients and your time.

To assess what the pelvic floor muscles are doing, we have the option to use either/or manual evaluation, as well as real-time ultrasound imaging (if you are seeing Amy Zipp, MS OT/L only for ultrasound imaging). No matter what method we use to do testing of the body's systems, we are always discussing this prior and helping you to understand the testing, to give consent if you feel there is information to be gained to help us understand your specific situation's needs. Pelvic health PTs and OTs use internal digital muscle testing to assess the quality of the contraction of the pelvic floor muscles as well as their tension at rest and movement based testing for assessing if there are any other types of prolapse or scarring that may be impacting your body’s ability to work in a functional range. We will not do an internal pelvic floor assessment without a medical provider consent either prior to the 6 week post-birth check up or during pregnancy without signed provider consent--but we can do MANY things in those cases without that aspect to help things improve that are bothersome. An internal pelvic floor muscle test is not always necessary for all pelvic health issues. With the addition of real time ultrasound to clinical practice, we have the advantage of being able to greater assess externally using imaging & without internal testing but still have more objective information to work on. We are also able to start earlier with rehabilitation than the 6 weeks post-birth time if you choose to do so! It is advisable to get into a recovery routine that is evidence based when you feel ready which for many people who are active is much sooner than that time.

Please arrive to the appointment knowing that you will need to either feed your baby/babies, or use a pump in between applications of therapeutic ultrasound & manual techniques.

This is a great question! We are so thankful to have worked with more and more personal trainers who are receiving education to learn about chronic injuries or other female related areas such as pregnancy and how they might impact fitness and health. In some cases a trainer or a coach is an additional member of an interdisciplinary team. Like many professions, there is high-variability in their educational background and experience levels so in general terms, trainers focus on exercises with more basic fitness goals. They cannot evaluate or diagnose for conditions such as a rotator cuff tears, radiating pain, neurological conditions, ulnar nerve impingement, pelvic floor muscle exam or lumbo-pelvic pain. This is really the primary difference. If the evaluation isn’t well-informed, then the approach to goal attainment is going to stall. Knowing what to look & when to refer out are both essential to success. As a general experience level, a trainer would not be able to help with motor coordination retraining to address HOW you are doing exercises. They would not be able to treat you for a medical condition. Also, generally they do not coordinate with other providers who would potentially be helpful for your care, such as post-op surgical protocols, pessary needs during load, referrals for various research based types of injections (ie, PRP, steroids, interventional pain medicine) and following post-procedural protocols. If you have someone you already like to work with, it does not have to mean that you don’t do that fitness aspect any more. The main idea is to get you back to whatever it is you WANT to be doing. We can both work to support you with the best challenges for your improving status. It is common that some healthcare clinicians do not have a strong fitness or training background. That is not the case for Pondera Rehabilitation. We truly 'bridge the gap' between fitness and rehabilitation with both formal training, informal training and actual experience level. We have been involved in training, coaching and education for other fitness and healthcare personnel for many years. We are comfortable designing a cross-training or resistance and conditioning program for a parent who wants to just go to the park & play with their kids without pain, a retiree who wants to travel in their RV smoothly, a high-performing swimmer reaching for reducing their times in the pool, or a fitness-lover who wants to get the most they can out of various workout classes. Additionally, Amy & Kirsten have both worked with a variety of high level athletes ranging from firefighters, collegiate cyclists, semi-pro baseball players, elite runners, to triathletes.

Our best recommendation is to use either a mobile phone or tablet to access the portal and then as you proceed through the intake forms, when instructed to do so, use the device's camera to take photos of the items it might ask for on certain forms (like insurance card if a Medicare client, or the completed bladder & bowel diary if a pelvic health client). Below information may also be helpful: First Login: to login you will need to create an account if you have not already using the "Communication Portal" link on this practice's website to access the secure portal. Enter the information asked for and submit. You will recieve a text message with a 6 digit verification code (one time use). Enter that onto the screen where you have been logging into the portal (your phone or tablet). You now have access to your Pondera Rehabilitation & Fitness secure portal to be able to access the messaging thread, fill out registration/intake electronic forms or book visits once cleared to do so. This basic video shows you how to login, insert credit card info, how to upload a document, as well as how to send messages. You can update your account information using the buttons in the top right. You are also able to access forms or to book follow-up appointments using the BOOK option.

In short, there is not a difference. The code for evaluations for submission to your insurance for reimbursement is different for each license, but all of the other possible 10+ treatment codes are the same between the two licenses. In terms of what goals are being addressed or what treatment approaches, the diagnoses we are addressing and symptoms we are treating...this is all the same in this arena. In some other areas of rehabilitation, there are more significant differences between OT & PT for goals and what they are within their scope to address. But in pelvic health, that is not generally the case. Differences between providers most often has much more to do with training background, varied experiences and exposure to a range of conditions, populations and treatment tools/approaches. Please see the TEAM tab at the top for additional information about each clinician.

In short, the answer is “NO” you do not need to wait. There are so many things we can do to get you moving towards meeting your goals post-partum, or to address issues that might have arisen during birth, or in the early weeks after delivery. Since we are trained on imaging ultrasound, we are able to use that to help you see what you are doing from a motor control standpoint; that is all done externally. Also, many areas that we are working on in the early phase have to do with helping you to regulate relative intra-abdominal pressure, the abdominal wall and early exercise progressions. We will not do any internal examination until you have been cleared by your birth provider but we often do not need that initially anyway.

Good Faith Estimate Effective January 1, 2022, a ruling went into effect called the "No Surprises Act" which requires practitioners to provider a "Good Faith Estimate" about out-of-network care. The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for therapy. The estimate is based on information known at the time the estimate was created. Because Pondera Rehabilitation & Fitness PC is a fixed rate provider, you will always know the cost of your session when you book. A fixed rate means that the amount of time & type of appointment dictates the amount you will be paying. With a fixed rate provider, the amount you spend for an appointment is always known ahead of time and is never more than what it was when you booked. It may turn out to be less if you seek reimbursement from your insurance plan using Reimbursify, a 3rd-party benefit for clients paid for by Pondera Rehabilitation & Fitness PC. Note: A Good Faith Estimate is for your awareness only. It does NOT involve you needing to make any type of commitment. Many clients at Pondera Rehabilitation & Fitness PC do file claims seeking reimbursement after deciding to see an out of network provider with their healthcare service provider using the above service, Reimbursify. It is currently stated that the PHSA (Public Health Service Act) & the GFE do not apply to any clients who are using insurance benefits, including "out of network benefits (i.e.., submitting superbills to insurance for reimbursement). However, because some of our clients have other variable insurance plans with as-yet-unseen stipulations, at this time we are requiring all non- fitness based clients to complete this form until the greater details of the 2022 law are more clear for fixed rate providers. The Good Faith Estimate states that it does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur and will be provided a new "Good Faith Estimate" should this occur. It is not clear under what circumstance this would ever occur within Pondera Rehabilitation & Fitness PC. If this happens, federal law allows you to dispute (appeal) the bill if you and your therapist have not previously talked about the change and you have not been given an updated good faith estimate. The times that this occurs are usually for services rendered in emergency rooms, or planned facilities where the facility may be in-network but a certain provider is not necessarily in your network and that leads to surprise billing. For example, a planned surgery for a total knee replacement, where an on-call back up anesthesiologist is needed but they are not in-network and you are charged for that individual’s services as an out of network provider. This is obviously not the care that Pondera Rehabilitation & Fitness PC is involved in. Under Section 2799B-6 of the (PHSA), health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request, or at the time of scheduling health care items and services to receive a "Good Faith Estimate" of expected charges. Common Service Codes (CPT) at Pondera Rehabilitation & Fitness PC: For fixed rate providers, we do not have set dollar amounts for each code. The total appointment session has a fixed rate so the amount for each code Page 1 of 6is determined by that total time (i.e.; 60 minutes, 90 minutes, etc). 97167 | Initial Evaluation (not a timed code) 97168 | ReEvaluation (not a timed code) 97110 | Therapeutic Exercise (each 15 minutes or portion there of) 97112 | Neuromuscular/NeuroMotor Rehabilitation (each 15 minutes or portion there of) 97140 | Manual Therapy (each 15 minutes or portion there of) 97530 | Therapeutic Activity (each 15 minutes or portion there of) 97535 | Self Care/Activities of Daily Living (each 15 minutes or portion there of) 97150 | Group Therapy (each 15 minutes or portion there of) Common Diagnosis Codes at Below are common diagnosis codes at Pondera Rehabilitation & Fitness PC ; however, the list is not at all exhaustive. With that said, diagnosis codes can change based on many factors. Understand that often a number of diagnoses may be listed to be sure that you are covered for any issues where an insurance company may not pay for certain codes in certain states on on certain plans. Please speak to your therapist with any questions or concerns. Other lack of coordination/poor motor planning/motor dyspraxia (R27.8) Other Muscle Spasm (M62.838) Code for Neuralgia and neuritis, unspecified (N79.2) Pain in Right Shoulder (M25.511) Mixed Urinary Incontinence (N39.46) Fecal Incontinence (F15) Constipation (K59.00) Cystocele; prolapse of anterior vaginal wall (N81.10) Pondera Rehabilitation & Fitness PC recognizes every client's therapy journey is unique. How long you need to engage in therapy and how often you attend sessions will be influenced by many factors including Ongoing life challenges Your schedule and life circumstances The nature of your specific challenges and how you address them Therapist availability You and your therapist will continually assess the appropriate frequency of therapy and will work together to determine when you have met your goals and are ready for discharge and/or a new "Good Faith Estimate" will be issued should your frequency or needs change at a re-Evaluation. Where services will be delivered. Pondera Rehabilitation & Fitness PC is both a mobile outpatient practice as well as telehealth. We do not quote insurance benefits, but do provide a worksheet under the FAQs tab of the website (www.ponderarehab.com/faq) for you to contact your insurance about potential reimbursement for out of network coverage. We bill using common CPT codes which are the same for outpatient rehabilitation whether it takes place in a clinical setting, in a home or via telehealth. This is the clinic/office location as well as the mailing and physical address for services: Pondera Rehabilitation & Fitness PC 7311 Galilee Rd Ste 175 Roseville, CA 95678 Business Tax ID Number: 844767181