Fees & Insurance

As a courtesy to our patients, we will submit claims for you. We will verify your insurance. We will not guarantee the accuracy of the information we receive from them, nor is it a guarantee of payment. You should contact your insurance company directly with specific questions regarding your policy. Your insurance is a contract between you and your insurance company. You are responsible for your bill according to your plan specific benefit.

Pelvic Wellness Center contracts with most insurance companies providing coverage to residents of Marion County, Oregon. Pelvic Wellness Center currently contracts with the following insurance companies:

Regence/Blue Cross Blue Shield, Providence, Pacific Source (commercial plans only, NOT community plan), First Choice Health Network, Kaiser Permanente Added Choice Point of Service plans, Medicare and Moda. We are also contracted with Regence Medicare Advantage and Providence Medicare Advantage plans.

*If you don’t see your insurance carrier on this list, please call our office for more information as this list is periodically updated .

Out of Network Insurance Companies

We do not bill out of network insurance companies. We will provide you with worksheet to assist you in process of understanding what your out of network coverage is when contacting your insurance customer service. Our office will also supply you with a superbill (detailed receipt) upon request so you are able to submit for reimbursement if you have out of network benefits.

If you have questions regarding insurances accepted, pre-authorizations, or services rendered, please contact us.


You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

•Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit  www.cms.gov/nosurprises or call  our office at 503.983.8811.


Co-payments and Deductible Estimate payments are due at the time of service. You are responsible for payments of all co-pays, deductibles, and co-insurances associated with your plan. We do offer self payment options. For self payment, our office will provide you with a detailed invoice (”superbill”) for you to submit to your insurance for ”Out Of Network” reimbursement upon request.

Cancellation Policy

In order to achieve maximum benefit from your physical therapy, it is important to maintain regular visits as prescribed by your therapists.


If you must cancel, you need to provide a 48-hour notice. If you cancel less than 48 hours in advance, you will be responsible for a cancellation fee of $75.00. This includes “no show” appointments. This payment is not billable to insurance. Failure to contact our office within 24 hrs of no show visit will result in the cancellation of all remaining appointments.

Pelvic Wellness Center reserves the right to change or amend this financial policy at any time.