How the Superbill & Reimbursement Process Works
Our reimbursement process is straightforward and puts you in control. Here's how it works:
At a glance: Zenith is a direct-pay clinic. We don't bill insurance directly, but we provide detailed superbills so you can submit claims and receive reimbursement through your out-of-network benefits. Many clients receive 60–80% back.
How the Superbill & Reimbursement Process Works
Our reimbursement process is straightforward and puts you in control.
Here's how it works:
1. Pay Upfront for Care
You'll pay for each session at the time of service. We accept credit cards, HSA, and FSA payments.
2. Receive an Itemized Superbill
After each visit, we'll provide you with a detailed superbill that includes:
- Service dates and times
- CPT codes (billing codes for each treatment)
- ICD-10 codes (diagnosis codes)
- Provider NPI and tax ID
- Total charges
Superbills are typically available within 24 hours after your session.
3. Submit Your Claim to Insurance
You submit the superbill to your insurance company. Most insurers accept claims via:
- Online portal (fastest)
- Mobile app
- Mail (check your plan for the correct address)
- Fax
4. Receive Reimbursement (If Approved)
Once your claim is processed, your insurance company will send reimbursement directly to you—typically via check or direct deposit.
Processing times vary by carrier, but most clients see reimbursement within 2–6 weeks.
Important Things to Know Before Submitting a Claim
Verify Your Out-of-Network Benefits
Before your first visit, we strongly recommend calling your insurance company to verify your out-of-network physical therapy benefits.
Questions to ask:
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Do I have out-of-network physical therapy benefits?
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What is my out-of-network deductible, and how much have I met?
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What percentage does my plan cover for out-of-network PT?
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Is there a visit limit or annual maximum?
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Do I need a referral or pre-authorization?
HSA & FSA Payments
Physical therapy services at Zenith are HSA and FSA eligible. You can pay with your HSA/FSA card at the time of service, and we'll provide documentation for your records.
Motor Vehicle Accident (MVA) Claims
If you're seeking care after a motor vehicle accident, your auto insurance (PIP or MedPay) may cover treatment.
We bill PIP claims directly when you have active coverage. Contact us before your first visit so we can verify your coverage and coordinate billing appropriately.
4. Receive Reimbursement (If Approved)
Once your claim is processed, your insurance company will send reimbursement directly to you—typically via check or direct deposit.
Processing times vary by carrier, but most clients see reimbursement within 2–6 weeks.
Insurance Plans That May Not Be a Good Fit
While many clients successfully receive reimbursement using a superbill, not all insurance plans are a good match for Zenith's direct-pay model.
Some plans are designed to limit or restrict out-of-network care—even when the care is clinically appropriate.
You may encounter challenges if your plan:
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Does not include out-of-network benefits
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Requires referrals or pre-authorizations for reimbursement
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Has very high deductibles that must be met first
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Reimburses at very low rates for physical therapy
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Routinely denies claims regardless of documentation
In these cases, reimbursement may be minimal or not available, even with a complete superbill.
Why Zenith Doesn't Participate With These Plans
Zenith chooses a direct-pay model so we can provide:
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Longer, one-on-one sessions
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Clinician-led care (not tech-based or volume-driven)
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Individualized programming without visit caps
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Decisions based on outcomes—not insurance rules
Participating in restrictive insurance plans would require us to shorten visits, limit care, or compromise clinical decision-making, which does not align with our standards or your goals in many cases.
What to Do If Your Insurance Isn't a Good Fit
If your insurance plan does not reimburse out-of-network care well, many clients still choose Zenith because:
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They value time, expertise, and individualized attention
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They want help with movement, not a single issue.
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They use HSA or FSA funds
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They want faster progress without administrative delays
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They value our performance physical therapy care
Our team is always happy to help you:
- Understand your options
- Decide if direct-pay care makes sense for you
- Explore the best path forward—without pressure
Bottom line: We believe healthcare should be built around people, not policies. While insurance reimbursement can be helpful, it should never dictate the quality of your care.
What Zenith Provides — and What Clients Handle
We want to set clear expectations about what we do—and what you're responsible for.
What Zenith provides:
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Itemized superbills with all required codes and information
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Superbills are readily available 24 x 7 in the client portal or delivered within 24 to 72 hours upon email request.
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Answers to questions about our billing and documentation
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High-quality, individualized care without insurance restrictions
What clients handle:
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Verifying out-of-network benefits with their insurance company
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Submitting claims to their insurance carrier
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Following up with their insurance on claim status
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Understanding their plan's coverage, deductibles, and reimbursement rates
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Prompt payment and clear communication
We do not:
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Bill insurance directly (except for PIP claims)
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Guarantee reimbursement amounts or timelines
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Navigate insurance appeals or denials on your behalf
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Accept insurance assignment of benefits
Ready to Get Started?
Real People. Real Progress.
Questions About Reimbursement?
We're here to help you understand the process. If you have questions about superbills, documentation, or how our direct-pay model works, reach out.
If you have questions about your insurance plan, coverage amounts, or claim status, you'll need to contact your insurance company directly—they're the only ones who can provide plan-specific information.
Ready to get started?
Book a free consultation to learn more about how Zenith can help you move better, feel stronger, and perform at your best.