Physical Therapy and Insurance FAQs

It’s busy season at Deep2Peak! Insurance-based PT is currently booking 2-4 weeks out and self-pay appointments are available online but are more limited than usual. Please contact info@deep2peak.com if you are unable to find a time that works for you and we will add you to our cancellation list. If you have an upcoming surgery, we recommend contacting us 2-4 weeks in advance to ensure continuous care. Individual therapists' availability varies.

Yes, although some of our therapists can be waitlisted.

Self-Pay Rates are as follows:

Single Hour $150

Kama'aina Single Hour $125

5-Pack Hours $600

10-Pack Hours $1050

Insurance plans that we accept are as follows:

Mackenzie Brown, LLC (Mackenzie, Brian, Nick):

UHA, HMAA, Medicare, HMSA (PPO, HMO, Akamai Advantage), most out-of-state BCBS and Anthem plans

Malia Lauer, LLC (Malia):

AlohaCare, HCHA, HMA, HMAA, HMSA (PPO, HMO, Quest Plans), most out-of-state BCBS and Anthem plans, Pacific Admin, TriWest, UHA, MDX Hawaii (Humana and United Healthcare), Worker’s Compensation

Securely upload your doctor's referral, a photo of your insurance card(s) (both sides) and driver's license or ID here along with your contact information and preferred contact type (email, phone, text). We will get back to you within 48 hours with your eligibility, deductible information, what you can expect to pay per visit for co-pays or co-insurance, and scheduling options. Please note for HMSA HMO, BCBS HMO, HMSA Quest, MedQuest, AlohaCare, and UHC Community plans - your referral must be signed by your assigned Primary Care Physician.

Securely upload a photo of your insurance card(s) (both sides) and ID here along with your contact information and preferred contact type (email, phone, text). We will get back to you within 48 hours with your eligibility, deductible information, and what you can expect to pay per visit for co-pays or co-insurance.

Securely upload a photo of your insurance card(s) (both sides) and ID here along with your contact information and preferred contact type (email, phone, text). We will get back to you within 48 hours with your eligibility, deductible information, and what you can expect to pay per visit for co-pays or co-insurance.

Yes and No

1) YES - For services that are considered skilled medical necessity such as physical therapy for an injury, surgery, acute problem, or new issue, we are required by law to bill Medicare for these services. Referral from your doctor is required in these cases.

2) NO - For established patients who are seeking maintenance care that is not considered a skilled medical service, you are allowed to self-pay by signing an ABN (Advanced Beneficiary Notice of Non-coverage) at your evaluation.

Yes. Please upload your doctor’s prescription with adjuster’s authorization and contact info here or fax to (808) 442-1140.

Not at this time.

Yes! Here's two options...

1) Pay out-of-pocket for your appointment. Self-Pay Physical Therapy does not require a doctor's referral and can be scheduled online here.

2) Pay out-of-pocket and request a "superbill" from your therapist prior to your appointment to submit it to your insurance company along with your purchase receipts. Some (not all) insurance companies will reimburse you for your cost. We recommend those attempting to get reimbursed to have a doctor's referral.

Because we are not contracted with any other companies apart from those listed above, we cannot bill on your behalf. If you would like to attempt to get reimbursed from your insurance company, we recommend that you first call your insurance company to find out their out-of-network reimbursement policy. If that is an option for you, you can purchase Self-Pay Physical Therapy (save all receipts), request a "superbill" from your therapist prior to your appointment, and submit this paperwork along with a current doctor's referral to your insurance company requesting reimbursement.

No. Insurance coverage starts when your referral is written and once your formal insurance-based evaluation is performed. We cannot backdate for services already received prior to the start of your insurance-based Physical Therapy evaluation.

We do not recommend that you be treated by more than one Physical Therapist at a time, and insurance does not reimburse multiple clinics simultaneously for the same case. If you would like to switch, you will need to be discharged from your current Physical Therapy case and request a new referral from your doctor, which will be subject to additional insurance authorization.

Please contact us to discuss transfer of care from your current Physical Therapist. All above insurance requirements apply, or you can purchase Self-Pay Physical Therapy.

Yes and No

1) YES - If you are using your insurance for Physical Therapy.

Because insurance plans can deny physical therapy benefits if there is no doctor's referral, we require a current doctor's referral prior to booking any insurance appointments even if your plan information says you don't need one. Please note for HMSA HMO, BCBS HMO, HMSA Quest, MedQuest, AlohaCare, and UHC Community plans - your referral must be signed by your assigned Primary Care Physician.

2) NO - if you are paying out-of-pocket for Self-Pay Physical Therapy.

We do recommend a doctor's referral if you are paying out-of-pocket and trying to get reimbursed from Travel Insurance or a plan that we are not in-network with.

Yes and No

1) YES - if your doctor has referred you specifically to another clinic, we cannot accept the referral and you will need to call your doctor and ask to be referred to us.

2) NO - if you have a hand-written prescription or generic referral for "Physical Therapy" that does not specify any clinic in particular, we can accept your referral.

We recommend printing our referral form and bringing it with you to your appointment to streamline this process.

There could be a couple of things going on here...

1) We don't accept your insurance. If a referral is sent to us directly from a doctor's office for a patient who is out-of-network, we have to call the doctor's office to let them know we don't accept their insurance. If this is your situation, you should have received a call from your doctor about getting referred to a different clinic.

2) It has been less than 48 hours since we received your referral and insurance information. We will call within 48 hours to get you scheduled. If you haven't heard from us, please call your doctor's office and ask for them to re-send the referral.

3) There has been some kind of snafu with our medical system's out-of-date information transferring processes and we didn't receive your referral. Please request it be sent again OR get a copy yourself and securely upload it to us along with a photo of your insurance card (both sides) and ID here. Please include your contact information and preferred contact type (email, phone, text). We will get back to you within 48 hours with your eligibility, deductible information, and what you can expect to pay per visit for co-pays or co-insurance as well as available appointment options.

We recommend printing a copy of our referral form, bringing it with you to the appointment, and politely asking the doctor or front desk staff to fill it out for you while you wait. Then immediately securely upload it to us along with a photo of your insurance card (both sides) and ID here. Please include a description of your urgent matter, your contact information, and your preferred contact type (email, phone, text). We will get back to you as soon as possible with your eligibility, deductible information, and what you can expect to pay per visit for co-pays or co-insurance and some options for scheduling.

A deductible is the set amount of money you pay out of pocket for covered services (per plan year) before your insurance starts to share costs. Deductibles typically range from $0-$7500, and are set by the insurance company based on the plan you or your employer have purchased. Patients must pay the full cost of any medical service (doctor’s visits, physical therapy, etc) until you have fully met your deductible. Once the deductible has been met, most plans require a co-pay (set dollar amount) or co-insurance (percentage of the cost of the service) for each visit.

A co-pay is a set rate you pay for prescriptions, doctor visits, and other types of care (including Physical Therapy) after your deductible has been met. Co-insurance is the percentage of the cost of the service you pay after your deductible has been met. Typically you have either a copay OR coinsurance (not both). We are required by law to collect your co-pay or co-insurance. Patients who have met their “out-of-pocket max” are not subject to co-pays or co-insurance for covered services. Out-of-pocket max amounts typically range from about $2500-$7500 and are set by the insurance company based on the plan you or your employer have purchased.

Mackenzie Brown, LLC (Mackenzie, Brian, Nick):

Insurance must process claims to determine your co-pay/co-insurance. You will receive a monthly invoice from Mackenzie Brown, LLC detailing charges submitted to insurance, insurance’s reimbursement, and payment owed at that time by you. Co-pays are due within 1 month of invoice unless other arrangements have been made.

Malia Lauer, LLC (Malia):

Insurance must process claims to determine your co-pay/co-insurance. You will be charged an estimated co-pay at the time of service, determined by your plan. After insurance processes the claim, you may receive another invoice/reimbursement if the estimated copay was slightly off.

Please check your Physical Therapy invoice for payment options.

Mackenzie Brown, LLC (Mackenzie, Brian, Nick)

Credit Card on file - call 808.757.5724 to save a card on file (statement will be provided monthly; please call to confirm ready to charge)

Check must be made out to Mackenzie Brown, LLC

Cash can be handed in to your treating therapist (Mackenzie, Brian, Nick)

Venmo @mackbrownPT - last four digits 5724

Mail payment to Mackenzie Brown, LLC, PO Box 811, Makawao HI 96768

Malia Lauer, LLC (Malia):

Credit Card on file or charged in-person

Check must be made out to Malia Lauer, LLC

Cash at your appointment

Venmo @maliaflower - last four digits 7924

Mail payment to Malia Lauer, LLC, PO Box 611, Hana, HI 96713

No. Co-pays and co-insurance must be paid directly to Mackenzie Brown, LLC or Malia Lauer, LLC. Packages purchased through Deep2Peak are not able to be applied to Physical Therapy co-pays or co-insurance under any circumstances as these are all separate entities.

The number of visits per injury is determined by your insurance company based on the type of injury or procedure. All insurance companies have different requirements to obtain authorization and for allowed visits per injury/calendar year. Your therapist will acquire authorization for you and help design a plan of care based around your specific clinical need and what your insurance company allows.

Yes. If you are discharged from your insurance case but would like to continue Physical Therapy, your therapist will recommend a self-pay package to continue your plan of care.

Some insurance plans offer additional riders to cover Massage Therapy and/or group training classes. Call your insurance plan to find out if you have these benefits.

Yes. Please upload your doctor’s prescription with adjuster’s authorization and contact info here or fax to (808) 442-1140.

Yes. Please upload your doctor’s prescription, Claim #, and adjuster’s authorization and contact info here or fax to (808) 442-1140.

Active and Fit covers the first 10 in-person group classes or supervised workouts (called “visits”) per month for enrolled members.

Active and Fit does not cover any private sessions including Personal Training, Nutrition Coaching, Massage, Physical Therapy, etc.
Active and Fit does not cover late canceled (< 6 hours before class start) or absent classes or supervised workouts.
Active and Fit does not cover more than 10 visits per month.
Active and Fit does not cover more than 1 visit per day.
Active and Fit does not cover classes attended via Zoom.

We recommend anyone who is considering using Active and Fit to first book a free 30-min assessment with a personal trainer here. Your trainer will help guide you on the best classes for your goals and schedule, and whether you are eligible for supervised workouts.

We recommended calling us at 808.214.8224 to be sure you understand the benefits and limitations of Active and Fit prior to enrolling in our facility.

Once you are enrolled in Active and Fit and have chosen our facility, please email your Fitness ID card to info@deep2peak.com. All Active and Fit enrolled members must have a back-up class pack or credit card on file and will be automatically billed monthly for any uncovered services.

Visit ActiveandFit.com or AcActiveandFitDirect.com or contact your health plan to determine your eligibility.