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 Patient Forms/Insurance

Below you can find some helpful forms that you will need for your visit to O’Brien Physical Therapy & SOZO PT.

Please download, print, and completely fill out both forms and bring them with you on your first visit. If you have any questions, please give us a call. We are always happy to hear from our patients.

 

Medicare Forms (Please pick form associated with primary area of injury)

For 3rd Party Personal Injury and Motor Vehicle Accident Patients:

Print and completely fill out forms and bring them to your initial appointment.

Massage only patients:

Patient Forms Required for First Visit

IN-NETWORK Insurance Plans:

(Although we will provide you the courtesy of verifying your insurance benefits, we strongly encourage you to verify the status with your insurance company)

  • Ambetter
  • Ameriben
  • American Specialty Health
  • Ameriplan
  • Bardavon
  • BCBS
  • Beech Street
  • Bridgeway
  • Cigna
  • CorVel
  • Fortified
  • Galaxy Health
  • Gilsbar
  • Health Net Federal Services
  • Humana
  • IHP
  • Medicare
  • MedRisk
  • Meritain
  • Multiplan
  • Mutual of Omaha
  • One Call Care
  • Optum Health
  • Pacific Source
  • Physicians Mutual
  • Premera
  • Premier Provider Network
  • Prime Health
  • Summit
  • Three Rivers
  • TriCare
  • TriWest
  • VA
  • United Healthcare
  • UMR
  • USA Managed Care
Chandler Only

  • Aetna
  • Alliance Health
  • America’s Choice
  • Arizona Complete Health (Formerly HealthNet)
  • Care 1st
  • Claris Pointe
  • Cofinity
  • Covenant Companies
  • Evolutions Health Systems
  • First Health/Coventry
  • Health Smart
  • Integrated Health Plan
  • Independent Medical Systems
  • Integra
  • Key Risk
  • Magellan Complete Care
  • National Health
  • Occunet
  • Orchid Medical
  • PHCS
  • PNOA
  • Rockport
  • Rural Arizona Network
  • Stratose Care
  • The Reny Co
  • Three Rivers Network
  • Workwell Systems

Scottsdale Only

  • Affiliated Health Funds
  • Health Management Network
  • Provider Select

We also accept Aetna, Humana, Health Net & BC/BS
non-HMO plans as OUT-OF-NETWORK and 3rd party MEDICAL liens.

We are IN NETWORK with the following plans at Chandler location ONLY: AETNA | HUMANA | HEALTHNET

 Please contact us to verify coverage!

We also accept cash, check, Visa, Discover, or Mastercard

For billing statement questions or explanation of benefit (EOB) inquiries, please email billing@sozopt.net or contact us and our biller will return your message..

For more information on our services, in-stock product availability or if you have any questions, please feel free to contact us.

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