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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.

 

SOZO Physical Therapy Clinic Chandler
FAQ 2
SOZO Physical Therapy Clinic Scottsdale

O’Brien PT

Patient Forms Required for First Visit

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:

SOZO PT

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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