Insurance and referrals

Do I need a referral for physical therapy with HMSA?

It depends on the plan. HMSA PPO members can usually book physical therapy directly. HMSA HMO and HMSA QUEST members usually need a referral from their primary care provider. Hawaii law does not require a referral to start physical therapy, but the plan's rules still apply.

The details

What to know

Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.

EMS Therapy checks the plan before the first visit and says exactly what to ask for. The most useful referral wording is "physical therapy, pelvic floor, evaluate and treat" (or "physical therapy, evaluate and treat" for an orthopedic problem), with the diagnosis and EMS Therapy named.

Referrals can be faxed to 844-886-0285. EMS Therapy is in-network with HMSA PPO and HMO plans and HMSA QUEST, and sees patients anywhere in Hawaii by video.

The first step is a free 15-minute discovery call. Phone 808-330-7934.

How it works

How a virtual visit works

Most of pelvic floor physical therapy is education, breathing and pressure management, movement retraining, and a home program. All of it works on camera. During the evaluation, Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating with breath and movement. An internal examination is not possible by video; if a hands-on assessment would change the plan, she says so and helps the patient find local care.

A woman at her kitchen table on a video visit with her physical therapist
  1. Discovery call

    15 minutes, free, by phone

    A short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.

  2. Evaluation

    60 minutes, by video

    Dr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.

  3. Your plan

    Same visit

    You leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.

  4. Follow-ups

    45 minutes, every 1 to 2 weeks

    Progress checks, program updates, and techniques you can do yourself, for as long as they are useful.

For a video visit you will need

  • A phone, tablet, or laptop with a camera
  • A private room
  • A mat or towel
  • About an hour
Dr. Elana Shalem, DPT

Your physical therapist

Dr. Elana Shalem, DPT

Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Hawaii.

Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.

More about Dr. Shalem

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