Health Insurance and Physical Therapy

We have all been injured at some point, that's just life! Sometimes we can just brush ourselves off and move on. But when we've really done a number on ourselves we need medical attention. For example, you are playing basketball and roll your ankle. You go to the doctor and are diagnosed with an ankle sprain. The doctor gives you a prescription for Physical Therapy and tells you, "Come back if it doesn't get better". Ok, so now you have to find a Physical Therapist so you pull out your health insurance card, call the number on the back, and see which PT you can go to. You book an appointment and begin your treatments with the belief everything will be covered by your insurance. If only it were that simple! What most people do NOT realize is that health insurance has changed significantly and is not as straightforward as it once was. Many services that were previously covered are no longer covered OR covered after a deductible is met. Unfortunately, Physical Therapy is one of these services. A large number of insurance policies require you to meet a deductible upwards of $15,000 (depending on your plan) PRIOR to paying for therapy services. Then, once the deductible is met, you still have to pay a co-pay averaging $50/treatment. And the kicker is, you may be paying these steep prices for substandard care. I am not saying that the therapist is not qualified, but because reimbursement rates for providers has dropped insurance-based Physical Therapy clinics have to see more patients/hour in order to make the same profit. I know what you are thinking....."WHAT THE HECK??!! Nobody told me this." The truth is, no one will because these clinics need you to keep coming back. But I am here to tell you that you have a BETTER option - Cash-based Physical Therapy clinics. Why would I pay for PT when I have insurance that covers therapy services? Well let’s compare: Insurance-Based Clinic

• Insurance does not cover PT the way you think it does - high deductibles, copays, facility fees (shown as “service charges"), and so on

• With changes in healthcare and insurance, medical/healthcare providers do not get reimbursed at a rate high enough to cover their services. Therefore they have to see multiple patients at a time to be able to cover costs

• This leads to you sharing your 1 hour treatment time with 2-3 other people

• These clinics utilize unlicensed techs that provide 50-75% of the supervision as the PT is trying to split his/her time among 4 people

• You are paying a copay/deductible to have a tech count reps

• Less one-on-one PT time means that the therapist does not have time to give you the most appropriate treatment = you need MORE sessions to get results

• Many times the PT does not even put their hands on the patient due to a lack of time – when manual therapy is extremely important to positive therapy outcomes

Cash-Based Clinic

• It is ALWAYS one therapist with one patient for one hour

• Treatments are performed by a licensed Doctor of Physical Therapy, absolutely NO techs are utilized

• You will always be seen by the same therapist which allows you to develop a good relationship thus enhancing the treatment experience

• Manual based therapy – you will never be placed on a machine or left to count reps on your own. Do to the way your musculoskeletal system works, manual therapy yields better results with exercise than exercise alone = saves you time = less sessions required = less out-of-pocket expense for you!!!!

• Flat rate regardless of the treatment performed – so you always know how much your session will be

• Cashed-based PT services in the end will cost the same and in most cases even SAVE you money

Please, before you just choose any clinic educate yourself on your options. If you have any questions regarding Cash-Based Physical Therapy call me today for a FREE strategy session. Remember, you are in control of your own health!