Physical Therapy Outside Of Your Health Insurance Plan
Every year more and more of our patients are paying cash out of their own pockets for our physical therapy services. Like most health care providers, we bill insurance companies as a service of convenience for our patients. In recent years, deductibles have climbed to $5000 or more, copays have become higher, and scrutiny by insurance companies over what is covered has increased. We are now at a point where many of our patients/clients have lower out-of-pocket expenses if they simply pay for our services without going through their insurance carrier.
Government regulators allow us to provide discounts if sessions are paid for by the patient on the day of service, with further discounts if they pay for multiple sessions. We can afford to offer these discounts because we significantly reduce our administrative expense if we are not billing your insurance company and then waiting for 30-90 days or more to get paid (unfortunately that is not unusual). As the patient you have less cost, however your payment to us does not apply to your deductible. If you have a flex spending account or health savings account, your payments to us may be reimbursed.
Why would I want to pay you instead of having my insurance company pay?
It all depends upon what is cheapest for you. Full price physical therapy can range from $250-$325 per hour. It is a misleading number because few patients or insurers actually pay this amount. If we are “in your network” that means we have agreed to a reduced fee from your insurer and we simply write-off the remainder. If we are “out of network”, your insurer pays us whatever they want, and you are responsible for the remainder. When all is said and done, you may have less expense if you simply pay us our time-of-service discount than if you try paying your portion after your insurance company has paid their portion. As stated above, insurers are paying less and less.
“Billions Wasted on Billing” New York Times, http://opinionator.blogs.nytimes.com/2011/11/12/billions-wasted-on-billing/
Is physical therapy at Body Mechanics different?
Our patients confirm that we are somewhat unique in this current health care setting. We have set up a practice style that is more effective in a shorter amount of time to get you well and over your injury. We schedule each patient for one hour one-on-one with the same physical therapist each visit (occasionally 30 minute sessions are possible). Most of what we do is with our hands (manual therapy) and what we teach you with specific prescriptive exercises. All of our physical therapists have advanced training and at least 5 years of experience (several with 15+ years). We encourage lots of questions and discussion to help you help yourself.
Some (not all) clinics “in your network” will schedule multiple patients at the same time, see patients for 5-15 minutes each with more time spent hooked up to machines or doing exercises that could be done at home. They also may have you see different therapists each visit to accommodate a staff that is part-time, inexperienced, or overbooked to produce more volume. These are all measures that allow clinics to see more patients in less time and produce more revenue to account for the lower rate of reimbursement per visit that they accept by being “in your network”. Know that this is not always the case. You may be able to have good, consistent therapy from a clinic that is in your network. Arm yourself with the ability to recognize what is and what is not good practice. We often recommend that patients struggling with the cost of their therapy first go to a clinic within their network, and then come to us if they are not getting good results. Ultimately the value of your care and getting better will be more important to you than the cost. If you have further questions, or you wish to schedule an appointment with one of our physical therapists, email firstname.lastname@example.org or call Downtown Milwaukee (414-224-8219) or Pewaukee (262-695-3057)