10 Sep Do You Take My Insurance?

“Do you take my insurance?” is one of the most frequent questions that we get asked. While the simple answer is “No”, this really is a loaded question.

But before you stop reading and click off, we will try our best to eloquently and concisely explain why we don’t take insurance and how you can benefit from this.

Price Transparency

Insurance is so complicated where you almost need a degree to understand your coverage, financial responsibility and how the process works (click here for our Insurance 101 guide).

There’s no way around it, whether you decide to work with an in-network or out-of-network provider, you are financially responsible to pay your deductible. In many cases, when the dust settles (even if the deductible has been met), patients could still be left with unexpected bills due to insurance providers billing higher fees for service or finding out later on that your insurance did not cover the services you received.

When someone chooses to work with us, they know the upfront costs and will never get blindsided by any additional bills. We can and will provide you with a receipt or Superbill that you can submit to your insurance company that will be credited towards paying off your deductible. When your deductible has been met, you may be eligible at that time to receive reimbursement anywhere in the range of 40%-80% (depending on your coverage).

We Don’t Let Insurance Companies Dictate Your Plan of Care  

It’s sad but it’s true. Insurers decide which services are reimbursable and that either: 1) effects the services that providers choose in order to maximize reimbursement or 2) it forces them to increase the number of patients that they have to see.

This means several things: 1) let’s just say that you are coming in for a knee injury. PT has been progressing well and your knee feels great. But for some reason, on the day of your appointment, your hip is hurting and causing you to noticeably limp. When you tell your PT about it, you are told that they can’t do anything for you until you get a prescription. Why? In some states (only 2-3 states do not have Direct Access), PT can’t be administered without a physician referral. But, the main reason is because insurance won’t generally reimburse for care rendered to another body part until another PT evaluation has been performed and a new plan of care has been developed.

“And do you know what is worse? If you elected to go to PT for your hip and knee, you would have to go in on separate days!!!”

An increase in patient volume also means 2) less skilled-care for you and less time that you get to spend with your PT. Assuming that the average co-pay costs $35-$50/visit, it will take you 3-4 visits to get the same amount of skilled care that you should expect to receive from us in one 60-minute appointment.

Which leads to next reason why we don’t take insurance …

Going to Physical Therapy 2-3 Times a Week for 4-6 Weeks is So 1990’s …

While there are some injuries (post-operative or catastrophic) that require more frequent visits, a majority of injuries that we see do not require you to be seen 3 times a week for 4-6 weeks. Let’s face it, we all lead busy lives and if a majority of us were polled, we would probably say that the one thing that we don’t have enough of is – time.

We are firm believers that a majority of the onus is on you to be accountable for your own health.

Our philosophy is that we are partners, in your health journey, to get you out of pain and to empower you with the knowledge and tools to get you back to doing the activities you enjoy.

For many of the common musculoskeletal injuries that we see, we typically get our patients better within a handful of visits.

So for the reasons mentioned above, this is why we don’t take your insurance. The benefits are exponential in return – you get unmatched quality of care, see results sooner, save valuable time and potentially save yourself money (for more click here to see What Sets Us Apart).

We would love to hear your comments and would be more than happy to answer any questions that you may have regarding your insurance. Until next time …