Health & Wellness, Physical Therapy

A question I get asked a lot is, why don’t you accept insurance for physical therapy? Well, without going into too much detail, the simple answer is that it changes how we can deliver the physical therapy to our clients. But I suppose I’ll give a little more details on that.

I think we can all agree that our health care system has a few bugs that need to be worked out (maybe bigger than a just a few). Due to the costs of health care, decreased reimbursement, and the rising number of individuals who require the services covered, health care professionals are spending less and less time with each client. It has all come down to the bottom line, how much money can we make in as little time as possible to cover our expenses and maybe turn a profit. I think we can all agree that this model is failing us. Doctors are frustrated because they’re running around all day seeing more patients than they can handle. And patients are even more frustrated because they feel they are being neglected and just pushed along a conveyer belt of different providers. Our health care system is handcuffing the individuals who provide the service and is creating sub-par treatment strategies and outcomes.

Physical therapy clinics that take insurance don’t just have to worry about getting the patient better. They also need to make sure that they follow every specific rule that the insurance provider has put in place based on the diagnosis, amount of visits allowed, what the doctors orders are (which aren’t always the best option), how much their co-pay is per visit, and whether or not they’ll be seeing the physical therapist, or passed along to a physical therapist assistant or even physical therapy tech. In most cases, a patient sees multiple therapists or assistants during the course of therapy. How is it that they can create a good working relationship with someone and build trust if they keep getting shuffled through staff due to scheduling and insurance reimbursement? Short answer, you can’t. And what happens if Mrs. Smith, who has been receiving treatment for her shoulder, comes in and her knee is hurting as well? Unfortunately, the treatment plan and diagnosis is only for her shoulder so the physical therapist can’t spend time working on the knee or else he wont be able to bill for the session.

At Naples Personal Training, we understand the importance of quality, one on one care. Because we don’t accept insurance we are able to spend more time with the patient and get a complete understanding of what they are going through and how we can help them. We aren’t tied down by insurance codes and different standards that we meet. If we decide to work on one area of the body one session, and then another area the next, we don’t have to fight with insurance companies on why we chose to do this. We simply do what we believe will benefit the client the most.

And for those individuals who still don’t want to spend money out of pocket because they have insurance and feel they should use it, here’s some math: The average Co-Pay for physical therapy per session is anywhere from $20 to $60. And in Florida, unlike other states, there is no restriction on the dollar amount charged for Co-Pays. In Connecticut for example, they have it written in the by laws that co-pays for in-network must be limited to no more than 30$. So say you are going to Physical therapy here in Florida for a shoulder injury. You’ll most likely end up going in for treatment 2-3 times per week, spending part of each session with either ice or heat on you, maybe receive some manual therapy, and then perform a few exercises that don’t really seem to be doing much. If you have a Co-Pay of $30-$60 then you end up spending anywhere from $90 to $180 a week. Going the non-insurance route, you could come in once a week, at a cost of $120 and receive quality time with the therapist, in an environment that isn’t rushed or monitored with strict rules/regulations about what the PT can or cannot do with the client. Every exercise will be based on clients needs, and nothing will be done that wont help improve outcomes. By having this freedom, we are able to limit the weekly session for our clients, improve treatment outcomes and satisfaction, and save them time and in most cases money over the long run.

Leave a Reply

Your email address will not be published. Required fields are marked *