Benefits of Out of Network Physical Therapy

Updated: May 6, 2021

I went into physical therapy because I loved the human body. I loved learning the biomechanics of how joints and muscles work and how everything in the body is interconnected. As a practicing Doctor of Physical Therapy I now get to share that passion and education with my patients. I love that I am able to empower patients to take care of themselves and help them better understand their bodies’. I also love that I not only get to help my patients get out of pain, but also stay out of pain by working them on their specific goals and activities in order to provide the best long term results.

The sad part of our profession is that the traditional model of physical therapy does not allow for this. Most insurance companies feel that once the pain is gone, PT services are no longer needed. Do you want to squat without pain? Play tennis with your friends on the weekend? Sadly, insurance doesn’t always see these activities as necessary. This means that visits can be delayed due to unnecessary paperwork or even denied all together. In addition, reimbursement for PT services has been continually declining over the past few years. This means that in-network clinics are forced to see a higher and higher volume of patients.

Typically at an in-network clinic you’ll find:

· Therapists treating 2-4 patients at a time

· Techs and aides used to supervise exercise and treatments

· Limited time to discuss your concerns with your therapist

· Multiple modalities used at each visit, including heat, ice, ultrasound or E-stim. All of which are billed.

· The need to come multiple times per week

These in-network clinics are forced into a model where patient centered care has had to go out the window in order for them to make a profit.

In order to provide the high quality patient centered care that I believe everyone deserves, being out of network is the only option.

As an out of network provider, you, the patient, benefits through the following ways:

· I’m able to spend a full hour with you. This gives you, time at each visit to discuss any concerns or questions you may have and the ability to have a Doctor of Physical Therapy working with you for all of your exercise and manual therapy treatment. You are never passed off to a tech who was handed a piece of paper with a list of exercises.

· Sessions are tailored to your needs and goals. We will never use disproven modalities such as E-stim or ultrasound and then bill you for the time. All treatments are thoughtfully programmed, aimed at saving you time and money.

· You will spend less time in physical therapy. 2-3 visits per week is unnecessary. Due to the high quality care and one-on-one sessions, we’re able to accomplish much more in one visit than would be in 3 visits of the traditional model.

· You’ll stay pain free long term. We make sure you have the knowledge and tools you need to take care of your body.

· You’ll never receive a surprise bill from us. We’re transparent and upfront about our cost so you won’t ever receive a bill for hundreds (or thousands) of dollars months after treatment.

I believe investing in your health and body is important and the ability to choose your provider ensures the highest return on investment.

The cost of healthcare plans and rise in deductibles means many people must initially pay out of pocket anyway. In addition, many insurance companies do offer out of network benefits, which means if you do choose an out of network provider, like myself, you may still be able to get reimbursed 50-80% of the total cost.

In need of treatment but still not sure if out of network is right for you? Contact us at Functional Phyzio and Performance Therapy and we’ll walk you through our practices and policies to see if we’re a good fit to work together!

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