Why pay cash for physical Therapy?

Physical Therapy Outside Of Your Health Insurance Plan

Every year more patients are paying cash out of their own pockets for physical therapy services. Like most health care providers, we bill insurance companies as a service of convenience for our patients.

However, with most insurance plans, patients are responsible for paying for the cost of their physical therapy services until their deductible is met. In recent years, deductibles and co-pays have risen and scrutiny by insurance companies over what is covered has increased.

For most insurance plans, patients have to cover their physical therapy services out of pocket before their coverage kicks in, and then they may still have a $30 copay each visit. Based on theses trends, some patients may actually have lower out-of-pocket expenses if they simply pay for services without going through their insurance carrier.

Government regulators allow discounts if sessions are paid for by the patient on the day of service. We can afford to offer these discounts because we significantly reduce our administrative expense if we are not billing your insurance company.

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.

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.

Quality of care and the insurance-based model

The other effect of the trends mentioned above is that some clinics have had to schedule multiple patients at the same time, have them spend more time unsupervised, or see different therapists each visit to accommodate staff and produce more volume. These are measures which 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-network.

At Northbound PT and Wellness we schedule each patient for a one hour one-on-one with the same physical therapist each visit for hands-on treatment (manual therapy), education, and specific prescriptive exercises. We see less patients than a typical therapist office, which mean we have more time to focus on you and provide the personalized care you deserve.

Every person needs to select the set up that works best for them medically and financially. We seek to offer our all clients effective and efficient physical therapy services to help you get better as quickly as possible.