Out-of-network physical therapists are becoming more popular as the demands of productivity and insurance companies increase. An out-of-network simply means that physical therapist that chooses not to participate with insurance companies. There are many reasons why a PT may make this decision, but most of us choose to do this to benefit our patients. Here are 4 reasons you need to see an out-of-network physical therapist today!
1. WE ARE ABLE TO OFFER A PERSONAL ONE-ON-ONE SESSION
This is my favorite part about being an out-of-network provider and truly what drove me to make this decision for Life Changes Physical Therapy. Due to decreasing reimbursement for services from insurance companies, the typical outpatient clinic requires their staff to see 2-4 patients at one time. In my career, I have experienced seeing up to 6 patients at one time, being tripled-booked for multiple appointments of the day, and seeing 20+ patients in one day. In my opinion, this is unacceptable. There is no way to provide exceptional care to multiple patients at once – to truly listen, understand, and respond to the patient’s symptoms and needs. Choosing to be an out-of-network provider allows me to see only YOU during YOUR visit. Better quality of care, and ultimately better results, will follow.
2. WE ARE ABLE TO USE ALL THE TOOLS IN OUR TOOLBOX
Restrictions set by insurance providers continue to increase and this includes what the insurance company deems necessary for your treatment. Now I have NEVER seen anyone from the insurance company evaluate my patients so I am dumbfounded as to how they know what you need. Nevertheless, your insurance company may have fine print restrictions on which services physical therapists can provide for reimbursement – and to make it even more confusing each insurance company and each individual policy may be different. It creates an ethical dilemma for many therapists – should we provide the treatment we know will improve our patient’s pain or do we provide the treatment that will get us paid? Choosing to be an out of network provider allows me to safely utilize my full skill set and to choose the treatment that the patient needs. Ultimately this benefits my patients by allowing them to achieve their desired results more quickly and efficiently.
3. WE ARE NOT LIMITED BY INSURANCE RESTRICTIONS OR VISIT LIMITS
All insurance policies have restrictions and often times set strict limits on the number of visits their patients get with a physical therapist. These restrictions are often times in the “fine print” and may include limitations on what you conditions you can be treated for or what level of function the insurance will pay for you to get back to. For example, I once had a patient post-back surgery. He was a hard worker and a full time dad to his 2 young children. He did very well with physical therapy but it was slower than the insurance wanted. In the middle of his course of therapy, the insurance denied any more visits even though the individual still could not even lift his own children. I fought with the insurance through letters and finally over the phone only to be told by an unqualified individual that his policy only covered returning to his “activities of daily living” and lifting his children was not considered an activity of daily living. By choosing to be an out-of-network provider, we no longer have to put up with insurance companies making decisions a licensed healthcare provider should be making. You and I can determine what level you need to achieve and how many visits it will take us to get there.
4. YOU KNOW YOUR PRICE UP FRONT – NO SURPRISE BILLS LATER
There are few things more confusing in this world than the healthcare system when it comes to costs. You go to a doctor’s appointment, get some services done, then months later you get a bill telling you what you owe. This number may be more than what you thought it might be or you may have forgotten about it all together. All in all, there is very little transparency. Choosing to be an out-of-network provider, my patients know the exact cost up front with no waiting or wondering. Recent research also suggests that this model saves patients money in the long-term as they are often able to achieve results in fewer visits.
Choosing an out-of-network physical therapist gives you the quality of service and transparency you deserve for your care. If you’d like to learn more about out-of-network physical therapy, call Life Changes Physical Therapy today or visit our website for more information!