“I do not want to do this any more.”
In July 2019, I had a threshold moment. I was working at an in-network physical therapy office. My caseload on that day was typical, 9 clients in 4 hours. Working in this environment was one part art, another part mania. Often, I would need to orchestrate the care for 2 to 3 clients at the same time. This involved teaching a series of exercises to one person then dashing across the clinic to dry needle another and then run to another room to welcome another client.
On this particular July morning, one of my favorite clients came in, Tom. He had been working with me for years. Although he was jovial upon greeting, his body language let me know he was not pleased with the tardy start to our session as well as not receiving 100% of my time and attention.
Later that day, I reflected on my morning. I had an uneasy feeling. The client’s I had been working with were not receiving the care, focus or expertise they expected and I knew I could deliver. My personal treatment philosophy has always been to care for the whole person: spirit, mind and body. The brevity of the treatments and the frenetic pace of the clinic restricted my ability to facilitate physical changes in my clients as well as foster intellectual and emotional growth in those I served. Following this day I began my search for another way!
Time is the only resource you cannot get back
2. Sustained Fitness Physical Therapy, “Average total cost of care.”
The simple question you should ask yourself regarding a cash-based network is ‘Is it worth it?’.
First, let’s distinguish the difference between cost and value (1). Cost is what we pay. Value is what we get out of that payment.
How many times have you gone to see one of your doctors and spent more time in their waiting room than in their office? Then when you finally see your doctor, they spend 5 to 10 minutes with you. Or if you go to an insurance-based physical therapist, you may spend 15-20 minute with them before getting passed off to an aide to exercise with 4 or 5 other people performing things you could probably be doing on your own anyways.
The typical routine for insurance based physical therapy is to work with them 2 to 3 times a week for 60 to 90 minutes. So that’s at least3 hours of your time at the office and that’s not including commute and wait time.
Deductibles. What is it?
Most insurances will have a deductible. This is an amount you must pay before any reimbursement or coverage kicks in. Real world example, a local blue cross plan has have an $1800 deductible before insurance kicks in for an innetwork clinic. Most in-network clinics will cost $90 (regular out patient office) to $500 (hospital based outpatient office) a session. This means you would need to attend 3 to 20 sessions before getting to pay only your co-pay.
Most clients who work with us, see us 7 to 10 times. Our cost of care is usually less than what you would pay for your in-network deductible.
On average, treatment for out-of-network physical therapy is about $1700 cheaper than in-network (2). THAT’S $1700! Coming to Joe Norton Physical Therapy can help you not only minimize the cost, but also maximize the value.
What Makes Us Different
As a cash-based physical therapy business, our number one priority is to help you feel better.
We achieve this goal by spending 60 minutes of one-on-one time with you, where we address your aches and pains, offer hands-on treatment and coach you to grow stronger.
This focused process with experts in rehabilitation and movement entails less visits and less time commuting because you get so much more out of your 60 minutes with us than 15-20 minutes with your insurance-based options.
The time you save commuting, working with technicians, and confronting your insurance can go toward you getting healthier and stronger.
Money is important, and we know that. We provide a full disclosure on our costs. You will never receive a bill in the mail months after completing care informing you owe hundreds of dollars.
Deductibles are increasing and insurance premiums are rising. The value of insurance-based treatment remains stagnant (3). When you come see us, you don’t have to stress about paying a copay or hitting your deductible.
Insurance wants to play the middle man. Don’t rely on copays or deductibles to get you mediocre treatment. The foundation of care and treatment is the relationship between therapist and patient.
On average, in-network physical therapists see 2-4 patients per hour for about 15-20 minutes each. This is because they have a pre-negotiated agreeement with insurance companies on how much they will receive per session. As a result, they need to work with a high volume of clients to meet their bottom lines. We guarantee one hour of treatment where we focus solely on your wants and needs.
You’re the Boss
Insurance companies are persnickety. They might not cover your treatment because it was written off as “physiotherapy” instead of “physical therapy.” We aren’t picky with titles. We have your best interest at heart here at Joe Norton PT. In the lens of a cash based-system, you have the power to decide the value of your care, not your insurance. We want to set you up for long-term success and we believe that a cash-based model best complements that objective.
Leaky Buckets- longterm effects and relationships
We recommend you ask your insurance if they cover out-of-network care. If needed, we can always send the bill to your insurance company for reimbursement. That way we do our job, your insurance company can do their job, and you get back to your strongest self while making the most of your coverage.
Remember that no one knows what treatment you need better than yourself, so don’t let insurance dictate the sort of care you want and need!
References:
Sawall, Sarah. “Value vs. Cost (When Not Using Your Insurance Saves You Money).” Resilience Rx, 16 June 2021, https://resiliencerxpt.com/blog/value-vs-cost-when-not-using-your-insurance-saves-you-money/.
“Physical Therapy.” Sustained Physical Therapy and Training, https://www.sustainedfitness.com/physical-therapy.
Snowbeastperformance. “Cash Based VS Insurance.” SnowbeastPerformance, 23 Feb. 2022, https://www.snowbeastperformance.com/post/cash-based-vs-insurance.