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Don’t Use your Insurance for Physical Therapy!

In my 15 years career as a physical therapist, I have worked in various inpatient and outpatient settings with different reimbursement / payment models. The one consistent reality I have had to face in regards to patient care is dealing with, advocating, explaining and justifying  for the care of my patients to insurance companies.
I have always have a hard time understanding how a non medically trained person sitting at a cubicle could solely decide on authorizing, allowing, finding medically necessary and/ or extending the care of a patient that has been deemed appropriate and/or necessary after assessment by a medical professional.

Let’s face it, health insurances are big businesses and are in it for one thing: saving themselves money while increasing premiums, co-insurances, co-pays all while covering less and less medical and paramedical treatments, making their “beneficiaries” responsible with an ever increasing part of the bill.
I have spent countless hours on the phone, by fax, mail or emails justifying the benefits of my physical therapy treatments and allowing patients to receive the proper care anyone deserve. As a provider, this of course takes away from patient care time and stands against my values that healthcare is a necessity, not a luxury.

Insurance companies have made receiving and being reimbursed for medical care an increasingly difficult task, requiring more and more paperworks from both the patients and the providers, adding to the likelihood that mistakes will be made…all in order to simply deny services…And while delaying payments to both patients and providers.

This pattern has become clearer and clearer over the course of my career and has reached pathetic level of bureaucracy. Insurance companies simply don’t have patients best interests in mind…Increasing premiums and decreasing reimbursement stating cost are rising, all the while giving their corporate high ranked employees a 7+ figures salary increase. I am no math wiz, but…???

This is why I decided to be an out-of-network provider (except for Medicare and Work Comp) when I started and set my business up. I want to work in a business model where my efforts, services and time go to my patients, not a multimillion dollar company that will make your work more difficult.  

Modern physical therapists and health care practitioners should focus on patients. This is why I offer a 20 minutes free phone consultation, allowing myself to determine if that potential patient is a good candidate for physical therapy, how I can help them or if he/she should be referred to another practitioner, and also if I will be a good fit to help them achieve whatever goal they might have. 

Nowadays, most clinics still spend these first phone calls or contacts only discussing insurance details such as benefits, co-pays, deductibles, booking the initial treatment depending on, guess what, insurance. Instead of finding out more about the patient problem, how long it has been, how it affects them in their life, what are they not able to do, what would they like to achieve, this first conversation is driven by the insurance and the patient’s history and condition is barely addressed. Patients often make their decisions on receiving PT treatments only on this: “Is it covered by my insurance and what is my co-pay”…all the while forgetting about their high out-of-pocket deductibles.

Stating the above could be seen as futile because money and the cost of things are a concern for everyone… and I get that. 
This is where really understanding the cost associated with using your health insurance or not for physical therapy treatment becomes that much more important. The following might surprise you because most people are used to providers being in network and accepting their insurance and they never had to weigh the benefits an out-of-network provider might offer.

Gone are the days when patients had no co-pays (or under $10) for each treatment, low deductibles and infinite amount of covered visits. Instead, it is not unusual for patient to have co-pays ranging from $25 to $75 per treatment, out-of-pockets deductibles that are $1500 and above…and all this for care provided by an in network provider.  Physical therapy treatment reimbursements have been on a steady decline, with insurance companies switching to an increased patient/beneficiary financial responsibilities model.
In order for many clinics to keep their doors opened, therapists have to see 2 to 4 patients an hour(per therapist). As you may already know or can picture, this quickly leads to subpar care, with very limited (10-15mn) one-on-one care and least than adequate time to communicate. This lack of time spent with the patient can lead to unnecessary lengthy plan of care…even when patients are seen 2-3 times a week….leading to consequent bills if you multiply copays by # of visits and factor the cost of the treatments that the insurance will not cover until the deductible is met.

To put it simply, if you are far from meeting your yearly deductibles and are receiving physical therapy at an in-network provider, you will likely pay for the entirety of your physical therapy treatments out of pockets…
Which may surprise you since you spend so much money already on your insurance premiums and copays.

People are more and more savvy in looking up and get informed about their conditions on their internet. Sometimes , that also helps them cut cost by seeing the provider they know they will most likely benefits from, helping them save time and money at the same time.
Even though most people have insurance, they do realize now more than ever than they have power over the decision that will impact their health.

When I talk with prospective patients, it often becomes obvious that 99% of people value time, expertise, empowerment over their condition/ injury, personal attention and overall experience they receive. 
They realize that what I have to offer, the time spent with them one-on-one can lead to better care and better understanding of their condition and how to manage it. And for people with high deductibles and copays, the value that Butheau Physiotherapy provides becomes even more logical and pertinent since they are paying for physical therapy services even from an in-network provider.

Benefits of Butheau Physiotherapy treatments:
One-on-one hands-on care 45, 60 and 90 minutes sessions
-Treatment packages and payment plans available, with no hidden cost.
-Holistic, comprehensive treatment approach, a look at the big pictures and all your complaints ( not only what the insurance dictates)
-Evidence based treatments with modern, proven and effective techniques
A blend of manual therapy techniques, including The Mulligan Concept, Proprioceptive Neuromuscular Facilitationexercises, neuroplasticity through Rekinetics™, pain science and pain reducing techniques, neuromuscular reeducationtaping.
-Treatment location convenience: your home or work space
-Appointments available within a few days at convenient times, often with short notice.

Call or text us at 4252814171 to learn more about o
ur services.

Butheau Physiotherapy
15034 5th Ln S
Burien, WA 98148

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