In this day of consumer driven and directed healthcare, many people are looking to be more conscious financially about their healthcare services. Many young healthy individuals do not elect traditional insurance programs with high insurance premiums. Therefore, they are paying a different insurance structure. Some, from high deductible insurance plans to catastrophic plans. However, people with traditional insurance programs are often frustrated with the confusing nature of insurance and what their benefits are when services are necessary.
We are a cash-based physical therapy practice and you pay a flat rate for the time regardless of what services are provided. We do not bill insurance companies since we have no relationships with them. Therefore, we are categorized as an out-of-network provider. There are NO limitation or influence by a third-party entity dictating what services can be rendered or the number of visits allowed.
Unfortunately, at this time by law, we cannot treat Medicare clients for services that are covered by Medicare, because we do not bill Medicare (CMS) directly or indirectly. Additionally, Medicare beneficiaries cannot opt-out of said coverage. It is illegal to accept cash payment from Medicare clients on basis of treatment UNLESS beneficiary or the beneficiary’s legal representative refuses, of his/her own free will, to authorize the submission of a bill to Medicare. We CAN work with clients who would like consultation and development of wellness and performance programs as these services are not covered by CMS. (Please see Medicare Beneficiary Consent in the forms section)
Often times people ask why a treatment session cost so much versus if they were to utilize insurance and pay their co-pay. Education in key to assisting clients in understanding the value of our services. Cash-based models usually has an overall cost reduction to both the provider of services, but more importantly the client. Providers do not need to inflate their cost in hopes to be reimbursed the true value for their services. Additionally, personnel is not warranted to manage any billing needs therefore reducing overhead allowing providers to spend more time with clients. Quality vs quantity.
For clients, payment for services are transparent without any hidden cost- true fee for service. With traditional insurance models, you pay insurance premiums whether services are needed or not. When you do utilize services, co-pays and deductibles still lead to out-of-pocket expenses. We can assist you by providing the necessary documentation for you to pursue reimbursement directly from your insurance company should you choose to do so. This can lead to an overall cost savings to clients for treatment costs once reimbursed.
"Making the medical process simple so that we can just focus
on the medicine!"