Why Choose Cash-Based Physical Therapy?
Insurance can be expensive and frustrating for both consumers and providers. When we pay a lot for insurance, we want to get something back in return. One of the first questions patients often ask is “Will my insurance cover this?” and “Who can I trust to provide me with the best care for my money?
The Cash-Pay model is gaining a lot of interest from both clinicians and patients. The main reason this model is so appealing is because it emphasizes quality patient care over quantity patient care, while removing the headaches and restrictions associated with insurance based care.
So what are the benefits to choosing cash-pay services?
If you live in a mid-large size city, chances are you may have to wait to be seen in your typical in-network clinic. This could be due to both the availability of in-network clinics, and/or the amount of time it takes for your insurance provider to approve authorization to eval & treat. This can take up to 3-4 weeks in some cases. If pain has you sleepless or unable to do the things you love to do or even just daily activities, waiting around can be a daunting process. Once you access care through your insurance, there will be restrictions on visits and potential delay in care. This makes the rehab process even longer, and we all know time is money, and time is our only non renewable resource.
Not to mention, with payers out of the picture, PTs can truly focus on providing exceptional patient care rather than being distracted by the ongoing demands of insurance companies just so their patients can have a fair shot at recovering.
2. Total Cost of Care.
If you’re not a math person, hang onto your britches and just hear me out. Depending on your provider and coverage, cash-based PT can save you MONEY and TIME. For example, if a cash based PT at $50 per half hour session gets you better in 4 visits ($200 total) and an insurance co-pay PT at $30/session gets you better in 8 visits ($240/total in co-pays), the cash based PT is actually less expensive in the long run, in both TIME and money.
OR let’s compare 8, hour long visits at a $100 cash rate ($800 total) to 8 visits insurance co-pay rate of $30 ($240 total). Seems like a no-brainer to go with the cheaper in-network option, right? Well that $30 co-pay is what you see assuming every thing else gets covered by your insurance. Your insurance is really being billed much more by the in-network therapy provider, typically at least $150, so add another $1200 onto your total cost of care for a grand total of $1440. What does that do to your future insurance rates? In some cases it could increase them. Or even worse, what if your insurance denies payment, who gets stuck with that bill? You do. If I walk into a grocery store to buy a carton of eggs, I have to pay the price listed for it. If it’s $4, I can’t tell the store, “today I feel like paying $1” and stick someone else with the $3 difference. If I try to use my insurance to pay for my healthcare, there is no guarantee they will pay for it. I get stuck with whatever difference the company does not pay which is most likely going to be more expensive in the long run.
3. Less restrictions on visit #: When you use your insurance, you may only be approved a couple of visits. What if you are going to need more visits or a longer window of treatment and your insurance won’t cover it? Paying cash for your PT services puts you at the helm of determining what kind of care you need, not your insurance company.
4. Shop local. Going to a private cash-based clinic offers you the opportunity to support the local economy. As a local cash-based clinic, we are not outsourcing jobs. We are not a part of a big franchise. We are here to help the community in any way possible and are likely to support other small businesses as well! (email us at email@example.com for community involvement inquiries!)
5. Does your PT even lift? Or play sports?: You have the autonomy to choose your provider! If you’re an active person, you want a PT who understands the active lifestyle. When you choose a clinic doing running, olympic lifting, CrossFit, or other sporting assessments make sure your PT really understands all aspect of the sport. Let’s say I injured myself when picking up a heavy piece of furniture and it’s now impairing my ability to do CrossFit OR (insert favorite exercise/sporting activity here). If I’m going to hire someone to do a movement/pain assessment and treatment, I want them to understand not only the mechanics of my typical exercises, but the type of equipment I use, be able to demonstrate techniques or drills to improve my abilities, and even have other people within the local community they can recommend such as functional medicine providers, coaches, Chiro, gyms, etc. to compliment their services. Unless your PT has experience in many sports and the ENTIRE realm of fitness, they most likely won’t have those complimentary recommendations to their services.
6. What about HSA and FSA money? Can I submit cash-based services to my insurance for reimbursement?
Good news! We accept both HSA and FSA funds as forms of payment! Don't let that money go to waste. We are also able to provide patients with an invoice or "superbill" that they can submit to their insurance for potential reimbursement. Not all insurance benefits are lost when you go the Cash-Pay route.
So my advice to consumers and clinicians alike are to assess your benefits of care under different clinics. We comparison shop most things in life, why not shop your wellness care too! You might just surprise yourself in what you learn.