In today’s world of healthcare insurances having a high-deductible health care plan is all too common. After a visit to the doctor’s appointment we’ll get a our EOB (explanation of benefits) leaving us with a $300 bill. Why is this ?
Simple if you deductible has not been met for the year, then services provided would come out of pocket.
**Disclaimer this is NOT legal medical advise, please consult your healthcare provider to verify if this applies to you.
Injections and surgery, often the go-to treatment or technique for a doctor, often mask our pain or miss the real source of the pain (for example, a shorter leg on one side of the body, causing the pelvis to be asymmetrical, could be the cause of back pain). If you want to get to the root cause of your dysfunction or pain source not just treat the symptoms, it is well worth seeking a doctor of physical therapy, or licensed massage therapy, especially for issues related to the musculoskeletal system, whether that be tight hamstrings, a crick in the neck or dull, incessant pain in the back.
Now I’ll give you some examples as to how you could save money by seeing a Cash-based physical therapy practice.
In a traditional P.T. outpatient clinic, they would see you from 8-12 visits 2-3 visits per week for 4-6 weeks, this is pretty standard for a medical doctor to prescribe for musculoskeletal pains and aches, for example shoulder rotator tendonitis.
If you went to a traditional P.T. clinic (often is shopping centers or stripe malls), that accept your health insurance you would have to pay a daily co-pays 3x a week often $30-40 each visit.
While all healthcare plans vary and have different tiers of co-pay costs you would still be responsible for them out of pocket. Just to sign your name and sit in a lobby (or your car during COVID-19).
Additionally and most importantly, if you have not met your annual deductible ranging from $2500-5000 + you may also be responsible for the cost of each visit until you met your deductible.
I like to break it down like this: 12 visits for shoulder tendonitis 3x a week for 4 weeks:
- decreased time spent with your physical therapist due to the system forcing therapist to see multiple patients per hour 2-3
- actually 1 on 1 time with your physical therapist 12-15 minutes of actual manual therapy 45 minutes left to do exercises by yourself or with a Physical therapy tech
- average co-pay costs $40
- average cost per physical therapy codes $350-400
- 3x $40 just in co-pays =$120 weekly to sign your name and check -in
- 3x $375 per visit out of pocket = $1125 per week
- $1125 x 3 weeks = $3375
- 3 weeks of care = $3375 + $480 (4 weeks of co-pays) = $3855
- + all the time taken out of work just to go in 3x a week = priceless
How a cash-based physical therapy practice does business for the same example shoulder tendonitis.
- 1 on 1 full 60 minutes with your physical therapist
- no sharing your time with anyone else
- No copays $0 cost to you
- average cost per physical therapy $175-250 per hour
- instead of 3x a week often this is reduced to 1-2x per week depending on case by case as per the evaluating physical therapist recommendation
- with 60 minutes 1 on 1 physical therapist can also identify the source of pain, movement dysfunction and create a custom plan to treat your source of pains not just your symptoms
- those 12 visits often get reduced to 6-10 visits getting you out of pain and back to living as you should
- 8 visits x $185 = $1480
- cash based service your physical therapist will still give you a Superbill a detailed invoice explaining what was done during therapy
- the Superbill is then given to the patient to provide to their health insurance provider for reimbursement
- although cash based physical therapy businesses can not warrant all of the Superbill will be covered, that is up to the patient to discuss with their health insurance provider
- traditional in network cost $3855 vs cash based $1480 = $2375 of savings!
- time spent with therapist = average 15 min per visit x3 = 45 minutes per week vs 1 on 1 60 minutes per visits x2 = 120 minutes per week
- accelerating healing times and speeding up recovery
Did you know your doctor of physical therapy in most states have what’s called Direct Access, meaning you do not need to go into your doctor in order to get a script for physical therapy saving you yet more time and money.
These alternative therapies continue to have more research published that back up their health benefits — including research out of the National Institutes of Health.1,2 These holistic therapies, that come with little adverse effects (if any), cost just as much as your co-pay tagged onto a high portion of deductible, or less.
Omni Wellness & Performance is a cash-based practice and allows you to skip paying for your high deductible and co-pay and to pay for your session upfront. There will be no extra fees post-appointment.
Consider trying a service at Omni Wellness & Performance today, and be on your way to living a better life, pain-free, allowing you do what you love, once again.