Did Your Insurance Provider Go To Medical School? Then Why Are They Dictating Your Health Care?

Healthcare is changing.

Unfortunately your insurance premium is rising, however your access to medical care and health related services is decreasing. For many people, physical therapy services will still cost upwards of $75 per visit - with insurance!

You, the patient, need to take control of your health and wellness as insurance companies will continue to manipulate the system and the providers within it. Ultimately this causes you, the patient, to be the one who suffers as access to quality care will quickly diminish.


So How Can You Take Control Back?


In the following, we'll discuss the implications and constraints of a third party payment system, impact to quality of care and how to “avoid the mill.” Some of this may be unsettling to learn - but after reading, you will be empowered and equipped to make the best decision for your physical health.

To offset low reimbursement rates, many clinics have turned to higher volume as a way to make-up for lost/decreased revenue. This is obviously detrimental to patient care - your time with your doctor is very limited. This equates to less evaluation time, less assessment time, less manual (hands on soft tissue work) time and less corrective exercise time! Ultimately, this delays your recovery.

You may have even heard stories from friends or family that have described feeling like they were “milled through” their appointment. Unfortunately, this has become a real practice in health care.

PT Mill (noun): a rehab clinic setting where patients are numbers and simply shuffled along from one area of the clinic to another, most of the time by unskilled technicians and/or without any supervision.

The physical therapist in this setting becomes adept at managing traffic and less so at treating their clients effectively.

A good way to recognize a PT Mill is by how much hands-on time you have with your Doctor. A typical Physical Therapy appointment in this scenario typically looks like a 45-60 minute block with roughly 15 minutes or less of actual time spent with your Doctor. And if you have a question for your Doc, that will take up a portion of your table time. Considering myofascial manipulation is critical to your healing process - that 10 minutes isn’t going to do much.

As much as your Doctor may recognize the scope of treatment necessary to get you back to full health, they are often handcuffed by the insurance companies to provide it.


Introducing A Movement & Your Right To Quality Care


There is currently an important movement being enacted by many Health Care providers who want to liberate themselves from third party contracts (insurance). These Doctors/Providers are passionate about taking the control back and not allowing an unqualified, non-medical professional dictate patient care.

Professionals in the fields of physical therapy, dentistry, specialty medicine and even surgery have begun to operate within a cash practice model. The “cash only” term simply means that patients pay at the time of service. There are no third-party payers to dictate or complicate the relationship between you and your Doctor. In a cash practice maximum accessibility and value are stressed. Have a question for the doctor? They will answer it thoroughly. Need some extra hands on care? They will be excited to give it to you.

And another bonus: ALL of this great treatment is still 100% entitled to reimbursement by your health insurance provider.


An Example In Action:

Here is a great example of an email that was recently sent by one of our patients. Our patient is a competitive ultra runner and was extremely committed to returning to full health.


In-Network provider:

$40.00 per 60 min visit, with approximately 15 min contact time with PT provider.
I would go 3x/week totaling approximately 180 min of my time, and 45 min of contact time with PT provider.
Total out of pocket expense: $120.00 per week
Treatment: several months ($2,400)
Results: no improvement.

Physical Therapy Elite(out-of-network provider):

$75.00 per 60 min visit, with approximately 60 min contact time with PT provider. In my case, this was applied directly with Dr. Jessica.
I would go 1x/week totaling approximately 60 min of my time, and 60 min of contact time with PT provider.
Total out of pocket expense: $75.00, less 50% of the maximum allowable reimbursement from my insurance, totaling about $37.50 out of pocket.
Treatment: 6 weeks ($225)
Results: Significant improvement and return to normal training. The time I spent with Dr. Jessica paid dividends. I was amazed that in 6 weeks, I was back to full running form.

Our Decision and Commitment To You:

Physical Therapy Elite has made a very intentional commitment to operate without the control of third party adjusters dictating patient care or forcing high volume. Physical Therapy Elite was born out of the desire of a passionate group of individuals to offer a higher level of rehabilitation and human performance services where the physical therapist, the healthcare provider, your doctor has full freedom to apply their undivided attention and clinical expertise to YOU.