Hey guys, it's Stephen at CORE Therapy and Pilates today. I want to go over a topic about in network or what I call
contracted or insurance contracted facilities versus non
Contracted facilities or out-of-network, which is what we are here at CORE
I saw a video just the other day from a friend of mine down the street
who is a physical therapist, Jarod who got me involved in the cash based world and this is
a great post that he put out and I think it's fantastic for
All potential physical therapy clients to hear this. So what happens is we're at a point now where
Deductibles are higher than ever, co-pays and coinsurances are higher than ever and
January just a few days away
We're gonna see those deductions turn over
So people who are in network and have a high deductible with say two, three, four or five thousand dollars
which is very common today. They'll have to pay out of pocket to see a physical therapist in network or out of network
until that deductibles met... so the question becomes what's the difference in an network clinic quality of care?
well when you come to a place like CORE to see me or my physical therapist, Allyson,
It's one on one care with a physical therapist for
the whole time, we don't use aides or assistants, it's very focused on the patient, client
It's not what the insurance dictates and thinks we should be doing
When you go to an insurance based clinic, it's really based on what your insurance says and demands and dictates
It's a very different thing. But what I wanted to present today, there are a couple questions that you should ask if you're a potential
Physical therapy client trying to determine the cost
And what's the better value for going to an in-network place or in about a network place?
So I'm gonna read off a couple questions that you're gonna I want you to ask your insurance providers
One until I meet my deductible
What can I expect to pay for each session of physical therapy at in network PT clinic?
They may only give you percentages like 80 or 90 percent but the typical fee that
Private practices will be charging will be
$250 and above and if you go into a hospital facility will be charging $500 or above
the next question, What can I expect in reimbursement or
application to deductible if I get physical therapy at an out-of-network provider and send in
self claims
So just so you know if you do get in touch with an insurance company
They will try to persuade you to go in network and not out of network. That's just how it is. It keeps the
Contracts and whatnot keeps them in a little more control. I'll just leave it that way
Now what are the questions that I would want you to ask you the in-network facilities?
So you've called me we've gone over what we can do. What do you call them? You call the N Network quit officers
What do you ask them? First one on average how many patients per hour do providers treat?
Many times the physical therapists, they've seen two, three, four or five patients an hour sometimes morning
Are only physical therapists providing the care or do you use assistants, aides or techs?
How much one-on-one time will I get with the physical therapist in each session?
Average how many times per week do patients come in for treatment?
and with knowing this information and then coming in to see me for my
free discovery session, We can really look at what's going on
what's the best solution for you so you can make a better decision about your health and
Moving forward with all the information and knowledge. So this is just something to chew on as we move into the new year
I think a lot of people think because I don't take insurance that it's going to be a lot more
Expensive than going to the place that does take insurance
But I'd typically see people once a week and get them better very quickly
versus
Going to an insurance based Facility and going in two or three times a week
and doing the home work that you can do at home that I teach
You to do at home
Instead of having some aide that makes 10 bucks an hour
Watching you do it
So a little difference in the quality of care, a little difference in the speed and getting people in and all those things
So that's it for today. I just wanted to go over this in network and out of network
I think a lot of people get caught up in that and don't truly understand the deductible scenarios
co insurances, the copay. So I hope this helps you have any questions just
Leave them in the comments below
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