FAQs About Cash-Based PT
Going to an out-of-network provider seems scary, especially when you've been told your whole life that insurance is the only way to afford healthcare. But what if there was a simpler way?
What are the benefits of paying cash for my physical therapy?
Know what you're paying upfront.
With transparent pricing, we leave the guesswork out of paying for therapy. Say goodbye to the stress of wondering how much that evaluation will actually cost you when you get a letter in the mail from your insurance. We pride ourselves in only having you pay for the services you need.
We can treat anything and (most) everything, all at the same time.
Let's say you're seeing Neuro B.C. following a concussion and one weekend you sprain your ankle during a pickup basketball game... when insurance is involved, your therapist needs to attach a diagnostic code to every "episode of care", meaning they can't treat your ankle because it's not related to your concussion. So this leads you to paying DOUBLE to see the same provider (or finding a new one) to treat the same body. It's annoying for us because we want to help, and obviously it's annoying for you! Without insurance involved, we can patch up that ankle in the same session, without you having to jump through hoops.
*Disclaimer- while we'd like to believe we are experts in everything, sadly we are not. If something comes up and we know we aren't the best provider for you (e.g. pelvic floor therapy), we will help you find someone that is.
You don't need a referral from another provider to get answers.
Thanks to direct access laws in Oregon and Washington, you can refer yourself to physical therapy. That means no primary care physician, no script, just answers! Some insurances require a referral (even with direct access laws) to reimburse services but with cash pay, you avoid this.
As a team, you and your therapist will decide when your treatment is complete, not the insurance company.
Many patients experience abrupt endings to their treatment simply because insurance decides they don't want to pay for services anymore. Ask any clinician and they will tell you their least favorite part of the job is documentation. Why? Because it takes so much time and energy to convince insurance that our services are warranted. The pressure is on us to make sure our patients don't get stuck with a huge surprise bill or get discharged when there is so much progress left to make. With cash pay, there's no underlying fear of the end looming and together, we get to decide when you're truly ready to end treatment.
When you pay for 1-on-1 treatment, that's what you'll get.
In a typical outpatient PT clinic, you'll go in and realize your therapist is treating two or more patients at the same time. Questions and concerns can go unanswered, therapy feels rushed, or you feel like someone else is interrupting your treatment. At Neuro B.C., when you pay for 1-on-1 therapy, you are promised our undivided attention for the entire time. Although we might end up burning less calories running around between patients, it's a sacrifice we are willing to make.
No filler treatments!
Have you ever been to a PT clinic where the majority of the session you're laying on a table with electrical stimulation, ice, heat, laser, ultrasound, etc. and your therapist is nowhere to be found? Or you're just doing your home exercises that you already know how to do while your therapist furiously types away on their laptop? Or you're spending 20 minutes on a bike or treadmill doing steady-state cardio? And that little voice in your head says, "Why am I paying for this"?
The reason so many healthcare providers resort to "filler treatments" is because they are expected to fill an entire session with billable units in order to make the clinic money (aka productivity standards). When really, the patient only needed 30 minutes of hands-on care and could be sent on their merry way to use heat or do some cardio at home. Therapists feel pressured to document notes in session because when they aren't providing billable care, the clinic doesn't make money.
After working in facilities like the example above, we've grown tired of fluffing treatment sessions just to meet minutes. That's why, at Neuro B.C., if we have you hop on a treadmill or use a modality in clinic, there's a reason for it. That's also why we offer 30 minute sessions for when you're further along in treatment and just need those quick tune-ups.
We will never waste your time or money.
Won't this cost me more money than using my insurance?
We don't want to lie to you- it might. Every situation is different so it's important to do your own research and decide if cash-pay is right for you. There are plenty of good therapists out there who accept insurance that might help you reach your goals. The difference is, we truly believe we have our patients' best interests at heart and want to create life-long relationships to help you manage neurologic and other conditions in the longer-term. It's really difficult to do this with insurance involved.
There are some statistics that state cash-pay is actually cheaper in the long-run and give you more value for your money. With rising co-pay prices and decreasing reimbursement rates, insurance can be more of a guessing game and headache than it's worth. And with the push towards high-deductible and HSA plans, you can use your HSA funds towards cash-pay services.
The bottom line is: you have to decide if cash-based is right for you. We are here to answer any questions you have and help you cut out the middle man or woman.
Can I get reimbursed for my therapy?
In short, YES. Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide payment for services received "out of network". Going out of network means that you can choose to see a physical therapist who is not a participating provider with your insurance company and means that Neuro B.C. has not entered into a contract with individual insurance companies to receive reimbursement based on their contracted rates. It is important to note that in network provider status is not currently based on education, experience, skills, or treatment outcomes, but is often determined by the number of providers in a demographic area. Many patients choose to receive services out of network in order to see the physical therapist of their choice.
The process is actually quite simple: we can provide you with an invoice at the time of service and you submit it to your insurance company for reimbursement. The invoice has all of the necessary information (business name and address, tax ID, national provider identification, license numbers, etc.) as well as the patient’s ICD-10 (diagnosis) and CPT (billing) codes. You may choose to submit bills following each visit, one time per month, or at any other interval, typically up to one year following your treatment visit.
Please note: every insurance company is different and reimbursement rates vary.
To learn more about cash services, you have to do your own research. Start with this article from Consumer Reports: