We are Out-of-Network with all insurance carriers in order to provide you with the highest quality, 1:1 care based on your needs & goals.
We have decided to be an out of network clinic which means we do not accept insurance directly. We do this on purpose because we believe in putting you, the patient, first rather than treating based on what insurance will or won’t cover.
What does this mean for me?
This means our patients pay us directly for each visit and we do not submit claims to insurance. This allows our Doctors of Physical Therapy to spend a full hour with each patient. All services & communication with your provider are covered under our flat rate which means you will never be mailed a surprise bill and know exactly what your care costs. You also do not need a referral or preauthorization to see us.
If your insurance plan covers out of network services you are welcome to submit claims on your own to your insurance carrier. After each visit we provide you with a Superbill that you can easily access & download through the patient portal. Reimbursement varies by plan but can range from 50-80% of total visit cost. You can use this worksheet to gather all the necessary information from your insurance carrier to find out if you have out of network benefits.
Why Have You Chosen to be Out-of-Network?
Unfortunately insurance reimbursement for physical therapy continues to decline which forces many in-network clinics to schedule multiple patients at the same time, thus decreasing the amount of time you actually get spend with the physical therapist. Insurance also reimburses certain treatments at a higher rate which means physical therapists get pressured into selecting treatments that will pay more versus what would be the most beneficial to you. Insurance may also limit how long you can be seen which means you may not have fully met your goals and are forced to be discharged from care or pay out of pocket anyway for continued treatment.
Many times you can’t be treated for multiple problems by the same provider or at the same visit (i.e. pelvic floor issues and shoulder pain), requiring you to schedule more appointments, pay more co-pays, and have a decrease in your continuity of care due to seeing multiple providers. At Functional Phyzio you can be seen by the same provider for multiple injuries within the same plan of care.
Out-of-Network Can Save You Time & Money
Due to most visits at in-network clinics being only about 30 minutes where you spend limited time with the physical therapist, you are often recommended to come 2-3 times per week, which means more time away from your family, work and other obligations. You also have to pay a co-pay or co-insurance at each visit. The average co-pay is $45 per visit but can range from $25-$90. This means you could still be spending $50-$180 per week for 6-12 weeks.
Since we see each patient for 60 minutes 1:1, this decreases the need to come as often and also allows us to spread out your plan care, thus ensuring that we solve your problem long term and give you the tools & knowledge you need to take care of your body and stay symptom free for life. On average, patients see us for between 6-10 visits over 3-6 months.
If you decide you prefer to use your insurance we encourage you to use this list of questions when picking an in-network clinic in order to understand the level of service you will be receiving.