02/08/2024
What is self-pay/out of network medical treatment and why is it better?
Self pay medicine simply means the provider does not bill your insurance directly. The patient is responsible for paying for their treatment up front, and receive a bill to submit to insurance for reimbursement. This sounds scary, because it is quite different than most medical facilities we see for our medical care, but this model is actually very patient driven.
At Resolute Physical Therapy the patient experience is our priority. The choice to be an “out of network” provider was not taken lightly. Corporate,” in network” clinics have to negotiate with insurance companies and agree to be paid a lower price in order to bill that insurance directly. Therefore, in order to make up for the difference in cost, these clinics must book multiple patients (sometimes 2-3) within the same time slot, requiring the provider to split attention between multiple patients. In most cases, this leads to less individualized treatment and very “cookie-cutter” style exercise plans that patients could easily do at home. In addition to decreased value of treatment, patients are often required to come 2-3x a week, which is more time away from work or other obligations. In these clinics, care is frequently transferred to a PTA or technician for follow up visits, therefore most patients see the PT only a few times during their episode of care. The high volume “in network” clinic model values quantity over quality. We believe this model results in lower patient satisfaction and longer recovery times. We have also found that many patients are responsible for high deductibles and copays, which add up when you attend therapy 2-3x/week. For these reasons, the “in network” model does not align with our values and does not have the patient’s best interest in mind. At Resolute Physical Therapy, we will give you with the time and attention we feel like you deserve. Being “out of network” allows us to provide our patients with 60 minute sessions, one-on-one with a Doctor of Physical Therapy for the duration of your appointment EVERY TIME. Having individualized treatment for a full hour, you are likely to recover faster and with less overall visits, potentially saving you more time and money than you would spend at an “in network”
Although we embrace the self pay model, there are options to help work with you if finances are a barrier for treatment.
You are able to pay using an HSA or FSA card or your regular credit card. Additionally, many insurances will allow you to request reimbursement for your expenses. You will need to contact your insurance company to determine whether this is an option. We also offer payment plans and package deals at a reduced rate.