Knowing the difference between physical therapy that is in-network with your insurance plan compared to out-of-network is really important for you as the client!

Simply put, you get what you pay for.

At Physio Room we choose to put your needs first as opposed to the needs of the insurance companies.

There are 3 things we consider when looking at how Physio Room approaches physical therapy to make sure you get what you need.

Quality over quantity
Performance-based
Cost

Let’s dive into each one.

Quality over quantity. The truth is, out of network PT can provide a MUCH better experience for you as the patient. That’s because the patient is the client.. not the insurance company. When the insurance is the client, all of the focus is taken away from you. How so?

Well, in the medical system, the insurance companies actually determine the rates… which means you may not actually know the cost of the care you’re receiving until well after you’re done. Unfortunately, in the world of physical therapy, reimbursement from the insurance companies is quite low. As a result, clinics are incentivized to see multiple clients at the same time to generate more revenue. This ends up hurting the patients, and the providers in the long run.

The truth is, you can’t get the same quality care when your therapist is seeing 2-5 other people at the same time, and therapists feel the burden of more clients, becoming burned out with their career.

Have you ever been at an appointment and shared that time with other people? How did that make you feel? You end up getting a lot less time and attention from your provider and may even be spending the majority of the time with an aide or tech rather than your therapist. Instead of spending 20 minutes with a provider, wouldn’t you rather have a full hour of undivided attention?

Being out of network allows us to focus on YOU, not the insurance company. That means you’re no longer sharing your time and as a result, complete your plan of care in much less visits! Not to mention the added benefit of actually building a relationship between client and therapist beyond just why you’re coming into the office.

Performance-based. Speaking of insurance companies, they usually have a say in how you’re treated. At Physio Room, we are 100% performance-based which means we focus on you and your specific problems. Let’s say you’re seeing a physical therapist for knee pain. In a traditional in network setting, they’re only allowed to address your knee.

At Physio Room, we’re able to expand on things outside of your knee like sleep, nutrition, stress management, etc; things that will actually help you move the needle forward in your life, in your sports, and in your activities (of course, while also addressing your knee pain). Many clients have multiple body areas that are bothering them…

We treat the client, not just the body part. There’s a big difference!

Cost. Most people feel like going through insurance is cheaper than paying out of pocket, especially for something like physical therapy. But that’s not always the case!

The biggest factor here is that you’ll typically see your provider for LESS visits when in an out-of network facility. Remember, this is because you’re getting more one-on-one time and quality care from your provider. We won’t need to see you 2-3x a week for many many weeks.

More time, more value, better outcomes. We work with you to get to the root cause of why your symptoms are there, get you out of pain and get you back to your activities as quickly as possible!

Did we mention knowing what you are paying for? Fact is, there is much less transparency with in network clinics. They can’t tell you upfront what it will cost to work with them because it will completely depend on your insurance company. As a result, you often end up receiving a bill after the fact, for an amount that you weren’t even aware of, sometimes it may even come as a surprise because you thought that therapy was covered by your insurance.

At Physio Room, we will tell you exactly how much you’ll be paying and what value you will get for that. No surprises. This is rare in the healthcare world. In fact, we guarantee that if you choose to work with us, we will help you understand why you are dealing with the symptoms you are, what we think the root cause is and what you should be doing about it.

Ultimately, we aren’t here to tell you to never go see an in network physical therapy clinic. We just want you to be aware of some of the key differences so that you can make an informed decision that is best for you. Even if you do end up spending less money in the cases where insurance-based clinics cost less, the quality of the care you get will typically match.

We want to help you solve your problems and we want to do that as quickly with you as we can. We also want to give you the tools you need to help you stay out of pain so you can keep enjoying the life you love!

Let’s get the conversation started on how we can help you solve those problems. Contact us here and one of our PTs will be in touch very soon!