12/22/2022
Value versus Cost? In Network versus Out of Network Physical Therapy…..How does out of network Physical Therapy benefit you?
In the In Network Insurance world, there are many constraints and care is dictated by insurance companies with reduced reimbursement to the provider that forces the provider to make operational decisions to ensure a profit - treating 3-4 patients at a time, using assistants and Aides where you may see your provider for only 15 minutes, your recovery and time spent in therapy will be longer as a result normally requiring a 2-3 time a week frequency for 4-6 weeks on average with the standard of 12 visits per episode.
The benefits of working with an out of network provider let’s the care be determined by you and the provider alone. You would get 1 on 1 dedicated time with your actual provider who has more flexible over the services they can provide, you would usually only see your provider 1 time, 2 times a week max with a standard of 8 visits per episode on average - quicker recovery getting you back to those thing you enjoy quicker. You can also be provided a Super Bill to submit to your insurance company for reimbursement post treatment.
Based on the above as an example - A $50 co-pay for only 15 minutes with an in network Physical Therapist will cost you $3.33 per minute. In comparison, a $200 charge for 60 minutes with the out of network Physical Therapist will cost you $3.33 per minute with 1 on 1 undivided care with less recovery time.
Patients rarely understand their health benefits and weighing the pros cons over value-based care should be at top of mind.
If you have any questions, reach out. We got you! Make Vital Fit Wellness and Physical Therapy be your solution to optimal health!
