The New Physical Therapy Model

By: Chad Burnham, DPT, FAFS, CSCS

You Deserve Better Than Your Insurance

We have been transitioning to a different physical therapy model over the last year. It’s called the “patient care comes first model”. Now some would call this a cash-based physical therapy model, but we will talk about that later. Over the last 12 years of practicing in an insurance-based physical therapy model, I have seen many changes and witnessed the many disservices that insurance can play in patient care.

For starters, your insurance has too much control over your own care. This means your insurance will dictate what types of service you receive, how long this service may be, as well as the amount of these services you will be “approved” for. Let me give you an example. I just recently had a high school soccer athlete that had an ACL surgery and her insurance only allows her to receive 20 physical therapy visits/year. For those of you that are familiar with ACL rehab, you know that 20 visits will barely get you past the first phase. How about another example. We had a patient that had to be rescheduled three times over the course of a month because we have to rely on her primary care physician to put in authorization for her to start physical therapy. What is wrong with this picture?

So you can see my frustration with insurance and how they are not “patient-first”, especially when it comes to physical therapy. This is why we have transitioned to this new model as the traditional model just does not line up with our core values here at ProForm Physical Therapy.

So how is our model different from the traditional Physical Therapy model?

If you have ever been to a physical therapy clinic that follows the traditional model for physical therapy, you will not only receive less time, but you may also be sharing your time with other patients. And if you are lucky you may get some time with a physical therapist. Here is what the traditional model for physical therapy does not tell you. They do not tell you that you are sharing time with someone else, because the reimbursement is so bad. If you were one of these patients that got mixed up in the traditional model and performing exercises by yourself in the corner for 30 minutes…thats because insurance reimburses the most for exercise. WTF! It’s all about the numbers. The traditional physical therapy model sacrifices patient quality for patient quantity. And that’s the real truth.

Now, we know not being in network with insurance is a different concept for some to understand. My job with this blog is to inform you about the benefits of our “patient comes first model”. Although it may be a cash-based model, your health is worth it and is the best investment you can make.

So what’s the benefit if you don’t take my insurance?

1. You actually get to see your physical therapist. What a weird concept, lol. I know this sounds like common sense, but this is not what will happen everywhere. Traditional model physical therapy clinics will often utilize a physical therapist assistant to get more patients in the door. Here at ProForm PT you will receive 100% one-on-one time with your physical therapist!
2. Contrary to popular belief you might actually save money even if you are not able to utilize your insurance. As we are able to see patients longer during a treatment session, we do not have to see them as frequently throughout the week! This will play a huge role for those patients that have a high co-pay or deductible.
3. Get better faster! Yes you will get better faster with our model. We are very serious about quality over quantity of care here at ProForm PT. Not only will you save money, but you will get back to the things you love to do sooner.
4. We can treat whatever we want. In the traditional model you will be limited to treatment of a single body part. And if we need to treat another body part as part of your insurance then it will need to be a separate evaluation and may need separate “approval”. At ProForm PT we can treat whatever issues you may be having. Best part is it will not get denied by insurance!
5. Just because we may not be in-network with your insurance, does not mean that you may not have out of network benefits that could get you reimbursed. At ProForm PT we will provide you with a superbill at your request so that you can submit and get reimbursed by your insurance company.

Here at ProForm PT you hear us say that we are not your average PT clinic…This is just another reason why. The current model of traditional physical therapy has to change as it is not benefiting our patients the most as well as not benefiting our great community. Insurance is not the only way…and it surely is not the best way!

With our model here at ProForm PT you will not only save time, but you will ultimately save money and achieve your desired results…faster.

Just remember…you deserve better than your insurance and do not let insurance dictate your physical therapy care. We Don’t!