At a time when healthcare costs continue to rise, patients are becoming more cost conscious when accessing medical services.  As with many other practitioners and disciplines, gone are the days of the $10 copay. Physical Therapy is unique because it is a service that is recurring; most patients will be seen 2-3 times per week for a number of weeks making it both an investment in time and money.  Here are 5 ways to maximize your return on your investment.

1) Research and Interview your potential choices of clinics/therapist

There are many different approaches to physical medicine and many different types of clinics.  I encourage patients to be a savvy consumer and research their choices on online. Both Yelp and Google reviews are a great way to get a sense of past patients’ satisfaction and insight into the physical therapists approach.  Be sure to look to see how active the clinics review pages are and look for information about how much time the physical therapists spend with their patients.

Additionally, many clinics offer free injury screens.  Treat these free sessions as not just a way to get more insight into your problem, but as an interview of your potential therapist.  Look on the clinic’s website and find those physical therapists that were mentioned in the Yelp and Google reviews and try to be scheduled with them.

2)  Understand your insurance benefits ahead of time.

Medical billing and insurances is unfortunately a murky business; it isn’t like ordering off a restaurant menu.  Different insurance carriers pay clinics different amounts for services and each particular plan may cover at different levels.  I always encourage patients to call their insurance carrier and understand what their plan covers. The top things to know from the insurance carrier:

  • Deductible:  How much you pay out of pocket before insurance begins paying their portion.
  • Copay/Coinsurance: Once your deductible has been met this amount is either a flat rate (copay) or percentage (coinsurance) that you will pay for each visit.
  • Out of Pocket Maximum:  Some plans have an out-of-pocket maximum which is the total amount of money you’ll pay out of pocket in a particular year before insurance covers 100%.  In cases of having a surgery where medical costs will be higher, this can help with planning.
  • Visit limitations:  A significant amount of plans will have a maximum number of physical therapy visits patient can have per year.  This is also useful in planning if you think your particular case will require a significant amount of physical therapy visits.
  • Pre-Authorization:  Some plans require your physical therapist to submit information to the insurance to get prior authorization for you to attend physical therapy.  Even though your plan may allata have up to 60 physical therapy visits in a calendar year, they made dole them out is small batches of 3 or visits at a time.  

3)  Call the clinics and inquire about their billing and payment policies

Billing for physical therapy services can also differ between clinics.  Different PT companies may have different contracts with insurance carriers.  Some carriers pay a flat fee per visit; meaning that regardless of what is billed, the visit will be capped at that amount.  Others pay based on what particular services your therapist bills them. Your potential clinic of choice should be able to give you a sense of what a typical visit will cost. Taking this information along with the parameters of your particular plan, you should be able to estimate the costs of care for a month or two.  Remember, this also depends on when your insurance carrier accepts the charges from the clinic. If you are looking at a significant length of care or have a high deductible plan, be sure to inquire about payment plans.

4) Make sure your Physical Therapist is helping solve your problems

I am not going to comment on the different styles or philosophies of physical therapy. Every therapist has a slightly different take; and patients value different things.  Whichever direction a patient chooses, be sure that your physical therapist is using their most powerful tool: critical analysis each and every visit. Make sure that your physical therapist is helping you solve your problem and giving you guidance not just performing particular treatment techniques.  Physical therapists are here to help give you insight and how your physical therapy integrates into your world. Be vigilant in reporting how your symptoms affect you in your daily life and inquire how the physical therapist is addressing those concerns in his/her treatments. Remember, physical therapy is not something that is just done to you, but a partnership in problem solving to get you back to your life and activities.

5)  Be consistent and commit to the plan

I think the number one thing most physical therapists will tell you that unnecessarily extends a plan of care (which also increases costs) is inconsistency and noncompliance with treatment plans.  It is no different than taking an antibiotic; take as prescribed and finish the bottle. Inconsistently taking antibiotic decreases its effectiveness in knocking out the infection. Physical therapy is very similar; consistency in treatment to make Physical gains. Unfortunately the body takes some time to make these improvements so consistency is key to getting patients where they want to go. Set a goal and commit to a timeframe with your physical therapist to meet that goal.  Patients that take the “every so often” approach or frequently cancel/miss appointments end up making the plan longer and potentially requiring more management/visits. This translates to lost money, increase costs and lost time to meeting your goal. Your physical therapy is an investment in you.

Bonus Point

Go into to your physical therapy with the understanding that every case is a fluid situation.  It is almost never a straight shot to the promised land. It can sometimes be difficult to predict exactly how many visits or how much care a particular patient may need.  Depending on your particular pathology, lifestyle and life events there may be a couple ups and downs. The value of your therapy is how your physical therapist helps you overcome the bumps in the road.