Why pay cash for physical therapy if I have insurance?

INSURANCE:

• Most people have high deductible health plans
• Most will not meet their deductible
• That means your insurance will not help you pay for PT regardless of where you go. Unfortunately, we know this all too well and don’t bother working with insurance. Instead we provide quality one-on-one care, faster results, rate transparency, and true healing that targets the root cause of your pain.
  

CONSIDER:

• How much have I put towards that deductible?
• Without medical emergency, would I meet my deductible this year?
• If not, processing through insurance is unnecessary.
  

IF YOUR DEDUCTIBLE IS MET:

• Cost-sharing is handled in one of two ways: 
• 1) Coinsurance (Most Common)
• 2) Fixed Copay: If your specific plan converts to a flat copay, physical therapy is almost always billed under the "Specialist" tier. 
  

WHAT IS A SUPERBILL?

• A superbill is an itemized receipt that lists everything an insurer needs to process a claim.
• Depending on your plan, those payments can count toward your out-of-network deductible or you receive direct reimbursement sent back to you.
  

THE SUPERBILL PROCESS

• Pay upfront: You pay the full fee at the time of your appointment, using HSA/FSA or cash.
• Receive the superbill: The clinic gives you an itemized receipt.
• Submit the claim: You complete an out-of-network claim form from your insurance provider and attach the superbill. You can usually upload this via your insurer’s online member portal or mail it in.
• Get reimbursed: If your plan includes out-of-network benefits and you have met your deductible, the insurance company sends a reimbursement check or direct deposit straight to you.

Many patients have out-of-network benefits through their insurance provider and have been reimbursed between 50-80% of an insurer’s allowed amount. 

While this has worked for many people, we cannot guarantee that your insurance company will reimburse you.