Insurance In Healthcare
Insurance companies say they have our best interest in mind
But many of us know that is a lie we are told
We pay for our health insurance every month, and many times it is there for an emergency and we don't need or use it
But when a time shows up when you are in pain and need to see a physical therapist or get rehab for an injury they want to give you as little benefits as possible
How insurance works in the rehab space
It is most popular when someone is in pain or experiences an injury for them to start by seeing their primary care doctor
Laws have changed recently. Direct access now allows people with certain types of insurance plans to go straight to a physical therapist if they choose
If you go to your doctor they will typically make you get an X-ray or MRI, then give you a referral for physical therapy
And then the waiting game starts
You wait sitting around for weeks in pain for your MRI
After that you schedule an evaluation with a physical therapist, and wait even more
Then they send all your information to the insurance company and allow them to tell you and your doctor how many visits you will be given and how long they will cover your treatment costs, and you wait while they figure that out
Insurance companies need to know everything about everything
This is why most physical therapists spend more time typing notes on a computer than they do working with their clients
Depending on how your progress goes, they may add or take away visits depending on what they think you need
Keep in mind insurance companies make these decisions, not your doctor
If the insurance company caps you at 3 visits per week for 12 weeks, once those are up you can no longer continue with treatment
Unless you submit a claim requesting more which is not guaranteed, or you pay out of your own pocket
This is why Cash Pay practices are becoming so popular
This allows the health professional to use their best judgement for your treatment, not insurance companies with no experience or education related to rehab
Majority of insurance companies do not cover personal training
Insurance is for reactive treatment (After an injury has happened)
Not for proactive treatment (Things you can do to prevent pain and/or injuries)
And there are few personal trainers who specialize in pain relief & rehab like Platinum Training
Common misconceptions:
Most people opt out of cash pay rehab services because they can be expensive
And "If I pay for insurance I am going to use it", which is a fair argument
What it comes down to ultimately is what you care about more
The cost of the service, or the quality of service and outcomes you will get
If you work with a cash based rehab professional you can expect much better care, attention, and planning because there are no insurance restrictions and the healthcare professional gets to use their best judgement on how to treat your pain
If you work with a company who takes insurance, you can expect to be a number in the system. You will get the same exercise routines as most other patients who have similar pain. You will get general treatment and care from your provider and likely be unsatisfied with the outcomes
A different perspective:
How frustrated would you be if you chose the insurance route
The way that takes much longer and comes with more frustration
And after your treatment is done you're still in pain
Would you go through the same process to come out short-handed of reaching your goals again? Or would you try a different option?
What I see all the time:
People decide to go with their insurance because it is cheaper
It takes a very long time and they make minimal progress
Months later they come see me, a cash based personal training rehab company
And have to pay out of pocket after all their other treatment
But they get amazing results in the fraction of the time...
You actually would have saved time AND money by going with the cash based company to begin with
The up front costs may be more (depending on your copays and deductible)
But in the long run you will actually save time and money, and get the results you were expecting!
Cheap cost = cheap quality
There should not be a price limit you set on the quality of your life!
If you live in Edwardsburg and are dealing with pain you can now book your FREE assessment on our website
https://platinumtraining.com.co/products/free-injury-exercise-evaluation
P.S
If you're still worried about paying out of pocket for cash services because they can be expensive, ask us about our superbill!
A superbill is a form out of network cash providers fill out and have you send into your insurance company for a potential reimbursement
Keep in mind all insurance plans are different and there is no guarantee how much they will cover but it is worth a try to save some money!
At the end of the day insurance companies are businesses that want to make money just like everyone else
If you still think they have your best interest in mind look up their annual profits. They will shock you
Keep up the hard work
Until next time,
Garrett Kendall- ACSM CPT
68925 M62 Suite D Edwardsburg, MI
269-258-3040
platinum.train1@gmail.com