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Why You Want Out-Of-Network Physical Therapy

Why You Want Out-of-Network Physical Therapy

I was fortunate enough to pursue the career of my dreams in Physical Therapy. In school we learned how the body was designed to move, how it heals, and techniques and exercises to help people manage pain and get back to the activities they love. It has truly been one of the most rewarding decisions to pursue a career in an area I feel very passionate about that also allows me the opportunity to help my community.

I started my Physical Therapist career in a traditional setting in the corporate world. I quickly realized the career of my dreams was not exactly what I thought it would be… Unfortunately, our American health care system has become controlled by bureaucracy and insurance companies. My abilities to help people was hindered by insurance adjusters who have ZERO medical background. For several years I watched as many patients were denied care or delayed in treatments as a result of unnecessary paperwork and insurance dictating how many visits were approved for treatment.

Over the years, insurance reimbursement for therapy services has dwindled. This has created a cascade of problems in many in-network facilities at the expense of the patient. If you have ever been treated at an in-network physical therapy clinic, maybe a few of these short comings sound familiar:

  • 3-4 patients per physical therapist all at the same time
  • Limited time (less than 10 minutes) with your therapist
  • Exercises/techniques supervised by unlicensed therapy technicians 
  • Multiple and unnecessary modalities that you can do on your own time (ice, heat, Estim, ultrasound) 
  • 2-4 treatment sessions every week 
  • Unclear about final cost of plan of care until you get billed several months down the line
  • Rotating between therapists and having to repeat story again and again
  • Never progressing beyond basic cookie-cutter exercises
  • Athletes doing the same exercises as geriatric patients 
  • Very little or any manual therapy techniques 

Do any of these sound familiar? Unfortunately this is the model many clinics have morphed into as a result of insurance companies.

When I opened Elevation Athletics, I did not want the safety and health of my patients be dictated by unlicensed adjusters. I wanted a different model. I wanted the decision regarding a plan of care to be determined between the health care provider and patient. Nobody else. 

To provide my patients with the best care possible, I determined an out-of-network was the ideal choice. I believe in transparency, and the following are core values. These values are foundational to Elevation Athletics:

  • 1 to 1 care 
  • Full hour treatments EVERY visit with a Doctor of Physical Therapy
  • We listen to your individual goals
  • We believe that every manual technique, education, corrective exercise, sport specific drills demands the watchful eye of a trained Physical Therapist and not an unlicensed technician 
  • We believe in the importance of respecting our patients TIME. Patients need to own their recovery and coming into the clinic 3 times a week is unnecessary. As a result of the meticulous attention given at Elevation Athletics our patients start to improve and recover at a much quicker pace than a traditional in-network setting.
  • We believe in the importance of giving patient customized home exercise programs based on the needs and goals of our clients.
  • We believe in using the most up-to-date evidence based practices. This means we do not waste our patient’s time and money on unnecessary passive modalities such as ultrasound, or Estim patches. This saves our patients time AND money. 
  • We believe the ability to run, squat, and play sports pain free is vital to the physical and mental health and wellness of our patients. We are not limited by what insurances companies deem “medically necessary.” 
  • We have a no BS rule here at Elevation Athletics. We will tell you how many visits we predict you will need and how much it will cost on the very first visit. 
  • All of our patients will get the tools and knowledge to take care of their own bodies. We teach and educate to promote independence beyond the clinic setting. 
  • We want ALL of our patients to be pain free long term. We start by reducing the pain, then we fix the problem that created the pain to begin with

The healthcare landscape is changing. Many insurance plans have high deductibles now, meaning most people will be paying out of pocket anyways. Multiply that copay with the 2-3 times a week the clinic will request you attend during a single week! We believe in the importance of clarity and investing in your body. Your healthcare practitioner should align with your values and do what’s best for YOU. 

Thankfully, many insurance companies have out-of-network benefits. Which means if you come to a practice like ours, then you can still file for reimbursement and and potentially get money back or application towards deductible. 

If you are tired of being treated like a number, and not getting the care you deserve then reach out to us. If you have more questions about out-of-network practices like ours, we would love to walk you through our process. We would be happy to help you determine if we’re a good match for your therapy needs. If not, we will try to help point you in the right direction to someone who is.

- Dr. Ryan Perez PT, DPT, OCS, CSCS, Cert. DN, owner