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Do you take my insurance?

“Do you take my insurance?” is a common question that I get asked. While the simple answer is "no", this really is a very loaded question.


But before you stop reading, let me explain how you can benefit from this.


Price Transparency


Insurance is so complicated, and it often depends on your plan. BUT whether you decide to work with an in-network or out-of-network provider, you are financially responsible to pay your deductible. In many cases, when the dust settles (even if the deductible has been met), you could still be left with unexpected bills due to insurance providers billing higher fees for service or finding out later on that your insurance did not cover the services you received. There are many horror stories of patients receiving unexpected bills many months after their care at in-network clinics.

 

When someone chooses to work with Outshine, they know the upfront costs and will never get blindsided by any additional bills. I can also provide you with a receipt (aka superbill) that you can submit to your insurance company that will go towards paying off your deductible. Then when your deductible has been met, you may be eligible to receive reimbursement in the range of 40-80% which depends on your coverage.



A performance physical therapist warmly talking with a patient lying on the treatment table.

 

Don’t let insurance companies control your care


Unfortunately, insurance companies decide which services are reimbursable. This effects how providers at in-network clinics choose to bill in order to get max reimbursement. Because insurance companies are also known for reimbursing physical therapy clinics at very low rates, it forces these in-network clinics to see 2-4 patients at one time. This has multiple side effects.

-At an in-network clinic, you may end up paying $200-$400+ per visit until your deductible is met to see your Doctor of Physical Therapy for 10-20 minutes while you spend the rest of the time on a bike or performing exercises with guidance from an unlicensed tech. This means less skilled care and time wasted which equals more visits over a longer period of time to reach your goals.

-I can't get to know someone really well with such limited time. Therefore, it's nearly impossible to make long-term, meaningful lifestyle changes with patients in that setting. I tried....it's exhausting and just not feasible.

-Insurance companies don’t like to cover care provided for any improvements past basic function. So, for example, your insurance provider doesn’t care if you are pain-free all day but still experiencing pain when barbell front squatting. This is a problem because my goal is to get folks back to the gym and performing at a high-level, and not just doing basic activities of daily living.

-Insurance companies also don’t like to cover care provided for another body part without jumping through many extra hoops (sometimes even getting a new referral in some states).



A performance, cash-based physical therapist working with a patient to determine strength in their legs.

Focus on quality over quantity

 

There are some instances that require visits at 2 or 3 times a week like post-operative rehab. But in general, the cookie cutter plan of 2-3x/week for 6-8 weeks is not what most people need.


Let’s face it, we are all super busy and honestly could use more time in our day. So I certainly don’t want to waste your time. I will not make you wait 10/20/30+ minutes like most health care visits. And if you buy in to doing your part in this process with me, then I will go above and beyond to make sure you I do everything possible for you.

 

So those are the reasons I have chosen not to take your insurance directly. You will get unmatched quality of care, save yourself valuable time, see results faster, and potentially save yourself money at Outshine.

 

I would love to hear your comments and would be more than happy to answer any questions that you may have regarding your insurance.

 

Let’s talk soon,

Dr. Sieara

828-808-3704

 

 

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