What is Direct Pay Physical Therapy?
Honestly, it’s just a nicer way to say you pay me directly each visit for our session together instead of paying an insurance company who takes a portion and also gives me a portion. I have no relationship with any insurer.
Why would I do that?
For starters, you and I are both more invested when we have the direct relationship of getting you better. It leads to better outcomes. You’re evaluating your results and therefore my value every session. And if I’m not doing the job I know you’ll be looking somewhere else for care. Secondarily, more and more of us have high deductibles to pay before our insurance even begins to cover our care. Foley Physical Therapy is an excellent cost to value service for those shopping prices.
Beside the payment structure what makes Foley Physical Therapy different from any other physical therapy?
You and I have 1:1, uninterrupted evaluation and treatment sessions; you have access to me in and outside sessions, you have access to telehealth; there is greater quality and individuality to our sessions, AND there are usually FEWER overall physical therapy sessions needed for best results. Here are some facts: we average just over 4 visits/episode of care, our daily Square Pay feedback indicates our differences include: our thorough evaluation; our listening skills; critical thinking and judgement about your condition; individual program development, our communications skills and our use of your time. Check out our Google reviews also.
How do I pay you?
You can use any credit card, Apple or Android Pay, cash or check. If you have a Health Savings Account you can pay for treatment via HSA check or card, same with Flexible Savings account monies.
Why don’t you participate with my insurance?
Insurance companies do not adequately cover the type of quality physical therapy treatment most people want or need in order to manage their health. In their defense insurance companies are trying to offer the best average care to a volume of subscribers. But what that means for providers like me in the past is laborious paperwork, rules, phone conversations and costs and waiting time, passed back to you the subscriber to simply “get you visits”. I would have to hire another person to manage that paperwork, track your visit restrictions and submit and process claims. This of course would change my rates and or require a change to my philosophy of 1:1 care. Foley Physical Therapy is an easily accessible, transparent cost, simple to execute process of obtaining care as soon as you need it, for as long as you are benefiting. And, there are usually FEWER overall physical therapy sessions needed for a given issue, because of better quality, uninterrupted care in our sessions.
Do you have more to say about insurance reimbursement?
Yes. I disagree with having my opinion of your care needs reviewed and altered by someone with no clinical expertise in physical therapy. I disagree with having some of the modalities or tools I might choose to use not covered, based on out of date research. And, while I love the collaboration and discussion many patients have with each other during care I was exhausted by the “assembly line” process that even a good physical therapy company might have to develop to offset inadequate reimbursement by insurers.
And finally, in no other industry in the world are so many untrained (3rd party) people granted as much impact on the final product as in
our US healthcare system.
Can I get paid back by my insurance company for the cost of your care?
In many circumstances, yes. On the back of your insurance card is a Member Services phone number, call it and ask if you have “out of network” benefits for physical therapy. This will require you to fax or mail a summary of your visit to your insurance company each month for reimbursement. If you do not see your insurance companies form on my website ask Member Services to email you the document (and kindly share it with me as well for other members).
Foley Physical Therapy now strongly encourages you to download and use Reimbursify for faster and more transparent Member claims submission.
I have a crazy high deductible.
As deductibles climb employers are now offsetting your burden by offering Health Savings Accounts (HSA). Your employer probably kicks in some money to fund it and might encourage you to also. This pre-tax account can be used to pay for approved medical expenses such as physical therapy, and the account stays with you for as long as you like. Request a monthly summary from me to verify your expenses.
Why can’t I submit charges to Medicare or to my supplement?
Medicare rules and regulations are especially detailed and restrictive to enrolled and participating providers. Those of you with traditional Medicare and Medicare replacement plans are protected by the onerous rules and regulations, and you should be. You have paid in to Medicare for years. Medicare wants to be sure you are not held responsible for additional fees and expenses incurred for treatment of medically necessary health care. Feel free to discuss this with me further.
Honestly, it’s just a nicer way to say you pay me directly each visit for our session together instead of paying an insurance company who takes a portion and also gives me a portion. I have no relationship with any insurer.
Why would I do that?
For starters, you and I are both more invested when we have the direct relationship of getting you better. It leads to better outcomes. You’re evaluating your results and therefore my value every session. And if I’m not doing the job I know you’ll be looking somewhere else for care. Secondarily, more and more of us have high deductibles to pay before our insurance even begins to cover our care. Foley Physical Therapy is an excellent cost to value service for those shopping prices.
Beside the payment structure what makes Foley Physical Therapy different from any other physical therapy?
You and I have 1:1, uninterrupted evaluation and treatment sessions; you have access to me in and outside sessions, you have access to telehealth; there is greater quality and individuality to our sessions, AND there are usually FEWER overall physical therapy sessions needed for best results. Here are some facts: we average just over 4 visits/episode of care, our daily Square Pay feedback indicates our differences include: our thorough evaluation; our listening skills; critical thinking and judgement about your condition; individual program development, our communications skills and our use of your time. Check out our Google reviews also.
How do I pay you?
You can use any credit card, Apple or Android Pay, cash or check. If you have a Health Savings Account you can pay for treatment via HSA check or card, same with Flexible Savings account monies.
Why don’t you participate with my insurance?
Insurance companies do not adequately cover the type of quality physical therapy treatment most people want or need in order to manage their health. In their defense insurance companies are trying to offer the best average care to a volume of subscribers. But what that means for providers like me in the past is laborious paperwork, rules, phone conversations and costs and waiting time, passed back to you the subscriber to simply “get you visits”. I would have to hire another person to manage that paperwork, track your visit restrictions and submit and process claims. This of course would change my rates and or require a change to my philosophy of 1:1 care. Foley Physical Therapy is an easily accessible, transparent cost, simple to execute process of obtaining care as soon as you need it, for as long as you are benefiting. And, there are usually FEWER overall physical therapy sessions needed for a given issue, because of better quality, uninterrupted care in our sessions.
Do you have more to say about insurance reimbursement?
Yes. I disagree with having my opinion of your care needs reviewed and altered by someone with no clinical expertise in physical therapy. I disagree with having some of the modalities or tools I might choose to use not covered, based on out of date research. And, while I love the collaboration and discussion many patients have with each other during care I was exhausted by the “assembly line” process that even a good physical therapy company might have to develop to offset inadequate reimbursement by insurers.
And finally, in no other industry in the world are so many untrained (3rd party) people granted as much impact on the final product as in
our US healthcare system.
Can I get paid back by my insurance company for the cost of your care?
In many circumstances, yes. On the back of your insurance card is a Member Services phone number, call it and ask if you have “out of network” benefits for physical therapy. This will require you to fax or mail a summary of your visit to your insurance company each month for reimbursement. If you do not see your insurance companies form on my website ask Member Services to email you the document (and kindly share it with me as well for other members).
- Make a copy of the insurance claim form. Set it aside.
- On the new copy fill in the Subscriber details, date of birth and insurance ID information.
- Under Provider Information write “see attached” on one of those lines.
- Make a copy of that form and set it aside.
- That’s it.
Foley Physical Therapy now strongly encourages you to download and use Reimbursify for faster and more transparent Member claims submission.
I have a crazy high deductible.
As deductibles climb employers are now offsetting your burden by offering Health Savings Accounts (HSA). Your employer probably kicks in some money to fund it and might encourage you to also. This pre-tax account can be used to pay for approved medical expenses such as physical therapy, and the account stays with you for as long as you like. Request a monthly summary from me to verify your expenses.
Why can’t I submit charges to Medicare or to my supplement?
Medicare rules and regulations are especially detailed and restrictive to enrolled and participating providers. Those of you with traditional Medicare and Medicare replacement plans are protected by the onerous rules and regulations, and you should be. You have paid in to Medicare for years. Medicare wants to be sure you are not held responsible for additional fees and expenses incurred for treatment of medically necessary health care. Feel free to discuss this with me further.