Why I Don’t Take Insurance: A Modern Physical Therapist’s Perspective.
Updated: Sep 17, 2019
Dorina Kroll, PT, DPT
Owner, Physical Therapist
I get asked the question a lot: “Why don’t you accept insurance?” It’s a complicated question but I wanted to spend some time clearly laying out the reasons why I made the decision to keep Potomac Physical Therapy and Rehab out of network. Reimbursement rates from insurance companies have progressively worsened over the years causing therapists at traditional in-network facilities to have to see at least 2 patients per hour, sometimes even more. In addition to seeing multiple patients at once, many times therapists use technicians and assistants to provide much of the actual patient care and treatment. These facilities often use warm ups, cool downs, modalities such as hot and cold packs, ultrasound, etc. I can’t tell you how many times in the past I’ve seen this scenario: Patient A arrives at 1:00, 5 minute warm up on the bike, 15 minutes of manual treatment, 10 minutes of new exercises, handed off to a tech for remaining exercises until 1:50, 10 minute cool down with ice-pack and the hours up. Why is this the case? Because the therapist still has their 12:30 patient there until 1:30, the 1:00 Patient A, a 1:30 patient has arrived, maybe 2 if they are double booked. This is a reality of our current health care system. The result is significantly less time with the PT, more time with modalities and exercises that can be done at home, and increased sessions per week to show improvement.
This method of treatment is one I do not agree with. I believe in a hands-on approach to rehab. I think it’s important to spend one-on-one time with the patient for the full treatment session. I believe in providing my patient with highly skilled exercises that are on par with the level of education required to receive a doctorate in physical therapy. I need to be readily available to my patients when they need my guidance. This level of highly skilled therapy and attention are only possible with this out of network, fee for service model.
Interestingly enough, my patients and I have discovered that given the high copay rates, high deductibles, increased number of sessions required (at upwards of $200+ per visit), they are actually saving money by going the out of network route. The comfort and convenience of getting physical therapy at home, the extraordinary level of care and attention, the up front / no ambiguity fee schedule, and finally THE RESULTS are what keep my patients happy. And if my patients are happy, then I’m doing my job the way I have always dreamed of doing it.