A little-known fact about in-network physical therapy is that your healing is typically controlled by your insurance company. Your insurance company decides how many times you can be seen and when you have healed enough, without talking your health goals into consideration. When rehabilitation is cut short because of insurance restrictions, athletes are placed at a much higher risk of injuring themselves again when returning to play. The case outlined below highlights these points perfectly.
CASE STUDY OF INSURANCE AND IN-NETWORK PHYSICAL THERAPY
Mrs. Smith (name changed for privacy) tore her Anterior Collateral Ligament (ACL) and had knee surgery so she could return to sport after her injury; playing and coaching basketball. Her insurance required approval before being seen at physical therapy for her ACL tear, which is where most barriers start. She couldn’t receive care immediately after surgery, because she had to be assessed by a physical therapist before they could approve treatment, and it took over two weeks for the insurance company to respond.
Care from a physical therapist immediately following surgery is important in order to minimize your pain, expedite your recovery, and help you achieve better outcomes. Physical therapy following surgery improves your muscle balance significantly to decrease your likelihood of reinjury and prepare you for your next goal in life.
When Mrs. Smith finally received authorization, she was only given five sessions or two weeks to recovery before she had to apply all over again. This process of submitting authorization delayed her care on multiple occasions, as you can imagine, and the insurance company ended up cutting her therapy months short because they had determined that she had recovered “enough.”
Mrs. Smith was able to put weight through her knee again but was not even close to her goal of coaching and playing basketball again. Orthopedic and sports physical therapy involves training the whole body and the area surrounding the trauma site to protect it and prepare the athlete for a successful return to sport. With the way insurance and the healthcare system is currently set up, this preventative medicine typically requires out-of-network care in order to take full control and protect your health. To learn more about these barriers to recovery during rehabilitation, click here.
WHAT DOES OUT-OF-NETWORK COVERAGE MEAN?
It just means your insurance company does not get a discount to work with that provider. The discounts usually mean that your insurance company pays your provider to spend less time with you. Doesn’t seem fair, does it? Rates in some cases are the exact same as in-network, call us today to find out what your out-of-network coverage is. At Bateman Therapy Services, we reject the idea that your insurance company should decide how much your health is worth. In order to provide this elite level of care at a reasonable price for patients, Bateman Therapy Services has developed an out-of-network relationship with insurance companies.
INJURY PREVENTION
Sports medicine physical therapy can actually help prevent an injury. If you are strong enough in the right muscles to protect vulnerable joints, an injury is much less likely to occur. Just to give you an idea of how insurances mess with your health, many don’t reimburse for injury prevention, even though it’s cheaper and faster than recovering from an injury after it happens. To learn more about sports medicine physical therapy and how it can help you, click here.
It’s really an unfortunate system because terrible injuries can be prevented by coming in every few weeks to or whenever you plan on adding a new sport to your routine. That is much easier than waiting for an injury to sideline you, because an injury can take over a year of physical therapy multiple times a week to recover from. Insurance companies also don’t replace loss wages when you get injured, so it’s up to you to protect your health and financial viability.
CONCLUSION
At Bateman Therapy Services, we have a working relationship with insurance companies and we are in a position to protect your best interest. Our goal is to help you become more confident in how you move through life and/or progress you to our Wellness Program to maintain your gains.
The reality of a mobile clinic that works with insurances to determine the best route for your care is that you will be working with someone who values your time and health as much as you do; you don’t have to rely on the mercy of an insurance company looking to make a payday from your misery. Your care needs here are based on your goals, so you can focus on healing. Bateman Therapy Services removes the barriers imposed by insurance companies so that you can fully and successfully recover. Call today to schedule an appointment and start your path to living the life you want to lead.
ABOUT BATEMAN THERAPY SERVICES
Bateman Therapy Services is a family-owned professional physical therapy practice. Mobile physical therapy allows us to easily provide physical therapy to Livermore, Pleasanton, Danville, San Ramon, and the surrounding area. Many people treat outpatient physical therapy the same as any other pain management, like massage, chiropractic care, and acupuncture. However, physical therapy is different because the goal is to prevent your pain before it happens. Physical therapy keeps you living the life you want to live and helps train you for the life you want to lead.
We specialize in all conditions of movement, including but not limited to: sports medicine, lower back pain, stretches for sciatica, hip labral tear, shoulder labrum, arthritis, outpatient orthopedic and sports physical therapy, virtual physical therapy, and more which can be found here. We can even help you find a MVA lawyer to help you claim a settlement for a car accident. For the best physical therapy near you, click the button below to call Bateman Therapy Services.
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