Why are you out-of-network with my insurance?

We are often asked why we are out-of-network providers with insurance companies. When we started Good Land Physical Therapy & Wellness, we knew that we wanted to be able to provide you with the best care possible and have made all of our decisions based on this goal. Choosing to be out-of-network is one way we are able to provide that care.

Here are just a few of the reasons we’ve chosen to be out-of-network:

1. You don’t need a referral. Some insurance companies require you to get a referral from a physician prior to seeing a PT, even though this is not legally required. This leads to games of phone tag, waitlists, and sometimes referrals to other providers before our clients eventually end up in PT anyway weeks later. We’re able to see you without a referral, getting you in quickly and on the road to feeling better now. 

2. No visit limits. Many insurance plans put arbitrary limits on how many times you can see a physical therapist in a year – regardless of your injury, surgery, or physician recommendations. We know that one size does not fit all and that your PT plan should be based on what you need, instead of what your insurance plan dictates.

3. No preauthorization. Some insurance companies require preauthorization, even with a referral. This requires clinics to get permission to see you and dictates how many visits you are approved at a time or how long you can see your PT. We have seen this lead to a delay in starting care or having to pause for weeks in the middle of treatment as the clinic waits for authorization. This can lead to a lack of progress or even backsliding. We don’t think that this is good for patients or their recovery. 

4. We can help you return to what is important to you. Some insurance companies do not cover returning to sports or other active hobbies. We know that things like running, golf, yoga, cycling, Crossfit, pickleball, tennis and more keep people moving and are great for long-term physical and mental health. Insurance companies might not think that these are important, but these things are important to both you and us.

5. Tune-ups and maintenance. Cars need periodic tune-ups for maintenance and we humans are a lot more complicated than cars. We have patients that check in every other week, once a month, or just as needed to help keep them moving and doing the activities they love. Often insurance companies do not approve of these periodic visits, even though they often keep people active, healthier, and keep chronic conditions at bay.

6. Dry needling and other treatments. Many insurance companies do not cover effective treatments, such as dry needling. We have found dry needling to be extremely beneficial in addressing muscle tightness, improving mobility, and reducing or eliminating pain in many of our patients. We do not think insurance companies should determine what treatments are covered - that is for you and your provider to decide. All of our treatments are included in our visit prices, including dry needling. 

7. Transparency in costs. At most health care centers, you often do not know how much your visit is until weeks (or months!) after the appointments. This seems ridiculous to us. You’d never buy something from a store unless you knew the price. Health care should be the same. We charge $150 per hour, $80 per half hour. No surprises.

8. Cost-savings for you. No, really. Many larger organizations bill exorbitant prices for physical therapy visits. In this era of high-deductible plans, our patients are often on the hook for these super high visit costs until they meet their deductible. With one-on-one sessions, faster improvement in fewer sessions, and predictable costs, our patients often save money seeing us out-of-network.

9. We can provide the care you want and need. We know you know your body. We work with you to determine a plan of care that works for you, your condition, and your schedule. We don’t think that an insurance company should make decisions about your health care from behind a computer screen. 

We are able to provide you with a superbill that you can submit to your insurance toward out-of-network benefits or out-of-network deductibles. Depending on the situation, we also may be able to work with worker’s compensation and car insurance companies after work or accident-related injuries. If you have any additional questions, please reach out to us on our contact page or set up a 20-minute complimentary phone consultation.