Benefits of Cash-Based Therapy

Insurance VS Cash Based Models:

When patients go through insurance for physical therapy, the insurance company dictates the treatment plan. This means that your insurance company gets to determine what treatments you are and aren’t allowed to receive, how much time you are allowed to see me for each session, how may sessions you are allowed to have, and what symptoms/issues are allowed to be addressed…

Can you believe that insurance companies state that the diagnosis of dyspareunia, or pain with sex, is not a medically necessary reason for pelvic floor therapy treatment and will instantly deny any claim with that diagnosis? Insurance companies also do not cover wellness, educational, or injury prevention services. Crazy, right?

Additionally, low insurance reimbursement rates put therapists in the position to need to treat 2-4 patients at the same time in order to generate enough income to keep their business open. While this model works okay for treating knee and shoulder injuries - it doesn’t work well for pelvic health concerns. Pelvic floor therapy sessions require 1:1 sessions with the therapist and client.

A cash-based model allows me, your therapist, to do what is best for you during your treatment without having to get approval from your insurance company. This means…

  • I can spend one-on-one time with you

  • We can address multiple problems at once

  • I can administer any treatment we decide is best for you

  • You can choose your own goals

  • You can determine how many sessions you would like to attend

  • We cans schedule 60+ minute sessions to address your body holistically

  • I am able to provide wellness and educational services in order to help you prevent significant injury/issue in the first place

 

Transparent Pricing:  

Insurance companies do not process claims, approving or denying coverage, for 60-90 days after the claim submission. This means you could attend 6 therapy sessions in January, and then receive a notice of coverage denial in April which leaves you with a large and unexpected bill after the fact.

At Holistix - there is transparent pricing. You always know exactly what you’re going to pay before you get started so there are no unexpected costs.

Seeing a cash-based therapist can sometimes be less expensive than billing through insurance depending on the treatment plan and your deductible. This is because having a 60 minute 1:1 session with a therapist gets you better faster, meaning you need less sessions overall. When you have a high deductible and go to a clinic that schedules 30 minute sessions where the therapist is working with 3 clients at once, you may require 10+ visits for symptoms to resolve, whereas, with a cash based therapist who provides 60 minute 1:1 sessions, you would likely see an improvement in much less time, perhaps 3 sessions!

As an out of network provider, I do not submit insurance claims myself. However, I can provide you with a Superbill to turn into your insurance company yourself which may reimburse you for all or part of your treatment.

Check with your insurance company to see if you have coverage for out of network occupational therapy services.

***Due to legal constraints - I am unable to accept cash payment from those with Medicaid / Medicare coverage for rehabilitation services … Those with Medicaid / Medicare CAN receive wellness/injury prevention/education services ***