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Author: Richard Symister

Your Insurance Benefits: Know Your Terms To Get The Best Value.

Dealing with insurance companies is a big headache. Authorizations. Referrals. Documentation. Delays. Hold time.

But have you ever tried deciphering your benefit terminology? Migraine city! The task can be very confusing, and can totally turn you off when reviewing your physical therapy benefits.

But if you want to get the best value out of your next round of physical therapy, then you need to understand them.

Let’s try to simplify the key terms you should know before choosing your PT.

Copayment

This is an amount your insurance company sets, not your Physical Therapist. They range usually between $30-$50. Think of this as a “service fee“ for seeing your Physical Therapist.

Do the math. If you’re seeing a Physical Therapist 2 to 3 times a week, your costs can add up quickly. And let’s not forget. Insurance companies are consistently raising copayment amounts every year! add up. This is why MovEvolution adopts a one-hour session, one time per week protocol, saving you time and money … because we’re so dang good at what we do!

Coinsurance

Another confusing term that often gets confused with a copayment. Coinsurance is the percentage or amount that you are responsible for once your insurance company starts to reimburse your PT for visits. 

For example, if your physical therapy treatment was $100, and then your insurance company picks up 90%, your coinsurance would be $10 or 10%.

As mentioned above, these out-of-pocket costs can add up if you’re seeing your physical therapist multiple times throughout the week. 

Think “quality” over “quantity”. More visits are not often better, particularly if you are working with a specialist who is providing high-quality care, great advice, and solid home programming.

Deductible

This is probably the hardest term for clients to wrap their heads around. Let’s explain this way:

You join a sporting promotion company that gives you a monthly stipend for sneakers and jerseys. The caveat is you have to spend a certain amount, $500, before they start to assist with your payments. (This $500 represents your deductible.) So until you spend $500 worth of sneakers and jerseys, you are financially on your own. Once your closet is stocked and you’ve crossed the $500 mark, your company starts to pick up part or all of the bill.

Now, you have a couple of options with us as far as your deductible:

If you have a reasonable deductible amount, we will work with you to spread out payments. Often, your deductible can get knocked out in a few physical therapy sessions, leaving you with only your copay, or nothing at all, to pay per visit. 

If you have a crazy high, out-of-this-world deductible, your best option may be to pay out-of-pocket for your physical therapy.  MovEvolution has outstanding visit bundles.

Insurance sucks. That’s why we save you the headache and check your benefits for free. Register and schedule HERE or contact our office manager for more information HERE.

Heal. Move. Evolve.