Posts made in November, 2013

How Direct Pay Service Benefits YOU

Posted by on Nov 8, 2013 in Back In Action Blog | 1 comment

“How Direct Pay Service Benefits You”   Back in Action Physical Therapy insists that quality care should not be rushed or dictated by insurance companies. A direct payment system offers you the highest level of care for a flat rate of $60 an hour. Let me explain how this benefits your health and saves you money. Under the “standard” medical model, you are treated in blocks of roughly 15 minutes, deemed a “unit.”  Each unit is priced separately. That means exercise is a unit, hands-on-treatment is a unit, and so on. Typically, each unit is billed in the $50 to $60 range, adding up to $200 to $240 an hour. That’s right, if you warm-up on the bike for 10 minutes, you just paid nearly $50 for those ten minutes. This happens everyday in every clinic.  Now this is where it gets really interesting… Insurance adjustors (i.e. people who are not medically educated) limit the number of times you can be seen by your physical therapist, regardless of how you are progressing. They also decide how much your insurance company will actually pay (typically in the 50% range) on each claim. They use many tactics to pay as little as possible on claims, such as denying charges, insisting charges be re-coded, an so on. Eventually the insurance company sends a check to your physical therapy provider. This can take up to six months. So your provider needs to hire extra employees to deal with billing, collections, and insurance company run-around. The result is that you don’t get the care you need, plus you’ll end up with excessive bills due to co-pays and deductibles. This is where I politely stepped out of the game. I had the worst professional experience of my career in a “turn and burn” clinic that placed zero emphasis on quality of care. It sickened me to have the office manager (a person with no medical training) claim that I was “losing the business money” because I didn’t prescribe unnecessary, profit-based procedures. Back in Action Physical Therapy was founded on the belief that top-notch care cannot be rushed, or rely on decisions made by insurance company adjustors. Each visit is 60 minutes, as opposed to the typical 30-minute, push-you-out-the-door care. I have the time to truly work with and educate you about your body. Knowledge really is power. By having extended time with each patient, I am able to provide faster results and better outcomes. My time is much better spent treating patients effectively than chasing around insurance companies to get paid.  This is why I have decided to take only cash or credit card at the time of care. IF you have insurance and want to use it- no problem. You pay directly and I will issue you a receipt you can submit to your insurance company. They will in turn reimburse you. Each plan varies, so you should review your policy specifics, but typically an “out of network provider” is compensated at a 70/30 split. This means that you end up paying a paltry $18/hr for the highest quality of care possible. I know you will feel and see the difference.  Don’t delay. Visit to set up an appointment today. Also please feel free to contact me at if you have any questions. Regards, Seth Burke,...

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