The UpSlope Difference
Whether You Decide to Work With Us or Not, Let Us Explain Just A Few Things To Help You Make A Confident Decision
You may have said or thought these types of things:
- “I would prefer to use my insurance benefits for PT.”
- “That seems like a lot of money.”
It’s totally normal for you to feel this way. The current healthcare landscape for active-adults and athletes is changing drastically. As insurance companies continue to reduce payment to PTs the quality of care that patients are receiving is being reduced. Co-pays are also at all-time highs and continue to increase. Below is some insight into how working with an out-of-network practice like UpSlope Physical Therapy & Performance can actually save you not only money, but time as well and ultimately lead to better results than a traditional, in-network practice
Whether You Decide to Work With Us or Not, Let Us Explain Just A Few Things To Help You Make A Confident Decision
The short answer:
In many ways, insurance companies dictate or strongly influence the treatment that patients receive at “in-network” clinics, and we refuse to allow that to be the case at UpSlope Physical Therapy and Performance.
The longer answer:
We are an out-of-network practice because the business model necessary for an in-network practice to survive rarely ever allows for the high-level care we insist on giving our patients.
What the heck does that mean? …
Due to progressively worsening reimbursement rates and pressure from insurance companies, the therapists at in-network clinics have to see at least 2 patients per hour (usually many more) and they often use technicians and assistants to provide much of the actual patient care. The care often includes modalities like heat packs and ultrasound, and the majority of a patient’s time at the clinic is spent doing exercises they could do on their own time. Furthermore, these types of clinics tend to require patients to attend 2-3 appointments per week.
We do not believe that modalities are nearly as effective as our hands-on treatment, and we also do not agree with having patients pay to perform exercises in the clinic that they can easily perform at home or at a gym. All of our patients receive one-on-one care and hands-on treatment from a Doctor of Physical Therapy in every session. With this one hour long-session, one-on-one treatment approach, the plan of care for the vast majority of our patients only involves one appointment per week.
When you consider the time savings of fewer trips to the clinic and the value of resolving your pain so much faster than average, the out-of-pocket expense at UpSlope Physical Therapy and Performance is a huge bargain.
On top of that, the out-of-pocket expense for our treatment sessions is sometimes less than a patient would pay at a clinic that accepts and bills their insurance.
How is that possible?!
As deductibles and PT copays have skyrocketed in recent years, many of our patients who have high PT copays or have not met their deductible pay less out of pocket for our treatments than they would if they went to a clinic that “takes their insurance.”
So before deciding on where to get PT based solely on which clinics “take your insurance,” make sure you know how much you’ll be paying at your in-network options versus an out-of-network clinic like ours …
These days, some insurance plans provide zero coverage for PT visits or require copays of over $50/visit. And if you have a deductible to meet, you’ll likely end up paying the full bill for your PT sessions until you meet the deductible (and these bills are often $200+ per session). However, you usually won’t start receiving those $200+ bills until after you’ve been getting care for 6-8 weeks and have racked up an enormous total balance (again, often being asked to attend PT 2-3 times per week).
And guess what else… just because you’re paying $200+ per session at a clinic that is in-network with your insurance, does not mean that your insurance is applying that full amount towards your deductible! They often only apply the amount that they have agreed is reasonable for your PT sessions which is, of course, far less than the amount the PT clinic actually charges.
Most people are quite unaware of the games their insurance companies play in order to pay out as little as possible and maximize their profits.
To help level the playing field, we’ve provided you with a list of questions to call and ask your insurance about to help you get the full picture:
1. “What percentage of the total PT bill will I be required to pay at an in-network clinic?”
- This question is especially important if you still have a deductible to meet. If you will be paying 100% of the bill until you’ve met your deductible, ask the prospective PT clinic the amount of the average bill sent to an insurance company. In most cases, you will ultimately be paying the full bill until your deductible is met.
2. If you have met your deductible, ask: “How much will my copays be for each visit?”
Consider the quality of care you’ll be receiving at your various options, and how much value you place on receiving higher-quality, one-on-one care from a Doctor of Physical Therapy rather than a PT Assistant (PTA) or an unskilled “Tech.”
Consider how often you’ll be missing work and/or time with family to attend your PT sessions. Again, you can ask any prospective clinic how many times per week their average patient is asked to come in for treatment.
Ask the above questions, do the math, and you may be quite surprised at what you find!
With all the above information, you can now get a real sense of what your true costs will be, what level of care you’ll be getting, and then make the best decision on where to receive your physical therapy treatment.
Can I bill my insurance for reimbursement of my out-of-pocket expenses?
This depends on the insurance you have, but YES, most NON-Medicare patients can send “self-claims” to their insurance company for their treatments at our clinic. You should be able to submit through your insurance company’s online portal. We provide all of our patients with the needed receipts and treatment codes that they need to do so.
The amount of reimbursement or application towards your deductible is completely dependent on your insurance plan. If you call your insurance company to inquire about what you can expect to receive, you should ask about reimbursement for “out-of-network Physical Therapy” expenses sent in via self-claims.
“I Still Want to Call Around to Find a Place That Takes My Insurance”
This can be a totally sensible thing to think about and want to do. We’ve included a checklist below of questions that will help you get the full picture of the quality of care you can expect to receive from each option.
“I Still Want to Call Around to Find a Place That Takes My Insurance”
No. The state of Colorado allows for direct patient access. This means a doctor’s referral is not needed to be seen for sports, or manual therapy services in Colorado. As Doctors of Physical Therapy, we have the tools required to treat injuries and conditions without prior intervention of a medical doctor/physician. If we determine that the attention of a medical doctor is needed, we will refer you to your primary medical doctor for follow up
Every one of our patients is treated as a unique individual. We address your whole body, not just the part that hurts or is injured. The goal at UpSlope Physical Therapy & Performance is to understand exactly what is going on, the root cause of the problem and why it’s important to you for us to help you solve the issue. You will be prescribed a specific treatment plan which is designed to address the problems responsible for your pain and symptoms and help you return to an active life as soon as possible.
Physical Therapy is not a “quick fix” and you should expect to put in some work, however many people do feel relief within their 1st few visits. Most people experience a change or significant difference within 3 to 5 treatments and we typically have work to do even once your pain and symptoms have subsided. Because, the goal is to help our patients in Northern Colorado become stronger and more resilient to this ever happening again.
It is impossible to predict the exact number of visits you will need as everyone’s individual challenges are unique. Our typical patient is seen approximately for 1 visit a week, for about 6-10 visits and we’ll know more specifically once we see you in the clinic.
Every patient is taught how to treat themselves at home using self-treatment techniques, modified yoga poses, activity modification strategies and corrective exercise. You will receive a personalized treatment program for treatment and long-term prevention of your condition so you can stay fit, healthy, and mobile without needing more pain medications, injections or surgery.
Yes. After we have you scheduled for your first appointment, we will give you access to our patient portal which is where all intake paperwork.
We understand that sometimes in life things can happen and cause your plans to change and that is understandable! Just let us know 24 hours ahead of time before your appointment and no cancellation fee will be applied. This will allow us to have enough time to schedule another client and help them get the treatment that they need. If you cancel for any reason less than 24 hours before your appointment or you simply do not show up, then a cancellation fee of 100% of the visit will be charged. These fees cannot be applied to future sessions and are non-refundable.
Address and directions when you enter:
3509 S Mason St Unit 2 Fort Collins, CO 80525
Feel free to park in unmarked spots or spots assigned to UpSlope Physical Therapy. Once inside, you will be greeted by your Physical Therapist who will be with you, one on one, for the entire duration of your appointment.
If we missed a question in our FAQ, for UpSlope Physical Therapy, please contact us through our website with your questions and we will get back to you as soon as possible with a response.