BURNING QUESTIONS WE HEAR the most.
(See? you’re not alone.)
Q: Do you take health insurance?
Yes. We accept any major plan with out-of-network benefits. (Oxford, Aetna, BCBS, United, Cigna) But we are not in-network with any plans. Hang on, don’t jump ship yet! We’ll explain why in a sec…
Q: What’s my co-pay going to be? How much is this gonna set me back?
No easy answer here; it depends on your health plan. If you’re not sure what your out-of-network benefits entail, send us your plan info and birthdate, and we’ll look into it. We can estimate your payment responsibility* before your first visit — we’re not a fan of surprises either, except in the form of baked goods. And when you come in, please be prepared to pay in cold, hard cash or by credit card. Bars of gold are alright, but they’re kind of clunky.
*Your insurance company usually refers to this kind of payment as “co-insurance” — your share of the costs of a covered out-of-network service, generally given as a percentage of the amount paid to the provider. For example, they might cover 60% and you’ll have to pony up 40%. But keep in mind, your payment is also affected by whether you’ve met your annual deductible.
Which leads us to…
Q: What about that (whopping) deductible I haven’t met yet?
As soon as we find that pixie dust, we’ll all be deductible free! Until then, we’ll do what we can to help ease the pain, but we can’t make it magically disappear.
Q: Why is Clutch an out-of-network provider? It’ll be cheaper for me to see someone
in my network.
Glad you asked. It boils down to quality over quantity.
We care very much about the quality of care you receive. Quality is what will get you better. As an out-of-network provider, we are choosing to see fewer patients in a day in order to ensure an extremely high level of patient care.
Insurance companies don’t look at patient care the same way we do. They put providers like us through the ringer with an application process to become “in-network.” If we’re chosen, we agree to receive significantly less reimbursement for treatments (as low as $40 for an hour treatment, inclusive of your copay — no, really) because we’ll be exposed to a bigger pool of patients. But the only way to offset our operational costs is to see more people in a day. That leads to a “patient mill” style of physical therapy that really bums us out, and undermines how we want to treat patients. We just can’t, and won’t, participate in that.
At Clutch PT you will work one-on-one with a skilled, licensed physical therapist who cares about you and what you’re there to accomplish. You will have your therapist’s undivided attention for at least 45 minutes in a private treatment room.
At an in-network clinic, you’ll likely be lined up on a table in an open gym with a bunch of other people while one therapist directs all of you at once. Ultrasound/heat/electric stim/ice may be used as substitutes for individual care and treatment, but those things are just filling your appointment. If you’re only being treated for 5-7 minutes individually, it’s really tough to get better. Your therapist should take the time needed to diagnose the underlying cause of your problem, correct it and make sure you understand how to be your own advocate when you’re not in treatment. That takes expertise and individual attention. That’s why we are out-of-network.
Like parachutes, physical therapy is not something you should get for a bargain basement price. You get what you pay for.
We’d be happy to rant about the specific ways in which insurance companies are squeezing everyone, but our communications guru says we should be “positive,” so we’re holding our tongues. But we’re willing to bet you have some nits to pick about the system too. Happy to discuss in person when you come in. Fortunately, since we’re out-of-network, we’ll have time to cover that during your treatments, and get to know what makes you tick.
Q: Crap. I don’t have any out-of-network benefits at all. Now what?
Don’t panic. We want you to get better, so we’ll work with you. We offer discounts for patients who pay cash up front.
Q: Do I need a prescription for physical therapy?
Nope! NY state has “direct access,” which means you can come to Clutch PT for a diagnosis of any musculoskeletal injury without seeing a medical doctor first.* (Woo!) If you need care beyond 10 visits (or 30 days, whichever comes first), then you will need a prescription. But we’ll cross that bridge if we come to it.
* Medicare patients — this doesn’t apply to you. Sorry about that.