Out of Network Insurance and Physical Therapy
There's no better way to put it: health insurance is confusing. Period.
If you've ever found yourself staring at an Explanation of Benefits, wondering just what you're looking at, or shaking in your boots over monthly premiums when it comes time to switch up your health insurance plan, know that you're not alone!
Navigating health insurance, and understanding your benefits and coverage is not an easy task. Many of our patients come to us before beginning treatment, worried that their insurance won't cover their physical therapy because they have an out-of-network plan.
Fusion Performance wants to help as many people in need of pain relief as possible, and we're more than happy to talk with you about how our out-of-network policy works.
Call Fusion Performance today to schedule an appointment and in the meantime, keep reading to learn more about how we participate with out-of-network insurance plans.
What does “out-of-network” mean?
When a physical therapist or medical provider is considered “in-network” under your plan, it means that they have a contract with your insurance company that ensures that the insurance company will cover services you receive. Typically, the out-of-pocket expenses for patients are much lower when they choose to receive physical therapy or medical care from providers that are in-network with their insurance company.
Now, what's the difference between in-network and out-of-network? If a physical therapy clinic is out of network with your insurance, it means they “do not belong to the insurance company's network, and no contract exists between provider and insurance company. Most physical therapists will encounter both situations of being in- and out-of-network.”(gethealthie.com) This means that your out-of-pocket expenses are going to be much higher than if your plan was in-network with that provider.
The good news is that at Fusion Performance, we provide services to patients in-network and out-of-network.
What if Fusion Performance does not participate with my insurance?
If your insurance plan is deemed out of network, we can still provide physical therapy services to you!
A majority of insurance companies allow their members to see providers that are out of network, with the exception of Medicare and HMO plans.
Doing this means that you can choose to see a physical therapist who does not participate with your insurance company. The insurance company will pay a specific amount towards your treatment, but it will be less than they would have paid if our clinic was in-network for you.
Therefore, you will be responsible for paying the difference between what Fusion Performance charges and what your insurance company pays. Some people opt for out-of-network services because they want to receive care from a specific provider.
What if I don't have insurance?
If you don't have health insurance to cover physical therapy services at Fusion Performance, it's not a problem. You may still receive service by paying us directly or working out a payment plan with our billing coordinator.
Call us today to find pain relief
If you aren't sure what your out-of-pocket costs will be, don't hesitate to ask your physical therapist at your appointment. Our therapists are skilled and knowledgeable individuals who know how to navigate the complexities of insurance, whether we are in or out-of-network with your plan!
