Why Don't You Take Insurance?

“Why Don’t You Take Insurance?”

This is a common question that prospective clients often ask us. All the PT’s at Steady State used to work in insurance based clinics so we know first hand what it’s like. We thought we would dig into the numerous reasons why we chose not to work with insurance companies. 

We want to provide you with a better service. Working with insurance companies doesn’t allow us to treat you the way we believe you should be treated.

1. One-on-One 60+ minute sessions
   1. Your Doctor of Physical Therapy will be with you every step of the way. No more being passed off to a student or another provider. 
   2. Your time is valuable and you have our undivided attention. We prioritize spending time getting to know you as a whole-person.
2. Complete cost transparency
   1. Taking out the middle man means you know exactly how much you pay. Your visits never run out. 
   2. No more co-pays 2-3x/week with a bill in the mail months later.
3. Based on your goals. Not insurance’s.
   1. We see people who want to be pain-free walking. We also see people who want to smash their next marathon or decrease their shoulder pain in their group fitness class. 
   2. These are valuable goals and we don’t have to make up weird arbitrary goals just so insurance pays for your treatment.
4. Decisions based on our expertise
   1. We get to make personalized treatment decisions based on what will help you meet your goals, whatever they may be. 
   2. We aren’t limited by insurance companies telling us what we can vs. can’t do (they also didn’t go to school for this for 7+ years).  
   3. We get to use all of our knowledge, tools, and experience to get you the best result. 
5. Long term health and wellness
   1. We know how important it is to get you back to your active lifestyle. Your mental and physical well-being is our priority. 
   2. Insurance companies often view these services as “unnecessary.” Instead, we want to help you get BEYOND the minimum baseline.

Why Cash Based?

We want to show you how choosing Steady State will not only help you get out of pain and reach your goals, but also save you money compared to an insurance clinic.

In this example, we will take a look at 2 different patients (Sam and Jesse). Sam chose Steady State and Jesse chose a local insurance based practice. Sam and Jesse are dealing with the same injury and have the same insurance coverage/deductible of $4000 (national average). 

Steady State (Sam):

Initial Evaluation: $249 for a comprehensive 75-90 minute evaluation. 

Sam received a full 75-90 minutes with a Doctor of Physical Therapy.

Insurance (Jesse):

$35 co-pay (national average) for 60 min eval.

Jesse paid $152: The average cost for each PT session if you haven’t met your deductible. You will receive a bill in the mail.

Sam

The Steady State doctor listened to Sam’s entire story and together they created a holistic plan based on her goals and limitations. All of her questions got answered. 

This plan included exercises and treatments that prepared her for her goals!

Jesse

After a brief conversation with his PT, Jesse was given a handout of exercises that is clearly given to all patients with similar injuries. 

Jesse felt confused and less prepared since this plan isn’t individualized for his specific goals. 

Sam

Just a few sessions in, Sam is already seeing noticeable improvement. She’s out of pain and looking to keep it from happening again!

Sam and her PT have also addressed new ways to recover and manage her stress. 

Jesse

Each treatment visit, Jesse’s PT is treating 2 other patients simultaneously. Lack of attention means his progress is slower. 

He typically did the exercises with a student and thinks to himself…Can’t I do this at home on my own?

Sam

Sam’s initial evaluation + first handful of follow up sessions successfully met her original goal of getting out of pain and getting back to doing the things she loves to do!

Jesse

Jesse came to PT 2x/week for 6 weeks because that’s what his insurance would cover. 

He is not seeing the results he wants but he eventually met his deductible. 

Sam

Sam is feeling stronger day-by-day and her individualized plan has allowed her to return to her normal life quicker than expected. 

Sam and her PT continue to check off goals. They create new goals to progress with this new baseline.

Jesse

Despite regular visits 2-3x/week, Jesse is still doing the original exercises he was given on Day 1. 

He is starting to get anxious with the slow, up-and-down progress. He wonders if he might have to deal with this forever…

Why Cash Based? By The Numbers

Before we dive into the breakdown, we will assume that Sam and Jesse have $1500 remaining on their $4000 annual deductible. 

It’s clear that an individualized plan/care allowed Sam to reach her goals with less time commitment than Jesse…but what about the financial investment?

Steady State (Sam)

Initial Evaluation: $249

9 Follow Up Sessions $1741

(Clear and Transparent)

Total: $1990 

Insurance (Jesse)

Initial Evaluation: $152

18 Follow Up Sessions: $1800

(deductible met after 10th sessions)

10 sessions @ $152

8 sessions w/$35 co-pay

Total: $1952 

At the end of the plan of care, Sam visited Steady State and has spent $38 more out of pocket than Jesse. 

Furthermore, had Jesse NOT met his deductible, this care path through insurance PT would have cost him $2,888 ($152/session x 1 initial evaluation and 18 follow up sessions) out of pocket, which would have him spending $898 MORE for a less-effective care than if he had gone through Steady State. 

Although both patients were recovering from similar injuries, Sam’s symptoms resolved quickly and got results in almost half the time. Steady State’s individualized care allowed for a fuller recovery that got Sam back to the lifestyle she loved sooner. 

Which path will you choose to get back to your peak performance?