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Facts on Cash-based PT for Patients

How Does Rudy L. Paul, MS, PT & RPM Physical Therapy Financially Justify Offering “Concierge”, Cash-Based Physical Therapy to Prospective PT Patients?

The following question is a common one and I answer it often, so I decided to answer it for all my patients to read …

“Why is choosing self-pay, concierge RPM Physical Therapy mathematically & financially better for our patients to consider versus using an insurance-based option?”

First, and probably the most important, is that all of my RPM Physical Therapy patients enjoy:

1) the longer, personalized physical therapy sessions that include total body workouts, and

2) they each receive a higher value due to the level of personalized attention paid to their musculoskeletal therapy issue(s).

To help prospective patients “do the math” or, “run the numbers” based on their individual insurance situation or financial position, I have put forward some hypothetical examples:

Cash-Pay PT for those …Individuals Without Insurance

 For those patients who do not have insurance (which is quite rare), then cash-pay PT works well because my RPM PT rates will often be much lower than what patients would have to pay at any insurance-based clinic.

In fact, RPM PT’s rates are only 65% of what almost all the insurance-based PT clinics charge in the area. Therefore, since the numbers don’t lie and are pretty simple to understand, most patients opt to start PT with RPM Physical Therapy. It just makes fiscal sense!

Cash-Pay PT for those …Individuals with a High Deductible

Similarly, patients that have an insurance with a high deductible (note: the average deductible is $3500 to $5000 with the advent of the ACA: Affordable Care Act), will have to pay $3500.-$5000 out-of-pocket until their deductible is met! Then and only then will their insurance finally kick in.

Those patients will be paying much more for each PT visit if they go to a standard insurance-based clinic than they would be if they were attending RPM Physical Therapy for PT.

Again, until that formidable $3500-$5000 deductible is met they will be out-of-pocket! With RPM PT’s rates at about 65% or less, of what most standard insurance -based clinics charge.  It is easy for most patients, since they are paying $3500-$5000 out-of-pocket anyway, to make the decision to use RPM Physical Therapy for their rehabilitation needs because of the significant savings they will realize.

So, even though most prospective patients are initially swayed by the cost savings, they soon realize that they also get better and quicker results with their PT sessions. The longer physical therapy sessions that are personalized, one-on-one visits become something patients find they cannot live without. With our visits, each patient receives a much higher-level of physical therapy involvement and care–not necessarily because we are better PTs–but because we choose to only treat one patient per hour and NOT double or triple book our patients. This is company policy.

In addition, most patients submit the treatment receipts or, “summary of treatment invoices” to their insurance companies as self-claims where they may be applied toward satisfying their hefty insurance deductibles the same way they would if the insurance-based clinics submitted them.  (Please note: some insurance plans have in-network AND out-of-network deductibles.)

Cash-Pay PT for those …with Regular Insurance & Copays

If patients are paying a copay for their PT sessions (let’s assume it is $30/visit) but they are being booked with other patients, then they are being short changed on their private time in therapy.   Most are only receiving about 20-30 minutes of one-on-one care (and usually less), and when the MD has prescribed the patient to be seen in PT for 2-3 treatments a week for 6-8 weeks. This gets costly. It would equate to the patient paying between $360 on the very low end and $720 on the high end for their short duration therapy sessions.

That is a lot of money for the modified, shared 20-30 minutes of physical therapy treatment which was NOT one-on-one care!

In most cases, due to the advanced Manual therapy treatment techniques we practice and our longer, personalized one-on-one physical therapy sessions, the patients we see at RPM Physical Therapy get better faster! Many realize the same or better physical results with only one session of RPM PT treatments per week for 4-6 weeks, where the treatments are at $100/visit. The total investment patients would make for this premiere, “concierge” PT service is from $400 – $600.

Most patients usually end up losing their pain and getting better faster for a fraction of the cost of what they would pay if they went to a standard, insurance-based PT (depending on how high their copays are), and they can actually save money by opting for the RPM PT “concierge”, cash-pay route.

Something else that patients need to consider is the TIME COST of having to travel to and from the PT clinic for so many more treatment sessions when using the standard, insurance-based PT.

What is it worth to each patient to have 25-50% fewer trips by traveling to the RPM PT clinic? In addition, what would that added time and productivity mean for the patient?

Now, let’s consider the obvious, that is, the value of our patients starting to feel better sooner.      If our patients get back to participating in their sport or beloved recreational activity weeks or even months earlier, that carries a huge value for many people.  What would it mean for their stress level, their mental status, their family life, and their productivity at work if their pain level is resolved in half the time because they went out-of network to our RPM Physical Therapy clinic? Granted, we are straying from the “math” here, but this last point may be the most significant one.

And finally, our RPM Physical Therapy services are HSA / FSA-eligible medical expenses, just like any other PT clinic, so patients need to consider the major savings they will enjoy due to paying for their physical therapy using pre-tax dollars (if they have an HSA/FSA plan).

Here’s a hypothetical example of this savings:

$100 treatment fee x 25% tax bracket x 7.65% medicare / soc sec tax = $32.65 in savings…somewhat equivalent to only having to pay $68 for your treatment sessions.

At RPM Physical Therapy our concierge PTs can consistently get people better faster than the average PT who is many times double and triple booked and has limited time that they can spend with each patient. We are committed to providing physical therapy services that are truly higher in value and much more effective than the average, insurance-based offerings in our area.

Why do we do this? Because we feel that our patients and clients deserve it and they are worth it.  If they don’t believe it–we will tell them so!

In this instance, it doesn’t matter how the math works out. This is the keystone of our RPM Physical Therapy success and the success of any “concierge”, private-pay physical therapy practice.

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