Frequently Asked Questions (FAQ)

I have an insurance plan that I already pay for and it covers physiotherapy. Why would I pay cash to come see you? It seems expensive and does not make any sense.

• After witnessing how the insurance model works for over a decade now, I know the amount of money patients are responsible for after insurance adjustments and payments. While on the surface, paying cash when you already have insurance may not make sense, when you look at the numbers most patients will come out paying less in the cash-based model. 
• The reason for this is three-fold:
  1. In our model, you will be 1-on-1 with your physiotherapist for the entire session and you will never overlap with 1, 2, or 3 other clients as many other outpatient clinics do. This means more attention to detail is provided, more improvements are made, and recovery is faster so you pay for fewer visits.
  2. In our model, you will be with a Doctor of Physical Therapy (DPT) at every session and will never see a Physical Therapy Assistant (PTA) or a Therapy Technician. While we have a great appreciation for the roles of PTAs and Techs in other models, they do not receive the anatomical, physiological, and evaluative training of a DPT and therefore do not possess the license to reassess your condition at every treatment and change the plan of care on the fly to suit your needs if the current POC is not working. Without the ability to test, re-test, and re-evaluate you may spend several visits performing the same exercises and receiving the same interventions without any benefit. In our model, that just does not happen.
  3. Physiotherapists/Physical Therapists are considered “specialists” to insurance companies and are billed as such. Depending on your insurance type (Co-Pay, Deductible with Co-Insurance, or Deductible with Co-Pay) you might have several different cost outcomes, but they either equal or surpass the cash-based model in expenses. 
     • Co-Pays for specialists range from $45 - $100 and most traditional model outpatient clinics will want to see you 2-3 times per week until you reach your therapy cap of 18-20 visits. At that point you spent $810 on the very low end and $2000 on the high end. Unless your therapist has been documenting very well and can petition the insurance for more visits, you are done with your therapy eligibility for the year.
     • Deductible with Co-Insurance patients will pay roughly $300 for an evaluation and another $120-160 for each subsequent hour of therapy (that could be spent with a PTA or Therapy Tech). After the deductible, patients are still usually responsible for 20% of the bill, but by this time you are out of your 18-20 max therapy visits for the year.
     • Deductible with Co-Pay patients are similar to Deductible with Co-Insurance patients as they pay the full amount of the negotiated therapy prices until reaching a deductible and then after that, you will pay your Co-Pay amount of $45 - $100 per session. Once again, you are likely out of your 18-20 yearly therapy visits by the time you reach your deductible. 

Do you accept my insurance for physiotherapy or concussion management?

• We are a cash-based physical therapy practice and accept cash, credit, debit, HSA, and health FSA. We will gladly provide you with an invoice for services rendered, which you can submit to your insurance provider to request reimbursement. The amount reimbursed is dictated entirely by your insurance provider. However, Greg Propst is a certified defensible documentation trainer and is highly experienced in writing visit notes that demonstrate the need for services, which may warrant higher levels of reimbursement.

I have Medicare, but am willing to pay cash and would like to see you for physiotherapy services. Is this possible?

• Unfortunately, no. Medicare does not allow physiotherapists to opt out of participation so in order to see a Medicare beneficiary, it must be billed through Medicare and no cash payments are allowed. However, if you are interested in Nutrition Coaching or Functional Movement Screening, those can be paid for in cash and we would be happy to work with you to achieve your goals.

Do I need a referral to come see you for Physiotherapy?

• No. In the state of Texas we have limited direct access which means if you feel you need to be seen by a physiotherapist you may schedule an appointment directly for an evaluation and treatment. After 10 days we will need a referral from your physician if further treatment is necessary.

Do I need a referral to come see you for Nutrition Coaching?

• No. Nutrition coaching does not require a referral from any healthcare practitioner. However, if your physician has recommendations for you or you have underlying medical conditions that need to be taken into consideration we would love to work directly with your physician to ensure your nutrition and exercise goals are achieved safely.

Do I need a referral for Functional Movement Screening?

• No. Functional Movement Screening is meant to assess for mobility and stability issues that are non-medical and therefore the corrective exercises recommended following your assessment are not viewed as physiotherapy treatment. However, the screening does include “clearing tests”. Production of pain during these “clearing tests” would warrant the need to see your physician to rule out any pathology requiring medical intervention or a referral to a physiotherapist.

Do I need a referral for Recovery & Wellness Services?

• No. Recovery & Wellness services are designed for individuals who are non-painful and uninjured and therefore are not receiving rehabilitative physiotherapy services. So long as the targeted area of the body remains non-painful and uninjured, a referral is not necessary.

Do I need a referral for Concussion Screening & Management?

• No. This falls under the 10 day limited direct access physiotherapists in Texas have before we need a physician’s referral. However, if this is a new concussion and you have not been evaluated by an on-field/court physician, sports medicine physician, or your primary care physician we recommend getting that visit done as quickly as possible to ensure you or your child is medically cleared of more dangerous issues that could be going on inside that beautiful brain of yours. Once cleared, the exercises done in the Concussion Screening & Management program are all evidence-based and patient-centered to ensure the appropriate speed of recovery. If further treatment is necessary after 10 days, we will reach out to the medical practitioner overseeing the concussion for referral.

What is the difference between a physiotherapist and a physical therapist?

• Nothing. They are exactly the same thing and have exactly the same credentials. The two words are synonyms and can be used interchangeably. The real distinction is primarily based on the region where you live. In places like Australia, Canada, and Europe the profession is known as physiotherapy and in the United States we typically call it physical therapy. Previously, some practitioners would argue that physical therapy was an exercise-based approach whereas physiotherapy focused more on manual therapy such as stretching, soft tissue mobilization, myofascial release, and joint mobilizations/manipulations. Nowadays, the best practitioners all over the world are utilizing hands-on techniques, rehabilitative exercise, and modalities in a patient centered manner that achieves the best outcomes for their patients. I prefer the name physiotherapist because it is more ubiquitous in the profession.