WHAT IS CASH-BASED PT?

In a cash-based treatment model, the therapist enters into a contract with the patient to provide physical therapy services in a manner that both parties have determined will help them reach treatment goals most efficiently. The patient pays at the time of service, allowing the physical therapist to focus on providing the best possible service while keeping administrative costs low. You may pay for services using cash, a check, or a credit/debit card. Typically, coding for PT therapy services provided (CPT codes) is determined using complex matrix of “timed codes” and “untimed codes”.  This often results in confusing patient bills, as the amount billed to insurance will vary visit-to-visit based on the exact services provided that day. 

Cash-based billing eliminates this confusion and allows for clarity in decision-making on the part of the patient and their provider. Documentation for evaluations, treatment visits, and progress notes are performed just like any physical therapy practice and comply with all legal requirements. 

NM PELVIC HEALTH PHYSICAL THERAPY IS AN OUT OF NETWORK PROVIDER - WHAT DOES THIS MEAN?

This simply means that the therapist has not entered into a contract with individual insurance companies to receive reimbursement based on their contracted rates. There are MANY insurance companies, each with their own contracted rates and regulations, and NM Pelvic Health Physical Therapy’s energy is best spent working with patients. 

WILL I END UP PAYING MORE FOR CASH-BASED PT?

In many cases, the out of pocket expenses for a course of therapy will be LESS for services provided at NM Pelvic Health Physical Therapy. In large part, this is due to the ability to charge less per visit, with these charges being well below the national average charge submitted to insurance in a typical fee for service outpatient practice. NM Pelvic Health Physical Therapy – can charge less because the simplified cash-based fee structure streamlines billing and does not require hiring billing personnel or paying fees to a third party billing service. This allows us to focus all energy on patient care, and allows patients to make informed decisions regarding the costs of their health care choices.  

WHAT STEPS ARE INVOLVED IN SUBMITTING A CLAIM TO MY INSURANCE COMPANY?

The process is actually quite simple: NM Pelvic Health Physical Therapy, will provide you with an invoice at the time of service and you may submit that invoice and receipt to your insurance company for reimbursement (excluding Medicade and Medicare). The invoice has all the necessary information (business name and address, tax ID, national provider identification, license numbers, etc.) as well as the patient’s ICD-10 (diagnosis) and CPT (billing) codes.

HOW DO YOU ACCEPT PAYMENT?

You can pay with cash, check, credit card, HSA account, HRA account, FSA account etc.