Insurance

Agility Physical Therapy and Sports Medicine is a Hybrid insurance and Concierge Clinic. What does this mean? Have you had the experience of being one of 3-6 people a Physical Therapist is working with at another clinic? Have you seen the Doctor of Physical Therapy at the first visit and then worked with a Physical Therapy Assistant or Aide (athletic trainer or exercise physiologist) the rest of the time you were in rehab? This has become very common, but it is not quality and in some cases, not billed appropriately to your insurance company. Maybe the next scenario is more familiar.Has your Physician recently been bought out by a larger corporation? Do they have less time to spend at each session? Or Have THEY gone to a Concierge style of practice?

There is an easy explanation as to why that is happening. According to a study put out by the American Academy of Primary Care Physicians in 2015, it takes on average 2.5 admin staff for billing insurance and appeals in a clinic. Medical jobs went up in the 3 years prior to the study by 98%; however, 74% of those hired during that time were administrative staff. At the same time, insurance reimbursement since 2000 has decreased by 48%. Infact, in 2020, Medicare cut reimbursement by 8%. In order to keep income at the same level, they have to see more patients per hour in the insurance reimbursement model.

We are an Out Of Network Provider for most insurances. The exceptions to this are Medicare, TriCare, and Cigna. We WILL submit claims on behalf of each client, with the exception of Kaiser, Aetna and Medicaid, But you will be responsible for your portion as stated on the booking page of our website. That said, we do offer packages as well that can gain you a larger discount. Also, it should be noted that what will be submitted to your insurance will be discounted.

So Why do people still Choose to come in versus a clinic In-Network?

  1. They have tried other PT and “Failed”
  2. They feel like their story requires more 1:1 attention
  3. They have other underlying health conditions
  4. They are looking for a place where they feel like someone has time to listen to them
  5. We can use other techniques not covered by insurance at no extra charge like Class IV laser and Trigger Point Dry Needling
  6. The Whole Person Approach, not the Injury Approach