New Year, New Health Insurance Benefits!

With the New Year, most insurance plans start over. This means that there could be changes associated with your health benefits, so the New Year is the perfect time to review your insurance coverage. At Agility Physical Therapy, we want to make sure patients have a full understanding of the costs associated with their visits. Here are some tips to stay on top of the new changes with your insurance:

  • Have a current insurance card with you. This will expedite the process in verifying your benefits.
  • Familiarize yourself with your new benefits. The more you know, the easier the check in process will be at the beginning of the year.
  • Understand that the amount you pay at one office may be different than what you pay at another office. Each office could have different costs depending on the level of care and service provided.

To better understand what your health insurance plan covers, you must first understand the terminology. Here are some common terms to help when looking over your plan:

  • Premium: the amount you pay your insurance company for health coverage each month or year.
  • Health Insurance Deductible: the amount that the patient typically must pay out-of-pocket before the insurance company will begin to pay. For example, if your deductible is $1,000, your insurance will not pay for anything until you have paid $1,000 for services subject to the deductible. Depending on your plan, even if you have met your deductible, you may still owe a copay or coinsurance. In most cases, the lower the premium, the higher the deductible.
  • Out-of-Pocket Maximum: the maximum amount an individual/family will pay for the calendar year for services covered under their health insurance plan (includes deductibles, copays, and coinsurance) until the insurance company pays for all covered expenses.
  • Co-pay: a fixed amount you will pay for a covered health service, as defined by your health plan. Copays usually vary for different plans and types of services. Insurance requires that copay is paid at every visit. In most cases, copays go toward your deductible.
  • Co-insurance: the predetermined percentage of costs you pay to a medical provider once the deductible has been met. In other words, the coinsurance is your share of the total cost for a particular service. Coinsurance amounts very based on each insurance plan. For example, if your insurance plan’s allowed amount for an office visit is $100, you have already met your deductible and you are responsible for a 15% coinsurance, then you would pay $15 at the visit. The insurance company would then pay the rest of the allowed amount for that visit.
  • In-Network: this term refers to medical establishments that deliver patient services covered under the insurance plan. In-network providers are generally the cheapest option for policyholders. Insurance companies typically have negotiated lower rates with the in-network providers.
  • Out-of-Newtork: this term refers to medical establishments not covered under your insurance plan. Services from out-of-network providers are usually more expensive than those rendered by in-network providers.
  • HMO (Health Maintenance Organization) Plan: With an HMO plan, you are assigned a specific primary care provider, and you can then only receive treatment and care from physicians and specialists within the established provider network. Referrals are required for certain providers. Please check with your insurance carrier to see if a referral is required for our facility.
  • PPO (Preferred Provider Organization) Plan: With a PPO plan, you do not have to select a primary care doctor and referrals are not required for specialists.

Remember, your health insurance benefits should be something you use all the time—from yearly check up visits to movement screenings and wellness benefits. Make the most of your plans this year, and make it a happy and healthy 2019!

The majority of insurance plans, including Medicare and private insurers, pay for physical therapy services that are medically necessary. In the state of Colorado, you can go directly to a Physical Therapist under a law that grants “direct access.” This means that, with most insurances, you can visit your physical therapist first without a physician’s referral. With direct access, you can reduce costs with fewer visits to multiple providers, such as your primary care physician or an orthopedic surgeon, for conditions that are affecting your movement. For example, if you were to sprain your ankle or “throw out your back”, you can simply walk into your physical therapists office, who can then diagnose your injury, order imaging to rule out bone fractures or breaks, and begin your plan of care all in one visit.

At Agility Physical Therapy, we are currently accepting all major health insurance plans, with the exception of Aetna no co-pay plans, BCBS Federal and Kaiser non-PPO plans. For a complete list of insurances we accept, visit our insurance page. In addition to accepting most insurance plans, Agility Physical Therapy offers payment plans as well as discounted packages for self-pay rates. For more information or if you have a question regarding whether or not we accept your insurance, contact us at agilityphysio.com or 303-773-0771 and we will verify your benefits for you.

 

 

18 Ways Physical Therapy Can Make a Difference

If you are reading this post, chances are that you have heard of physical therapy (PT). Perhaps you have attended PT as a patient or know a friend who has had PT in the past. But if asked, you might not be able to define physical therapy or describe all the ways it can benefit a person. That’s no surprise; physical therapy is such a large profession with so many practice settings that it can be tough to describe what PT truly is!

Physical Therapists are movement experts who combine their extensive education, clinical experience, and the latest medical research to assess and treat people of all ages and abilities, from highly athletic to extremely physically debilitated. PT is a dynamic profession with established theoretical and scientific bases for therapeutic interventions, with an end-goal being to maximize and optimize each person’s capacity for movement. With use of patient education, corrective exercises and manual therapy, PTs can help relieve pain and normalize imbalances to ensure patients are as independent as possible.

Physical Therapy is a high-benefit, low-risk solution to treat many conditions. PT is considered a conservative intervention, meaning that it is less taxing on the body than harsh medications and surgeries, which should be considered last resort options. PT can truly make a difference in the following ways:

1. Avoid surgery. Physical Therapy can often help avoid unnecessary and costly invasive surgery altogether. Research has shown that PT can be more effective than surgery in the long-term for injuries such as rotator cuff tears, spinal stenosis, and disc herniation. If it is necessary to perform surgery, physical therapy will expedite your recovery by increasing your strength pre-operatively and preparing your body for the rigors of an operation.

2. Assess your Injury risk. In the same way you visit your primary care physician for an annual check-up, you can visit a PT for a full movement screen and orthopedic examination every year. PTs are trained to recognize postural habits and biomechanical shortcomings of each individual’s unique body. Movement screens can bring your attention to areas of weaknesses that may predispose you to future injury.

While everyone has different muscle imbalances, range of motion and alignment, a PT can pinpoint your specific limitations. After recognizing your individual impairments, your physical therapist can then give you the tools to overcome these subtle postural habits or limitations to prevent future injury.

3. Reduce or eliminate pain. Chronic pain, pain that lasts several months, is a common problem and can be very frustrating, especially if the underlying cause is unknown.

People can suffer from chronic pain in a number of areas in the body, including headaches or neck pain caused by postural syndromes, hip and knee pain as a result of osteoarthritis, or low back pain due to work-related activities. Patients who are experiencing chronic pain often fear performing daily activities and experience tightness, stiffness or increased used of pain medications.

If you are experiencing pain, PTs can provide hands on treatment to mobilize your joints, release soft tissue and restore muscle function, thereby reducing aches and pain. Patient education is important in understanding that chronic pain is complex involving more than damaged muscles, tendons, ligaments and joint tissues. Emotions, depression, anxiety and nervous system hypersensitivity are important components of chronic pain that will be addressed by your PT. Finally, understanding how to properly lift, sit, bend, reach and perform specific daily activities will help facilitate healing and decrease repetitive trauma to your body. Physical therapy can give you the tools and guidance you need to live pain free and improve your quality of life.

4. Avoid Prescription Medications. The ongoing opioid crisis in the United States reflects the unintended consequences of a nationwide effort to help individuals control their pain. The health care system has, since the mid-1990s, employed an approach to pain management that focuses on the pharmacological masking of pain, rather than treating the actual cause of pain. This strategy has resulted in a dramatic increase in opioid prescriptions, causing widespread misuse and addiction. In recent years, it has also led to a growing realization that current strategies for managing pain have to change, as opioid-centered solutions for dealing with pain at best mask patients’ physical problems and delay or impede recovery and at worst may prove to be dangerous and even deadly.

Ensuring that patients are aware of and have access to various options for care is a significant step in addressing this complex issue. PT interventions are an essential component of the multidisciplinary undertaking that is required to improve patient outcomes and alter the trajectory of this public health crisis.

The CDC released opioid prescription guidelines in March 2016, which recognized that properly-dosed opioids are appropriate for pain management in cancer treatment, palliative care, certain acute care cases, and end-of-life care. For other conditions, the CDC recommends non-opioid approaches, such as physical therapy. The CDC’s recommendations reference high-quality evidence that treatments provided by PTs are especially effective at reducing pain and improving function in cases of low back pain, fibromyalgia and hip and knee osteoarthritis.

Similar to how PT can help avoid costly surgeries, it can replace the need to purchase and consume expensive drugs. PT will address the underlying cause of your injury or condition, rather than prescription drugs which mask pain, and is a safer alternative for long-term pain. During an initial evaluation, your physical therapist will focus on your symptoms and the movement patterns that may be contributing to pain.

5. Prevent falls. A fall can result in joint dislocations, fractures, reduced self-confidence, permanent disability or other health, psychosocial and economic consequences. There are many reasons that a person may be at risk for falls. Potential causes for imbalance include reduced joint position awareness, visual impairments or problems of vestibular origin.

During your initial evaluation, your physical therapist will perform a screen to evaluate your fall risk. After isolating the cause behind your imbalance, your PT will prescribe treatment to address deficits that are contributing to your fall risk.

PT intervention will improve your balance, increase your neuromuscular control and coordination, and decrease your fear of falls. Fall prevention is important to avoid further injury and ensure that you can carry out your day safely and independently.

6. Refer you to specialists. Although it may seem like physical therapists can do it all, we recognize that, at times, your health condition may be out of our scope of practice. PTs identify problems that may require consultation with or referral to other professionals when appropriate.

Sometimes a person might require simultaneous multidisciplinary care from a team of health care practitioners. In such cases, your PT will work hand in hand with your primary care physician or specialty provider to ensure your wellness goals are met.

7. Increase your functional independence. Functional independence is the ability to carry out activities of daily living safely and autonomously. Whether you are experiencing a physical disability or not, participation in daily living activities is essential to your health and well-being.

If you are having difficulty standing, walking, standing from a chair or other daily activities, physical therapy can help. The treatment approach chosen by your PT depends on your specific goals, the degree of functional limitation experienced and the type and severity of the skill impairments noted.

8. Recover from a stroke, neurological injury or chronic disease. PT is essential following a traumatic injury or diagnosis of chronic disease. Adults and children who experience a stroke, Multiple Sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS), Cerebral Palsy and many other conditions have shown to benefit significantly from physical therapy.

After an unexpected injury, it can be difficult for patients to return to daily activities such as writing, eating, or climbing stairs. If you have been diagnosed with a chronic disease, PT can help manage symptoms or delay progression of the disease by maintenance of strength and mobility, incorporation of nutritional education, and improvement of gait and balance. It is current knowledge that nutrition, the intestinal microbiota, the gut mucosal immune system, and autoimmune pathology are deeply intertwined. Nutritional intervention can be very effective in managing autoimmune diseases, such as diabetes and hypothyroidism, which share the underlying pathology of chronic systemic inflammation.

At Agility PT, Dr. Marci has obtained her functional medicine certification. Dr. Marci’s training has equipped her with the scientific knowledge and experience to recommend individualized diet and lifestyle modifications to decrease your symptoms, restore hormone balance, and support the gut and immune system. Studies have shown that nutritional intervention is effective in controlling the progression of MS, Systemic Lupus Erythematosus (SLE), and Diabetes by modulating the autoimmune response and systemic inflammation. For example, symptoms of disease, such as fatigue in MS, pain and diarrhea in inflammatory bowel disease, or the need for acute medication in type 2 diabetes are considerably affected by food intake.

9. Recover from sports injury. While we try to prevent injuries, sometimes accidents occur. The fact that athletes place higher demands on muscles and joints increases their risk for injury. However, an injury on the field does not mean that you have to sit on the sideline indefinitely.

PTs have experience rehabilitating athletes with rotator cuff injuries, ligament sprains, muscle strains, tendinitis, overhead sports injuries, and pains that occur with running and cycling.

After a thorough evaluation of your condition, your PT will develop a custom rehabilitation program of hands-on techniques for pain and inflammation control. Your PT will also help you build up strength in your muscles, restore normal joint and soft tissue mobility, and recover neuromuscular control, speed, power and agility. It is important for an athlete to practice and feel confident in sport-specific drills before returning to play, such as deceleration, jumping and cutting. Studies have shown that instability activities which challenge the athlete’s balance after an injury make a successful return to sport 5x more likely.

If surgery is required, the physical therapists at Agility PT are trained to help athletes recover from operation of the knee, shoulder, ankle, hip and spine. Your PT is trained to monitor for signs of infection or complications that can occur in the operated joint or joints above and below as a result of injury or post-surgery. We will work with you to optimize your performance and help you reach your fullest potential following a sports injury.

10. Reduce or eliminate vertigo. Vertigo is a sense of rotation or rocking, even when a person is perfectly still. Movement of the head or body can worsen symptoms, and may lead to lightheadedness, nausea or vomiting. If untreated, this imbalance will likely lead to a fall or accident and cause further complications.

There are various reasons that dizziness and vertigo may occur. Some causes of vertigo include nervous system abnormalities, cervical spine conditions, vascular impairment, Meniere’s disease, vestibular neuritis, benign paroxysmal positional vertigo (BPPV), or inner ear infections.

PTs will perform an evaluation to determine the cause behind your symptoms. For example, if you have BPPV, our vestibular therapy experts can perform a series of simple movements, such as the Epley maneuver, which can facilitate the return of the crystals in the inner ear to their normal position. With this specific condition, symptoms can typically be completely resolved within one or two visits.

Dr. Marci at Agility PT has completed continuing education to receive Advanced Vestibular and Vestibular Rehab Certifications. With her specialization in vestibular rehab, Dr. Marci has helped numerous patients eliminate their symptoms.

11. Prevent an injury. PTs understand how different sports can increase your risk for specific types of injuries. For example, stress fractures and patella tendinitis are common in runners, while ACL tears often occur in female soccer players. PTs can design an appropriate injury prevention program individually tailored to you to keep you healthy all year long.

At Agility PT, Dr. Jessica has earned her certification as a Strength and Conditioning Specialist (CSCS). Her experience has prepared her with in-depth knowledge pertaining to biochemistry of energy systems and nutrition, exercise modalities, training strategies for performance adaptations, and most importantly, injury prevention. Her experience has prepared her to apply scientific knowledge in the design of safe and effective strength and conditioning programs with the primary goal of improving athletic performance and preventing injuries.

12. Find the best workout for you. PTs gather information from prior surgeries, diet, lifestyle, body mechanics, and personal preferences to determine what physical activities will best fit you.

Proper programming and prehab before starting a new type of exercise or increasing the intensity of a current exercise routine will help you address muscle imbalances, guarantee that you are progressing adequately and prevent injury in the long run.

Whether your goal is to manage weight, increase strength after an injury, improve athletic performance, or combat the effects of chronic conditions such as type 2 diabetes, PTs can develop a safe, individualized exercise plan.

With guidance on the fundamental principles of strength training and training cycles and individualized exercise prescription, you can avoid new and recurring injuries. Additionally, a model of progression needs to be implemented and followed, or results will be slow or non-existent.

13. Nutritional education. PTs are educated in nutrition, fitness and exercise. It is well known in the literature that nutrition plays a key role in both prevention and treatment of injuries.

When muscles are exercised, the result is tears at the microfiber level. This is a normal process that results in local inflammation in the specific muscle to repair the fibers and increase resilience against future damage. This is the process by which muscles grow, or hypertrophy. In a similar manner, when a person is injured, an inflammatory response is initiated.

The success of this repair and build process depend on the person’s body composition and is influenced by nutrition. If a person does not meet adequate dietary intakes when the body requires extra energy for recovery with exercise, repetitive stress injuries may result, such as tendinitis or ligamentous tears. Furthermore, nutrient deficiencies during recovery will delay the repair process and prolong healing. Therefore, nutritional status and energy requirements should be assessed throughout recovery and nutrient intake adjusted accordingly for optimal prevention and recovery from injury.

Often patients come in the clinic with a musculoskeletal condition, but sometimes working on mobility, control and strength aren’t enough to relieve their pain. These patients will truly benefit from lifestyle changes in addition to physical treatment. Nutrition is often the missing link to comprehensive care in managing and relieving musculoskeletal pain.

At Agility PT, Dr. Marci has completed training to become a functional medicine practitioner. Often there are multiple factors contributing to an individual’s clinical presentation and finding the root cause is the heart of functional medicine. Nutritional intervention is an effective and useful tool to improve overall health outcomes, optimize performance and help patients achieve goals.

14. Order Imaging. Incorporating greater purposes for imaging by PTs systematically improves patient management and cost containment.

The role of PTs in ordering diagnostic imaging has been in existence for several decades. The most notable example is in the U.S. military, where since 1972, PTs have practiced as direct access providers with imaging privileges. Imaging instructional content is foundational in PT education programs, allowing for competencies in imaging use and decision making in physical therapy practice.

The 53 United States jurisdictions define the regulatory scope of PT practice differently. The ability to perform certain skilled tasks, including imaging, may be granted overtly through explicit regulatory authority or denied by that same authority. The Colorado State Physical Therapy Board states that PTs may order diagnostic imaging.

How does this affect you? The ability for PTs to order imaging will reduce the delay in treatment that occurs with referral to another provider for imaging. Additionally, the combined advantage of direct access for PTs and their authority to order imaging will decrease costs for yourself and the healthcare system in terms of less visits to multiple providers.

15. Diagnose your movement pathology. PTs are recognized as practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for and prevention of impairments, functional limitations, and disabilities related to movement, function and health.

In Colorado, you can go directly to a PT under a law that grants “direct access.” This means that you can simply walk into a clinic and a PT can diagnose your ailment. This is an advantage that is not legal in all states. Going straight to your PT, rather than visiting your primary care physician who will then likely refer you to a PT, can save you a trip and get you better faster!

When people experience an injury, one of the first things they do is look up their symptoms on the web. Another common tendency is to follow the same treatment that a friend had for their injury. While we want you to be self-sufficient, diagnosing and treating yourself can be dangerous, costly and will likely lead to delayed recovery.

Physical therapists can distinguish a particular disease or condition from others that present with similar symptoms. For example, a PT can differentiate between kidney or liver condition and symptoms that mimic low back pain.

16. Save you money. Depending on your insurance, physical therapy treatment can be free or include copay. Although a copay may seem to be a burden initially, seeking treatment early on before your condition worsens will save future expenses.

Research shows that the longer you wait to treat a condition, the further delayed the recovery and the greater likelihood of developing compensations in surrounding joints. Additionally, the total costs of other treatments, such as surgery and expensive medications, can exceed the cost of seeing a physical therapist.

The scope of PT practice with direct access has demonstrated enhanced quality of patient care and reduced costs. The advantage of direct access to a PT will save you time and money as you can skip the steps of obtaining a prescription for PT from your physician.

17. Orthotics. Each step we take involves a remarkably intricate network of bones, muscles, tendons and ligaments functioning together as pulleys and levers to meet the demands placed on them with walking, running, jumping, and more. The complexity of this system, combined with the weight feet carry, account for why feet can be prone to many orthopedic injuries.

Some of the injuries PTs treat include bone fractures, arthritis, plantar fasciitis, bunions, and tendinitis, among many other conditions.

If you have had a foot injury, you know that it can cause a big restraint in your daily life. If left untreated, foot problems typically lead to more injuries up the chain, including the knees, hips and back. You can take a proactive approach by having a full evaluation by a physical therapist BEFORE symptoms occur in your feet.

The PTs at Agility Physical Therapy can make orthotics customized to fit your feet and promote proper alignment of your body from the ground up. While orthotics are appropriate for some patients, others don’t need them at all. For hypomobile or rigid feet, orthotics can cushion and support those stiff segments of the foot. For hypermobile conditions, as in pronated feet, orthotics can stabilize the foot. Orthotics can also help the foot redistribute forces during weight bearing activities to alleviate pain and prevent injuries.

18. Achieve Developmental milestones. At certain ages, children should reach specific gross and fine motor skill milestones. These skills are required to control muscles of the body for walking, running, sitting, crawling and other activities. While some children may develop faster than others, there are some milestones that should be achieved by a specific age.

Early identification of delayed developmental milestones allows communities to provide more effective and affordable treatment during preschools years. Proactive intervention can also lessen the need for expensive special-education services later in childhood or worsening conditions in the future. Physical therapists can provide early intervention services for children with developmental delay to achieve their age-appropriate milestones.