The most common question we get from new or potential patients is, "Do you take my insurance?" We wanted to talk a little about insurance networks, what it means to be "in network," and why we've chosen to stay OUT of insurance networks.
Insurance providers have networks in which they contract practitioners to perform services at discounted rates. To participate in an insurance network, practitioners have to agree to ALL of the insurance company's terms. Early on at APH we decided that agreeing to the terms set by the insurance companies (whose top priority is their bottom line -- $$$) was not in the best interest of our patients.
It's important to note here is that just because we are out of network does not mean that your insurance company won't reimburse for treatment! It simply means that we don't have a contract with them. We submit claims to insurance companies on a patient's behalf, just as an in-network provider does. If you choose, you can also submit payment to us directly and have your insurance reimburse you instead of us. It's a pretty simple process and we're happy to assist along the way if you have any questions.
Here are some of the main reasons we are an out of network facility:
1. We’re able to spend more one-on-one time with patients. You guys are important to us and we want to deliver quality services and effective treatment. Contracted reimbursements from insurance companies are so low that we would need to see multiple patients per hour just to keep the lights on. Our standards for patient care are just too high for that to be an option. At APH you get over a full hour of one-on-one treatment with our professional team. This allows us ample time to do all of our hands-on bodywork. It also allows us enough time to do therapeutic exercise with you as opposed to just sending you home with a printed handout and letting you do it on your own.
2. We’re able to treat the *entire body* with the all-encompassing All-Pro Method. Insurance companies require a diagnosis code to go along with every treatment code. This means that if you come in with that nagging high hamstring pain, the only thing we’re able to treat is your hamstring because that’s all we have an actual diagnosis code for. All the other contributing factors are left untreated and at APH where we know that "everything is connected," we know that's not effective for getting to the root of the problem.
3. We’re able to utilize all of our awesome modalities. We don't have to worry about what your insurance company deems necessary or billable. With your doctors at APH, you can decide that for yourself and opt in or out of any treatments you think will work for you.
4. The duration of your treatment plan isn’t dictated by the insurance company. Most insurance plans allow a certain number of visits under your plan. It’s the insurance company, not the patient/doctor team, that decides when the patient’s treatment is complete. Typically this is when the patient is able to resume “normal” activities. But what if your personal goal is to compete in a triathlon, which is well outside of what most insurance companies would deem normal or necessary? On that same note, what if you're feeling great after just 3-4 treatments? An in-network provider might want to keep you coming back unnecessarily to make sure they get all of the visits allowed by your insurance! And you might even have to pay a copay out of pocket for each visit! At APH we work with our patients directly to develop treatment plans in line with your personal goals so YOU -- not your insurance company -- can make those decisions.
In a nutshell, we care too much about our patients' well-being to be bound to insurance companies' contracts which are profit-focused as opposed to patient-focused. In many ways, going to an out of network facility can wind up saving you money in both the short and the long term.
At APH, YOU are our main priority.
Again, just because we are an out of network facility DOES NOT MEAN that you're not covered by your insurance. Contact your insurance company directly to determine your exact benefits and please reach out to us if you have any questions or issues regarding payment.
We have a few treatment packages in the works to streamline the process even more for patients and also to allow those without insurance access to insurance-like pricing.