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A New Physical Therapy Model

Traditional Therapy Model (Insurance Based) v.  Zang Physical Therapy (Concierge Physical Therapy or Out of Network)

I realize many individuals, including my own family had a difficult time understanding why or how this concierge physical therapy, fee-for-service Out of Network or “cash-based” model (whatever you want to call it) would or could be accepted. To a person, they all questioned my decision, as their view is that of the average consumers. Most if not all people think their insurance should cover anything and everything. Now, while I may agree with you, that is no longer how our healthcare system in this country works. Given the current state of healthcare, a greater burden is being pushed onto the consumer in the form of sky high premiums, large deductibles, co-insurance and/or co-pays. No matter how you slice it, you will pay more up-front (premium) OR you will pay for the utilization of services (deductible, coinsurance, or co-pay). The insurance companies will continue to profit hand over fist and you the consumer will be left with a healthy bill in your mailbox or email inbox.  While the model I propose may seem like a shock to the system, take a moment to scan the data I will present below for the potential cost-savings for the therapy services to the consumer (***the numbers may not reflect the exact cost per session based upon the plan you choose based upon your specific needs).

If you have questions, please call me for further explanation 717-440-6197

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Insurance Plan Example #1 with Deductable and CoInsurance

$3000 deductible (paid before any coverage by insurance), 10% coinsurance (percent patient pays after deductible met), no co-pay

PT eval $170

Avg PT session (1 hr) $160

Your time is important and this type of care on average will help you resume your desired function more efficiently and cost effective.

Insurance charts 2

Insurance Plan Example #2 with Deductible, CoInsurance, and CoPay

$1400 deductible, 20% coinsurance (applies after deductible met), $40 copay (not counted toward deductible)

PT eval $170

Avg PT session (1 hr) $160

Insurance charts 3

Insurance Plan Example #3 with Deductible and CoPay

$1000 deductible, $50 copay (not counted toward deductible)

PT eval $170

Avg PT session (1 hr) $160

Insurance charts 4

Medicare

Zang Physical Therapy is a non-par provider for Medicare meaning we do not accept Medicare rules for billing/payment. What this means is patients will pay for their treatment upfront within the allowable limit for charges and then will be given paperwork to submit to Medicare for direct reimbursement. As alternative option, Zang Physical Therapy will submit on the patient’s behalf such that they can be reimbursed directly. It is our understanding that patients are likely to get a portion of the cost of their treatment up to the allowable Medicare cap per year, however no guarantees can be made. To date, patients have been receiving their checks from Medicare within just a few weeks.

Patients will be required to obtain a script for physical therapy per Medicare guidelines.

Tricare

Zang Physical Therapy is a non-par provider for Tricare. This means we are able to treat active and retired military personal and their dependents. Under this model, patients will pay for their treatment upfront within the allowable limit for charges, and then will be given paperwork to submit to Tricare for direct reimbursement. It is our understanding that patients are likely to get a percentage of their visit charge reimbursed, however no guarantees can be made.

Patients may be required to obtain a script for physical therapy per Tricare guidelines based upon your specific plan.

Zang Physical Therapy ~ 836 Market St, Lemoyne PA 17043 ~ 717-440-6197 ~ andrew@zangpt.com ~