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 have a difficult time understanding why or how this concierge physical therapy or Out of Network 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. The current model MAY or MAY NOT pay when you are sick but does little or nothing to keep you healthy. Given the current state of healthcare, a greater burden is 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 this model I propose may seem like a shock to the system, in the end many patients ultimately make out from a cost perspective BECAUSE:

  1. All sessions are 1-on-1 with provider for full time selected (no hand-offs)
  2. Fewer sessions are necessary
  3. Which means less time away from work, family, activities (more time back in your week)
  4. Fewer subsequent trips to doctors, specialists, and less need for expensive tests or medications 
  5. And a greater understanding of how to prevent subsequent or future issues

I am sure you will have more questions and I am happy to answer them honestly. Please let me further explain how YOU can get back to what You love. Call  717-440-6197

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Traditional 3rd Party Payers

Zang Physical Therapy is considered an out-of-network provider with all 3rd party insurance companies such as Blue Cross, Highmark, Aetna, etc. This means we are not bound by their arbitrary fee structures and thus can treat clients based on their need and not what an insurance company is willing to reimburse. What this means is the client now gets all the time and attention they need without having their provider’s time divided among multiple patients in a large treatment facility.

 

As an out-of-network provider, we offer our clients all the necessary paperwork/documentation necessary to be able to submit the claims to the insurance company yourself. We are happy to walk you through this process and help you to understand your benefits as best we can.

 

For more help understanding your specific insurance coverage please contact your insurance provider. Be advised if you call twice you are likely to get 2 different responses related to coverage and will be told any information you are given is NO GUARANTEE of coverage even for “in-network” services.

Medicare

Zang Physical Therapy is considered non-par provider for Medicare meaning we do not accept Medicare rules for billing/payment. This means patients pay for their treatment upfront and then Zang Physical Therapy will submit on the patient’s behalf such that they can be reimbursed directly by Medicare. If the client has a secondary insurance as well, that may also cover a portion not covered by Medicare. 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 ~ 3514 Trindle Road Camp Hill PA 17011 ~ 717-440-6197, Fax: 717-388-4333 ~ andrew@zangpt.com ~