Why is Mid-Missouri Pelvic Health Out-of-Network with insurances?
When deciding to open a physical therapy practice, we had to decide if we wanted to be in-network or out-of-network with insurances. This was not an easy decision to make, as each has its pros and cons. When it came down to it, the deciding factor was “what will allow us to provide the BEST care?” And that meant not dealing directly with insurance companies.
Insurance companies have one primary goal and that is to make as much money as possible. Over the years, that has lead to reduced reimbursement, increased red tape for providers, and increased denials (aka surprise bills for patients of unknown amounts). This incentivizes in-network therapy practices to shorten treatment sessions, use therapy aides/techs (instead of actual therapists) to provide treatment, and even treat multiple patients at once in order to stay afloat as a business.
Jen has worked in the insurance-based therapy world for over 10 years and has seen insurance companies dictate WHAT can be done and HOW LONG the patient can be treated. This limits the ways we can help you and is frankly a disservice to the complexities of pelvic health. No two patients are alike and thus, their care should not be dictated by an insurance company’s algorithm.
Going out-of-network allows us to:
Have more time to find the root cause of symptoms and work on what’s important to you regardless of what diagnosis codes the insurance company will or will not reimburse (Yes, this is really a thing. Entire claims can be denied if the wrong diagnosis code is picked. These codes change year to year and insurance company to insurance company.)
Provide skilled one-on-one care focusing on quality over quantity of patient care
Transparent billing - you know exactly what you will be paying instead of any surprise bills months down the road
Long story short, we knew that in order to provide the best care possible, we needed to be out-of-network with insurance companies.