On Anthony Renna’s StrengthCoachPodcast.com #59, the primary topic of our chat was my views on Thomas Myers’ quite popularized talk @ Perform Better-Providence.
The take home for me was ultimately 2-fold: 1) When that many of the people in the front of the room are saying the same thing in just ways, there has got to be something right about it, and 2) Manual Therapy is a tool you must have access to although not always needed.
But in what seemed like a sidebar to the topic at hand, we also talked about the business model we have @ CentraState Sports Performance where we have folks come in on both insurance-based and cash-based programs.
Because the skill set of myself and Joe P allow us to both adequately provide manual therapy and movement training, we can avail ourselves to a larger target audience and also keep folks on “training” in the same setting and same individual they were working with when they were on “rehab.”
I recently received an e-mail from a colleague that we saw at an SFMA Level 1 a few years ago asking me to go into some more detail on how we work this out.
Here is my answer below, which I hope can spike some Comments with even more details.
Our model is based on our own interpretations of ethics. We are first able to increase our target audience for insurance-based dollars by marketing services for anyone that can demonstrate under a 14 on the FMS. We have a model that allows physical therapists to treat and train people that are not in pain. I trust you would agree that this is clearly a viable domain of PTs although not exclusively. But if your ethics and workplace allow for this, my opinion is that you have every right to charge insurance. Now if someone needs authorization, this may not work or work in getting you a lot of sessions, but for folks that do not need regular “approval” from their insurance company, we have found a great and ethical avenue to get people what they need proactively.
I don’t see many physical therapists that do this because they simply don’t know how. If you go into most PT or Chiro office and say nothing hurts, and you have normal ROM and MMT, they won’t be able to help you. They don’t know what to do. Partly is because insurance typically does not pay for functional limitations. They only care about the old school objective measures that do not correlate to functional movement.
If you follow my work, you know I do not delineate between rehab and training. To me, it’s all the same. It’s just about how your skill set allows you to restore or improve as many qualities as possible, so we just look at however we can get people in the door to do what we do, we don’t care how they pay.
As far as the concurrent week programs where we have people paying on insurance one time a week and cash another time, if they do require authorization, and we know the insurance companies are going to care about OPS, ROM, MMT, etc. which we must ethically provide, we typically are going to get denied for more sessions. So we can ration them and use the session for manual therapy, and then be far more liberal with their scheduling when they come in to train. We have more of an S&C studio setup than a typical PT office, so we can yell across the room or out into the gym where we do our movement stuff.