1. Focused Care.

When seeing patients in a cash-based model, clinicians are not concerned about reimbursement, meeting quotas of seeing a certain amount of patients to cover costs, or filling out the massive amounts of paperwork or medical forms to fight for insurance to allow more visits for patients. In a cash-based model, clinicians have more time and resources to directly work with their patients to help them meet their specific goals and ultimately getting healthier faster.

2. Accessibility.

If you live in a mid-size to large-size city, chances are you may have to wait to see a specialized provider until you can get in to see your primary care provider. This process can take months and then you may have to wait before you can get in to see a local clinician due to both the availability of in-network clinics and/or the amount of time it takes for your insurance provider to approve authorization to evaluate and treat you. This can take up to 3-4 weeks in some cases. If pain has you sleepless or unable to do the things you love to do or even just daily activities, waiting around can be a daunting process and during that time your symptoms could potentially be getting worse! Once you access care through your insurance, there will be restrictions and a potential delay in care. This makes the process even longer and more frustrating for both the patient and the clinician.

A cash-based clinic allows you to bypass these delays in the health system and get started with treatment faster. Not to mention, with payers out of the picture, clinicians can truly focus on providing exceptional patient care rather than being distracted by the ongoing demands of insurance companies (like being on hold for 45 minutes before you can talk to a real human), just so their patients can have a fair shot at recovering.

3. Achieve Faster Results.

Patients sometimes do not see the big picture when it comes to their care. Using your insurance is not always the best and fastest way to get better. For example, with physical therapy, most insurance-based practices will want to see patients 2 to 3 times per week and with a copay average of $30.00 to $50.00 per visit that equals $90.00 -$150.00 per week. However, cashed based practices have the flexibility of scheduling the patient once per week for a longer session, providing high quality care with results in less time. So in reality, the $150.00 in copays is comparable to the price as one session with a PT at $150.00. The flaw with this method is the psychology of – if you see a PT three times a week you get more for your money versus one time. Wrong! Think of it this way, you see a PT 3 times a week for 8 weeks verses seeing a PT for 4 times in 4 weeks. Cash-based practices focus on getting you healthy faster without having to jump through the nasty insurance hoops and with the perks of also saving you a ton of TIME! No need to use your PTO, miss work/school, or take away time from all the other things you enjoy doing in life!

4. Less restrictions on visit #.

When you use your insurance, you may only be approved a couple of visits. What if you are going to need more visits or a longer window of treatment and your insurance won’t cover it? Paying cash for your PT services puts you at the helm of determining what kind of care you need rather than your insurance company making those decisions for you.

5. Shop local.

Going to a private cash-based clinic offers you the opportunity to support the local economy. As a local cash-based clinic, we are not outsourcing jobs. We are not a part of a big franchise. We are here to help the community in any way possible and are likely to support other small businesses as well! (email pinnacle.performace.lbk@gmail.com for community involvement inquiries!)

6. Does your clinician even lift? Or play sports?

You have the autonomy to choose your provider! If you’re an active person, you want a clinician who understands the active lifestyle. When you choose a clinic doing running, olympic lifting, CrossFit, or other sporting assessments make sure your clinician really understands all aspect of the sport. Let’s say you injured myself when picking up a heavy piece of furniture and it’s now impairing your ability to do CrossFit or...(insert favorite exercise/sporting activity here). If you're going to hire someone to do a movement/pain assessment and treatment, you want them to understand not only the mechanics of my typical exercises, but the type of equipment you use, be able to demonstrate techniques or drills to improve your abilities, and even have other people within the local community they can recommend such as functional medicine providers, coaches, Chiro, gyms, etc. to compliment their services. Unless your clinician has experience in many sports and the ENTIRE realm of fitness, they most likely won’t have those complimentary recommendations to their services.

7. What about HSA and FSA money? Can I submit cash-based services to my insurance for reimbursement?

YES! We accept both HSA and FSA funds as forms of payment. Don't let that money go to waste.

8. Can I submit cash-based services to my insurance for reimbursement?

Yes! Upon request, we can provide patients with a "superbill." A superbill is basically proof of payment that also contains all of the coding you would need to be reimbursed by your insurance company if you choose to self-submit your claims. If you have not met your out-of-network deductible, your payments can be applied towards your deductible which would help you meet it sooner. We highly encourage patients to check with their insurance provider first to see if they cover out-of-network services. Many times they will! We have had several patients receive full reimbursement for their services after they submitted their superbills. This also applies to those who have insurance coverage through health share plans, such as Christian Healthshare Ministries. Many health share plans have GREAT benefits and have fully reimbursed our clients for services.

Our parting advice to consumers is to always assess your benefits of care under different clinics. We comparison shop most things in life, so why not shop your clinical & performance care too! You might just surprise yourself with what you learn.