North County Water & Sports Therapy Center April 2019


(858) 675-1133 |

15373 Innovation Dr. #175 | San Diego, CA 92128 | 858-675-1133 12171 World Trade Dr. | San Diego, CA 92128

MEET OUR KILLER B’S HOW BETTINA AND BRITANI MAKE OUR PRACTICE BETTER Here’s something you may not expect to hear from a lifelong clinician: The front office staff of a practice is just as important as the medical team. Sure, quality therapists and assistants are essential for a well- functioning practice. However, the clinical credentials of your team aren’t going to matter much if your administrative operations are lackluster. Delivering the best patient experience requires having the best administrative team. It’s a simple enough premise, but it’s hard to achieve. That’s why we’re so lucky to have Bettina and Britani on staff here at North County Water & Sports Therapy Center. In honor of Administrative Professionals’ Day, which is April 24, I want to take a moment to pay tribute to them in this month’s newsletter. The first thing to know about Bettina and Britani is that they are one heck of a team. In fact, they work so seamlessly together that many of our patients don’t realize they are two different people — though the alliterative names and similarly long, beautiful black hair don’t help in that regard. Regardless of which one you talk to, you can expect a friendly face, expert service, and a careful attention to your needs. Patient interaction may be the most visible part of their jobs, but it’s far from the only thing on their plates. Bettina and Britani do so much that is often overlooked. When they’re on the phone with a patient, they’re pulling up insurance information, coordinating schedules, and probably saying hello to a patient in the office. Basically, they do an insane amount of multitasking so that our therapy staff doesn’t have to. We spend an hour working directly with each of our patients. That’s rare to find these days, and it would be absolutely impossible without our pair of Killer B’s. Another of Bettina and Britani’s remarkable qualities is that they are just as adept at handling our staff as they are at managing patient intake and experience. Whenever I’m in a bad mood or feeling overwhelmed, I can expect a note of encouragement on my desk from Bettina to get me through the day. These touches may not seem like much, but they make a

huge difference. It’s awesome to know that the care and consideration they extend to our team is also offered to each of our patients. Bettina and Britani both believe that everyone should be smiling when they leave the office, and they do everything humanly possible to give patients a reason to smile. When I first opened a practice of my own, it was me, myself, and I for a while. I quickly learned that quality administrative support is crucial for a successful practice. In Betina and Britani, we have a lot more than quality. We have a dream team who strives to create an office that’s a joy to visit. I don’t know where we’d be without them, and I’m forever grateful for their contributions to our team.

Bettina and Britani, you ladies rock. Thank you so much for everything.

–Beth Scalone

1 858-675-1133


Scamming older adults has become big business. According to the American Journal for Public Health, an estimated 5 percent of seniors

If you ever receive a contract from an unknown entity out of nowhere, you should start seeing red flags. Unless you remember entering a contest, there is no chance you’ve won something. And it’s vital to understand that it is never safe to give out financial information over the phone or via email. COMPUTER SOFTWARE SERVICE FRAUD This type of scam is slightly more sophisticated. First, a hacker will call a victim and claim to be a member of a tech support team or an employee from a trusted company like Microsoft or Apple. Then, they’ll tell the victim there is a problem with their phone or computer and that if they cooperate with the “tech support” representative, they can sort it out. They may also ask you to install a piece of software on your device or provide credit card information to “validate your software.” The fact is that well-known tech companies will never send unsolicited emails to ask for your personal or financial information, and they definitely won’t ask you to install some shady software on your computer. If you ever receive a call out of the blue from “Microsoft,” hang up the phone immediately. The first step to stopping these criminals in their tracks is to be aware of their tactics. With these tips in your arsenal, you’ll be able to defend yourself and your bank account effectively.

are hoodwinked by criminals every year, and that statistic is thought to be a steep underestimate since so many scams go unreported. To stem the tide of seniors unknowingly giving $36 billion to scammers annually, it’s important for retirees and their loved ones to get savvy on the subject.

Here are the two of the most common scams older folks fall prey to — and how to avoid them.

ADVANCED FEE FRAUD The most common con in 2017 and 2018 was the classic “You’ve won a sweepstakes!” scam. Victims are told they’ve won some exorbitant amount of money, but they must pay a fee to receive the prize. After the “fee” is paid, victims receive a fake check in the mail, but by the time it bounces, the scammers are gone and they’ve taken the money.



There is no greater compliment we can receive than one that comes from a patient. Every aspect of our practice prioritizes patient care above all, so plaudits from the people we serve mean the world to us. Jan O’Hara, one of our recent patients, was kind enough to relay her experiences working with Dr. Tori Williams. Here, in her own words, is Jan’s story. Tori Williams has been extremely kind and helpful. I have never experienced the advice of a Doctor of Physical Therapy and truly appreciate her input. I have been injuring myself every day doing the flying-pigeon yoga move and Tori told me to stop practicing that pose. She also gave me several exercises to improve the strength of my muscles and tendons surrounding my injured left hip. I have been diligently doing my homework and have noticed a vast improvement in my hip. Tori listed my activities and realized that I do “too much” physically, so I’ve toned it down a bit. She taught me how to lift heavy objects (such as the buckets of water I have to carry each week), walk up and down the stairs correctly, and how to place my weight over my feet while exercising and walking.

I am very appreciative of all of the incredible assistance that she has given to me. I highly recommend Tori as a Doctor of Physical Therapy.

Sincerely, Jan O’Hara

Dr. Tori Williams may be the newest member of our practice, but she’s already making a significant impact on the lives of our patients. Great job, Tori! And thank you, Jan, for your kind words. 2


DOS (Date of Service) This is the date you received treatment. EOB (Explanation of Benefits) The EOB is the information an insurance company provides after a patient has received a medical procedure or service. It provides the details about how much was charged for a procedure, how much the insurance company is approved to pay, the amount already paid, and what the patient owes (often listed as patient responsibility). HMO (Health Maintenance Organization) A type of insurance plan that pays for medical services offered by a specific group of providers. Often the patient must be seen by the specific group of providers and have authorization for treatment, or the insurance will not cover the expense. It is always a good idea to ask if your provider is in network with the insurance company. POS Plan (Point of Service Plan) and PPO (Preferred Provider Organization) A flexible insurance plan that allows patients to choose their health care provider without the need for an initial referral (authorization) from their primary care doctor. Often with these plans, covered benefits are different depending on whether or not the provider is in network, so again, Most people with health insurance do not know much about their policy until they need treatment. When you do read a policy or receive a bill, terms can be confusing. No two insurance companies are the same. In fact, most insurance companies have several different polices, each with their own rules and covered benefits. The best way to plan is to understand. Our front office has put together some definitions to help you navigate the frequently used terms.

you should always confirm with the provider if they are in network with your insurance company.

Allowed Amount The amount the insurance company allows the provider to be paid for services billed. This is often based on the contracted rate for private insurance or government regulated such as Medicare. Patient Share of Cost There is often some patient responsibility in sharing the cost of medical visits. It most often comes in the form of deductibles, coinsurance, or a copay (see below). If you have a secondary insurance policy, it may cover those expenses. Be sure to provide your health care provider with both primary and secondary insurance information. Deductible A specified amount of patient responsibility. The patient must pay this amount for covered charges before the insurance company begins to pay for the charges. At the start of your policy year (most often Jan. 1, but not always, so you need to check), the patient will have to pay out-of-pocket for all charges until deductible is met. There are a few exceptions to this. For example, many annual wellness exams are covered without the patient having to pay.

Coinsurance A type of patient financial responsibility in the amount of a percentage of allowed charges. For example, an 80/20 plan indicates the insurance will pay 80 percent of the allowed amount (once the deductible has been reached), and the patient is responsible for 20 percent of the allowed amount up until the out-of-pocket maximum has been met. Out-of-Pocket Maximum The maximum amount of money the patient has to pay themselves. There are yearly and lifetime out- of-pocket maximum amounts, depending on the patient’s medical insurance policy. Once the out- of-pocket maximum has been met, the insurance company pays at 100 percent (unless a maximum limit of the policy has been reached). Copay A specified amount of money the patient must pay at each visit. Copay amounts vary depending on the type of provider the patient is seeing. Policy Holder The person that holds the insurance contract or policy. For example, most children under the age of 18 have insurance under a parent or legal guardian as the policy holder. Primary Insurance Main insurance plan supplied by an employer or government. Secondary Insurance Supplemental plan that helps cover the costs not covered by the primary plan.

In-Network Provider Providers or health care facilities that are part of a health plan’s network of providers. Out-Network Provider Providers or health care facilities that are not part of a health plan’s network of providers. This often means the patient will have a larger share of cost. Direct Access The patient can seek safe, quality physical therapy services without the delay of first having to go to their physician for a referral. Under direct access in California, the consumer is allowed 12 visits to a physical therapist to be completed within a 45-day period, after which they need to see a physician should additional treatment be needed. Be advised that not all insurance companies will cover direct access and a prescription from your physician may still be required to cover the cost. We will call your insurance company for you to find out if a prescription is required and notify you prior to your appointment. Referral A written order from the patient’s primary care physician that will need to be obtained before receiving any medical services except by the primary care doctor. Referrals usually apply to HMO insurances. Note that the terms referral , script , and prescription are often used interchangeably and add to the confusion. Prescription A written order from the patient’s physician that must include the diagnosis, frequency and duration, goals of therapy, and safety precautions.

Do you need physical therapy? Not sure about your insurance coverage for physical therapy services? Call our front office at 858-675-1133 and we will be happy to help.

When you call, please have the following information ready to provide our front office:

• Name and date of birth of the person to be the patient • Name and date of birth of the policy holder • Insurance company name and phone number (provider/customer service number) • Insurance policy/member ID number and group number when applicable • Doctor name and phone number (if being sent by your physician)

Today, a startling number of Americans suffer from opioid addiction. According to a report published in the Annual Review of Pharmacology and Toxicology, more than 4 percent of U.S. adults misused prescription opioids in 2018. Prescription drugs can lead to enough tragic overdoses on their own, but as the physical aspects of addiction set in and prescriptions dry out, addicts desperately turn to more serious drugs like heroin and Fentanyl. Opioid addiction is indiscriminate; it can strike anyone of any social class, race, gender, or economic standing. This is one reason the overprescription of opioids over the last two decades, coupled with a more recent flood of street opioids, led to more than 70,000 deaths in 2017. In an effort to stem the tide of opioid-related deaths, the CDC issued a set of new recommendations to doctors in 2016. They questioned the effectiveness of opioids for the management of chronic pain and encouraged physicians to instead focus on physical therapy, cognitive behavioral therapy, and other nonopioid pharmacologic options for long-term intervention. Studies show that physical therapy may have the potential to dramatically reduce opioid reliance, abuse, and overdose. In one 2017 study published in the WHY EXERCISE THERAPY SHOULD BE THE FIRST STEP IN RECOVERY

Journal of the American Board of Family Medicine, researchers discovered that, in cases where doctors referred patients suffering from low back pain to a PT as a first-line treatment, the odds that the patient ended up needing an opioid prescription decreased significantly. Other studies have also reinforced the same trend for treatment post-surgery: When physical therapy is the first recommendation, patients tend to use fewer opioids and actually spend less on treatment in the long run. The evidence seems clear: If patients follow the recommendations of the CDC and consider physical therapy before taking pills, they substantially lower their risk of dependence on and abuse of prescription drugs. Of course, you should always follow the advice of your doctor, but consider requesting a referral to PT first — it’s just a safer, more consistent, and less expensive option. And who knows? It might just save your life!



Radishes start showing up in droves during the spring and summer months, but all too often we only eat the bulbs raw on salads and

discard the greens. This recipes bucks both of those trends, with the radishes being roasted alongside their green tops.



1. Heat oven to 500 F. While heating, trim radishes and wash greens. Pat both dry using a paper towel. 2. In a large ovenproof skillet, heat oil over high heat until shimmering. Season radishes with salt and pepper, add to skillet, and cook until lightly browned, about 2 minutes. Transfer entire skillet to oven rack and roast for 15 minutes. 3. Once removed from oven, return skillet to stove. Over medium heat, stir in butter and add greens. Cook until they are wilted, about 2 minutes. 4. Finish with lemon juice and additional salt if desired. Serve immediately.

3 bunches radishes with greens attached 2 tablespoons extra- virgin olive oil Salt and pepper, to taste 2 tablespoons unsalted butter 2 tablespoons fresh lemon juice

3 858-675-1133

Inspired by Food & Wine magazine


Monday—Friday 7 a.m. to 7 p.m. 858-675-1133

15373 Innovation Dr. #175 San Diego, CA 92128



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Patient Success Story: Jan O’Hara


PT Helps Curb Opioid Abuse

Roasted Radishes With Radish Greens


Are the Padres Turning a Corner?



Petco Park is one of the best places in the country to watch a baseball game. The facilities are great, the atmosphere’s welcoming, and you already know the weather is exceptional. The problem is, the team playing at Petco Park hasn’t been competitive for quite a while. The Padres haven’t had a winning season since 2010, and it’s been even longer since they’ve been in the playoffs. However, for the first time in a while, the future looks very bright indeed, thanks to some savvy player development and blockbuster offseason acquisition. The first part of this equation is the result of the hard work of general manager A.J. Preller. When he took over the role in 2014, he opted for long- term stability over a quick fix. The team sought to lay the groundwork for a sustainable rebuild through trading and developing prospects. A list from Bleacher Report ranked the Padres as having the best farm system in baseball, with more than 10 top 100 prospects heading into the 2019 season. Many of those names, including shortstop

Fernando Tatis Jr. and pitcher MacKenzie Gore, are expected to be some of the stars of tomorrow.

To complement these prospects, the Padres went out and landed a star of today. A superstar, in fact. When this offseason began, there were two marquee free agents who were the talk of the town: Manny Machado and Bryce Harper. While Harper ended up with the Phillies, a likely destination, nobody expected the Padres to ink Machado to a long-term contract. (Editor’s note: This is not an April Fools’ joke. We really did sign one of the best players in baseball.) While it took plenty of financial resources to secure Machado’s signature, the Padres now have a perennial All Star among their ranks. That will go a long way toward assuring fans that the promising future of the team will arrive sooner rather than later. Most analysts don’t believe the Padres will become a contender just yet. The 2019 season should be the start of an upturn for the team

and a sign of big things to come. If those plans come to fruition, expect Petco Park to be brimming with optimism all summer long. 4

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