SHOPPING, INSURANCE & PHYSICAL THERAPY
Christmas has come and gonewith all the shopping for the most part over. Not sure about you but I absolutely hate shopping. Yes, I am a guy and know what I want, where it is and what it costs. I go and get it or better yet, buy it online. I remember when online shopping first started and me saying I would never use my credit card over the internet. Somuch for declarations. I would go out on a limb and state I buy over 60% of my items online. You can shop for anything online from cars to houses, clothes, insurance and heck now folks “shop” for significant others on several online sites. They are matched up from info that has been entered in regarding likes and dislikes, hobbies, sports, aswell as future desires. I personally know several coupleswho have gotten together from these sites and although the jury is still out, they seemalmostmade for each other. Who would have ever thought this was going to be common place? This brings up a subject that can be purchased from shopping either in person or over the internet. It can be very controversial or satisfying depending on which side of the fence you are standing. There has been a lot of information given regarding health insurance. Heck, we are now required to have health insurance and even punished if you have no coverage at all. This has caused a great deal of folks to purchase health care insurance based on the information they have been given or told or thought to have been told. The point is they have purchased some form of insurance. I want to review some of those purchases to satisfy the federal government’swishes to have health care coverage. I hear it all the time from folks who have purchased Health Keepers as theywere told they could choose their provider. Well that is certainly true however your provider may not accept that insurance. Why not you ask? There is a very simple answer. You see there is a basic cost to every service. HealthKeepers does not reimburse our officewhat it costs to provide the service for the folkswho come in for our services. It does not take a mathematician to figure out if you treat folks for a cost of service and the service provided cost more thanwhat you get reimbursed, youwill not be around very long to provide those services. There are others that do not come up to par however there are some that cover our costs and more. No different than anything else in our society. Any business has to make enough profit to cover their overhead and project into the future for expected cost and reserves. If you do not, you will not survive. I hear it all the time when it comes to healthcare. Folks feel we the provider need to
accept whatever an insurancewill reimburse. It is not quite that simple. You see, for us to provide the level of care we do, we must provide a place of learning for the providers that work with us. Without their continued education, we would not be able to provide the up to date services and you would not like to pay for something that is outdated or not as good as it could be. The problem is, a lot of consumers do not understand the differences in physical therapy. They look at different offices and believe they are comparing apples to appleswhen in fact, nothing could be further from the truth.
by different professionals. That is certainly not in your best interest. Unfortunately both offices will usually be reimbursed close to the same amount for your business. Next year (2021)Medicare has informed us (PT’s) that they will be reimbursing us 8% less (yes, I said less). Nowbefore you start asking questions, the cost for PTcompared to the cost paid for other services such asmedication, tests, and surgery shrivels in comparison. Much has beenwritten and contested but alas, Medicare in their infinite wisdom has decided they know best. Not sure about you but I do not believe our costs are going down. We have to pay just like anyone elsewhen it comes to set costs for space, utilities, employees, and even our own health care. Do you see any of this going down? Nope, neither do I. It is certainly going to be interesting to say the least for the coming years on how the government expects their constituents to be covered by Medicare. You will see providers bowing out of their participation as soon their expense of providing services will not be covered by the amount reimbursed for the same. Unfortunately the field is not level as those dictating the coverage are not held to the same standard as the very ones who pay for the service. Those representing us are in a completely different place as they do not have the same coverage. I really do not see anything changing with this until we are all deemed equal in the government’s eyes. Don’t hold your breath. Until that time, rest assured we will continue to be the practice that continues to push the limit to learn and grow and provide you with the best care we can. Although you may have to pay a littlemore for quality, in the long run you will usually appreciate better results with less visits and therefore less out of pocket expenses. This is one time I will encourage you to shop around and really understand your coverage and what you get for that coverage. You will be glad you did.
When purchasing insurance, you usually get exactly what you are paying for. The same holds true when it comes to covering cost of service. Back to Health Keepers, the premium paid is much less than when a person would buy one of the old standbys such as Anthem or Mutual of Omaha. A person should read the fine print in regards to their coverage before signing the dotted line. To expect equal coverage is akin towanting aCadillac ride frombuying a Ford Focus. “It just ain’t gonna happen”. Just because a professional may have been practicing for 15 years does not mean they have 15 years of experience. Maybe they have one year of experience 15 times. Again the problems arisewhen you have an office that works very hard to stay up to date and provide the best of care while another officegets bywithas little cost for human resources as they can. Both provide physical therapy services but on a very different spectrum. Youwill get very different results fromboth offices.The costs of providing those serviceswill also vary as one continues to invest in their professional development and the other choses to practice a different way. It is certainly acceptable from a legal and regulatory standpoint. I hear it all the time, so what’s the difference? If you do not know you will soon be finding out. One office spendsmore timewith the consumer both froma personal and educational point of view.They alsoprovide a great deal of experience gained fromworking in an environment that supports best practices and care. The other will perform services with less expertise and personnel, evaluating your situation less, and sometimes even having you seen
Pinehurst Artist: Beth E. Roy Beth E. Roy, artist for Pinehurst. Displayed through February 5th. Visit her website at www.betheroy.com.
ARTWORK AT THE OFFICE
Harrisonburg Artist: Trudee Smith Trudee Smith, artist for Harrisonburg. Displayed through February 5th. The paintings of Trudee Smith can also be viewed on her Trudee G Smith Facebook page.
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