7 Tips to Better Understanding your Health Insurance

What is your Health Insurance trying to tell you?

Copays, deductibles, co-insurances, and monthly premiums. How does one comprehend what they are actually going to spend when they come in for a physical therapy visit? While the answer may not be as cut and dry as you would prefer, it is still obtainable. Here are some questions you can ask your insurance company:

    1. Is there a visit limit on your coverage? Some companies will put a visit limit on physical therapy visits based on the calendar year. Some insurances will only cover services for “consecutive days”. For example, if your insurance provider says they will cover a case for your knee for 60 consecutive days, and you began therapy on the first of March, your coverage would expire on April 30th.
    2. Is the insurance coverage based on a benefit year or calendar year? Knowing the answer to this question will ensure that you know when your coverage is terminated or when your deductible will reset.
    3. The big one. How much is your copay? While this seems obvious, it is always good to double-check. Some companies tailor their policies to have their copay change in the middle of a patient’s care. For example, some plans will charge a $10 copay for visits 1-20, but visits 20-40 will be $20.
    4. Does your insurance policy carry an Out of Pocket Maximum? Your insurance may carry a $2,000 deductible and a $40 dollar copay. But your Out of Pocket Maximum may only be $4,000. This means if your total out of pocket expense hits that $4,000 mark, your services are covered at 100% for the remainder of your benefit year.
    5. Always check with your employer’s benefit coordinator about possible upcoming changes to your health plan.
    6. By law, when services are rendered through your health insurance, the company will supply you with an EOB (Explanation of Benefits) that will explain that the medical professional charged, what the insurance is going to cover, and what you will ultimately be responsible for.
    7. Ask questions! If you do not understand something about your plan, statement, or explanation of benefits do not hesitate to ask!

At Strive, your plan will always be verified prior to your first visit. Our billing specialists will reach out to your insurance company to confirm that your coverage is active, furthermore to see what your out of pocket responsibility looks like.

For more information, click here: https://www.strivephysicaltherapy.com/patcenter/

Drew Kelly, Inbound Marketing Strategist

Drew Kelly

CTE and Physical Therapy

Most people are familiar with concussions. After a head impact or whiplash-like injury, experiencing any of the below symptoms for any period of time indicates that a concussion has occurred.

Symptoms from Concussions

  • Blurred/Double Vision
  • Sensitivity to Light/Noise
  • Headache
  • Dizziness/Balance Problems
  • Nausea
  • Fatigue
  • Depression
  • Memory Deficits

CTE (chronic traumatic encephalopathy) is a progressive degenerative disease that is thought to originate from repetitive trauma to the brain. This trauma may or may not have resulted in symptoms of a concussion. Physical Therapy, an effective rehabilitative treatment for concussions, has gained significant attention in CTE research and prevention. Your skilled Physical Therapist aims to prevent CTE degenerative changes by ensuring previous head injuries are fully healed prior to returning to sports/contact activities. The rehabilitative process includes visual, vestibular and exertional rehabilitation after head injuries.

Symptoms from CTE

  • Memory Loss
  • Confusion
  • Impaired Judgment
  • Impulse Control problems
  • Aggression
  • Depression
  • Anxiety
  • Suicidality
  • Parkinsonism
  • Dimension

The most recent research indicates that work activity (e.g., military personnel) and athletes (e.g. hockey, boxers, football, soccer, lacrosse) that are subject to repetitive head trauma may be more likely to present with CTE (although genetics may play a substantial role in the likelihood of presentation). CTE symptoms may not occur for years after the last recorded head injury. Diagnosis of CTE currently occurs postmortem with the identification of a substantial increase in the protein Tau in the brain matter.

Strive Physical Therapy and Sports Rehabilitation is the market leader for all skilled care after concussion. Our Strive Physical Therapists maintain constant and direct communication with your Physician ensuring that our patients are fully recovered after their injury. Highly trained and experienced Physical Therapists enable safer return to play after concussion and decreased likelihood of more degenerative conditions like CTE.

John Walker

Clinical Director

John received his Doctorate in Physical Therapy in 2003 from Widener University and is currently a licensed Physical Therapist in New Jersey and Pennsylvania. John brings 11 years of spine, orthopedics, and sports medicine clinical experience to the Strive team which he joined in 2014. John is a Certified Mckenzie MDT (Mechanical Diagnosis and Therapy) Practitioner and has two noted publications including chapters on thoracic spine dysfunction and post-operative proximal femur fractures. During his time at Widener University, John was awarded Academic All-America District II for lacrosse and was 2-year assistant men’s lacrosse coach. John has his MBA from Temple University’s Fox School of Business with an emphasis on healthcare/ health system efficiency. Originally from Northeast Philadelphia, John lives with his wife in the Cinnaminson area of New Jersey.

Contact John Walker, DPT, MBS, CERT. MDT, CSSBB

Direct Access

Direct Access is getting you the care you deserve, faster.

In a new generation of healthcare that includes instant gratification through mediums such as urgent cares, comes the most overlooked, and useful, healthcare act that is signed into law in many US states, including New Jersey. It is called Direct Access, and it is making patients' lives a whole lot more manageable quicker.

Direct Access in Physical Therapy removes the need for physician prescriptions and allows the patient to go directly to a physical therapy provider for an evaluation. While a physical therapist sometimes obtains the same reputation as someone who administers medieval torture, they also are credited with being healers that can alleviate pain in a timely and natural fashion. For instance, a patient who is suffering from Vertigo or BPPV can usually expect prominent side effects such as dizziness to subside after just a few sessions. Attending a physical therapy evaluation can decrease acute back pain, ankle, as well as many other types of pain as well.

Direct Access is a testimony to how much education and schooling that physical therapists actually need to go through. For example, if there is a more substantial issue that is discovered during a physical therapy evaluation, that patient is referred out to a specialist by the therapist.

Moving forward, if you tweak your back while golfing, roll your ankle while running, or anything within the realm of physical therapy, just stop into any of our offices to stop your discomfort.  Or you can contact us here!

For more information on Direct Access and its benefits, visit WebPT!

Drew Kelly, Inbound Marketing Strategist

Drew Kelly

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