Why Cash-Based Physical Therapy?

Using a cash-based physical therapy model allows the therapist more freedom of treatment within their professional capacity. By not directly billing insurance companies, there is less administrative burden. There also can be less financial burden on the patient. Due to the current climate of many insurance plans, patients are required to pay high deductibles before their insurance benefits kick in to cover medical costs. With many insurance-billing practices and institutions, the price for physical therapy services is high in order to accommodate for their own rate of reimbursement and to cover higher overhead costs. Choosing a cash-based clinic usually results in significantly lower charges per treatment. Although payment is required at the time services are rendered, the patient can be provided with a “super bill” that includes information that can be submitted by the patient to their own insurance provider for reimbursement based on the individual’s plan. That often looks like a percentage reimbursed or the total going towards their deductible (or a specific “out-of network” deductible). To better understand how your insurance will handle these submissions, it is recommended to directly contact your insurer prior to starting therapy to find out the specifics of your plan.

* At this time, Maine Coast Movement cannot treat patients who are enrolled in Medicare due to federal rules on treating and billing these individuals. Patients who have Medicare replacement plans may be treated, but the plan may not reimburse for out of network providers. 

Direct Access:

At Maine Coast Movement, physician’s referrals are gladly accepted, but patients can also be seen without a referral. This can allow your to save time and money! In Maine, you have direct access to physical therapy services. Therapists are trained to screen patients for appropriateness of physical therapy treatment. This means, for example, that if you sprain your ankle playing basketball, you can be seen directly by physical therapy without having to be seen by your doctor first. Or if you are having a flare up of a chronic musculoskeletal issue, you can skip the doctor’s visit just to get sent to physical therapy again. If there are concerning issues that the therapist identifies, she can recommended you be seen by your primary care provider or other specialist. 

• Please check your specific insurance plan if you intend on submitting bills for reimbursement to  see if they require a physician’s referral for reimbursement, as some do.