I will try to keep the answer to this question as short as possible, but it’s one I feel very passionate about. I don’t directly bill health insurance or Medicare because I didn’t become a Physical Therapist to run from one patient to the next every 15 to 20 minutes and spend hours each day on paperwork. I didn’t become a private practice owner so I could become an expert at figuring out what treatment codes and billing techniques will keep my business from going bankrupt. I became a Physical Therapist to help people to the absolute best of my abilities, and I became a private practice owner to do so on my terms … not the terms of an insurance company or the federal government.
Unfortunately, the health insurance and Medicare systems have distorted the way health care practitioners can provide care and still remain profitable. In the case of Physical Therapy, most practitioners have to see multiple patients per hour and utilize modalities and technicians/assistants in the provision of care in order to remain profitable. In almost all cases that I’ve seen, this unfortunately diminishes the quality of care provided.
This scenario will only get worse as our population ages and our nation’s budget problems become even larger over time. Reimbursement for Physical Therapy services is bound to get lower and lower, and those PT practices who directly bill insurance and Medicare will have to see more and more patients each hour to stay in business. It’s a downward spiral, and I refuse to be a part of it.
It is so rewarding to go to my clinic every day knowing that I will spend a full hour with every patient and have the time to get significant results in each session. I can still provide the paperwork for my patients to send self-claims to their health insurance, many of whom do; but because I have taken myself out of the system in this way, I am able to provide the highest quality care and get my patients better much faster than average. It’s wonderful.