New clinic in Bishop puts a ‘Shift’ in physical therapy
Business offers different approaches for service, billing
A co-owner of a new physical therapy clinic in Bishop says her facility not only brings a new clinical model to the area but a “shift” to the physical therapy paradigm.
In a release, Tori Orlowski, doctor of physical therapy and co-owner of Shift PT & Performance, stated that when a doctor pulls out the prescription pad, or rather hits a button in a patient’s electronic chart, it may be helpful to understand that unlike the uniform pills in an orange prescription bottle, not all physical therapists are the same.
Many patients are told to “get some PT,” Orlowski stated, “when the reality is their care will be an individualized process, which involves working with a specific practitioner. The efficacy of PT is largely determined by the relationship between patient and provider, and the field of physical therapy is made up of a variety of practitioners with an array of specialties.”
She stated that while the current medical system may be difficult to navigate as a patient, it’s important to understand that finding the right physical therapist for a patient’s needs may greatly impact the success of the outcomes.
“It is important to understand that you have a choice in finding a practitioner who understands your goals, involves you in your care plan and who you feel comfortable working with,” she stated. “Unlike other medical practitioners, you will likely spend hours with your physical therapist throughout the course of treatment.”
Physical therapy and success
Orlowski noted that not all “physical therapy’’ is the same and, because physiological adaptation takes time, it can be difficult to ascertain whether or not treatment is working. It may be helpful to understand the field of physical therapy to have a better understanding of what a provider can offer.
First, she stated, there are a variety of settings and specializations within the field of physical therapy. Settings can vary from home health care to inpatient to acute care to out-patient clinics. Outpatient clinical settings are what come to mind for most people when they think of physical therapy. Within each setting, there are a variety of clinical models ranging from hospitals to non-profit organizations to private practice.
There are national and state boards regulating the practice of physical therapy, and many consumers are unaware that since 2015 the entry level degree for the field is a doctorate of physical therapy, or DPT. Physical therapists are trained movement specialists with a comprehensive understanding of the complexities and interrelationships of multiple body systems, including the musculoskeletal system, the cardiopulmonary system, the vestibular system and the nervous system.
Due to the nature of time required for the human body to adapt, heal and respond to treatment, it is important to find a therapist who is able to spend the time understanding your history, goals, barriers and can help you modify your care plan appropriately throughout treatment.
Deciding whether or not treatment was successful may take time, or in some cases, may not have a definitive finish line. However, your physical therapist should be able to provide insight into your impaired function and how to best pattern your life for long term resolution, or management.
Orlowski stated it may be helpful to view a physical therapist as part of
one’s health care “team”, who gets to know you and your body across your lifetime.
Finding the time
Orlowski stated that, like many health care providers, physical therapists have been subject to the constraints of a third-party payer system, which seems increasingly focused on reacting to illness rather than promoting health.
This has spurred the development of a new model of physical therapy practice, commonly referred to as “cashbased practice.”
A aash-based practice, she stated, means that providers are opting out of contracting with insurance companies. This model allows the practitioner to provide services, and the patient to seek services, without restriction from the third-party payer.
“Patients can reach their goals without interference from their insurance company,” she stated.
‘Surprise’ medical bills
Orlowski stated variability in insurance reimbursement is a source of frustration for front-office staff, clinic owners, practitioners and patients alike.
Often private PT practices have to negotiate the rate of reimbursement with insurance companies and different companies may pay different rates for the same services, she stated.
Inconsistency in reimbursement rates can negatively impact patients and hurt the viability of small practices that are dependent on timely, fair payment.
The cash-based model ensures practitioners are paid for services and that patients can seek medical care on their own timeline without having delays due to authorization or being given a limited number of visits.
Additional patient benefits of the cashbased model are cost transparency and potential reimbursement from your insurance,
Orlowski stated. Patients who see a cash-based physical therapist will know what they are paying up front and can come up with a plan for care that works for them financially without any surprise bills or delays in continuity of care.
This model of clinical practice allows for longer, more comprehensive evaluations and follow up visits, increased treatment accessibility and fewer visits overall.
“At Shift Physical Therapy, we’ve had patients note that with co-pay/co-insurance costs and a higher frequency of visits at traditional clinics, paying for treatment out of pocket is comparable, or less expensive,” Orlowski stated.
Insurance as a barrier
She stated that while it does require an additional step to submit your own “superbill” receipt (the invoice provided for PT services), it also allows patients the freedom to manage the total cost of care, up front.
“At Shift, many of our clients find they prefer the transparency of the cash-based system as there are no unexpected bills,” she stated. “Insurance reimbursement is then a welcome bonus. Many find benefit in knowing the cost of each visit, having control in scheduling follow up visits, and needing fewer overall visits due to longer individual evaluation and treatment sessions.”
She stated that although each insurance company is different, this model has been in practice for some time and a web search or a phone call with your company will provide instructions on how to send in “superbills.”
Orlowski stated Shift PT & Performance is enrolled with Medicare, which means that payment is taken at the time of service from the patient, but then “we, as the provider, submit the invoice to medicare. Then, as with other insurance companies, it is at the discretion of the provider to reimburse the patient.
Health care team
Orlowski stated that a physical therapist can be a part of one’s health care team.
“At Shift Physical Therapy and Performance our goal is to be part of your health and wellness, for life,” she stated. “We want to be there to help you not only reach your rehab goals, but also to prepare for backpacking season, run your first ultramarathon, learn how to manage osteoporosis through strength training, treat your vertigo, help you send your climbing project, return to high level sport after surgery or to simply go up or down stairs with confidence.
“We called ourselves ‘Shift’ because big change takes time, through consistent small changes.”
For more information, book a free 15-minute consultation at www. shiftphysio.com or call (760) 914-4401.
Shift PT and Performance is located at 308 W. Line St., Ste. B.