#Physicaltherapy Dilemma: How do you approach patients with Different Insurances?

Several years ago on EIM blog, I posed this very similar question to a host of PTs, mostly private practices of various types. Hoping to generate some thoughts around this and will send a summary in the next post.

There are lots of interesting PT discussions around the concept of treating patients according to their health insurance. The opinions have been wide and varied. I am checking in to see if our responses are the same as they were 14 years ago to this same question!

3 patients are seen back to back by the same therapist for rotator cuff tendinitis in a private practice. One patient is 65 years old and has medicare. The second is the same patient but has medicare advantage. The third patient is 50 years old and has private insurance which pays roughly $95 per visit for up to 30 visits. The fourth patient is 45 years old and has a high deductible insurance and a $35 copay, and your company contracts with his insurance company for a max of $50 per visit.

For the sake of discussion, there are no comorbidities or underlying factors-each patient has essentially the same diagnosis and all require physical therapy interventions.

Questions:

1. If you are the PT, are you concerned at all with their health insurance coverage and benefits? Would you treat them differently based on those differences with respect to time in clinic, # visits, interventions?

2. Same ques as #1 but you are the owner of the clinic?

3. Would or should a brand newly licensed PT treat the patients differently?

4. Does it make a difference if the PT is an orthopedic-certified specialist?

5. Does the scenario change if the patient is not at a private practice clinic but a hospital outpatient clinic or center where there might be higher reimbursement (non medicare scenario)?

Please take a stab at this? I will provide my thoughts but thought I would throw this out to our large subscriber base first.

larry

@larry

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