Most people pay for medical so they won’t have to pay as much when they need health care. However, some services cost patients almost as much with insurance as without. Physical, occupational, and speech therapy are often classified the same by insurance companies as treatment received by a specialist like a cardiologist or oncologist. Because of this, the co-pay is higher for these visits, which are usually more frequent than those required by others in this category. For instance, a stroke victim may need to see a speech therapist and an occupational therapist twice a week. If their co-pay is $32, the average according to The Kaiser Family Foundation, the weekly fee can quickly become out of reach for many patients.
Stop Accepting Insurance
Many offices no longer accept insurance because of the various hassles associated with doing so. Instead, they offer to bill the insurance company after payment is received in order to help clients receive reimbursements. Why should you stay away from being an in-network provider? Because you won’t be held to their requirements or limitations. This allows therapists to focus on what is best for the patient rather than what is best for the insurance company’s bottom line. The one caveat is that many patients are afraid to visit providers who are not in their insurance network. It may take time to build up a client base and to earn consistent referrals from physicians and medical facilities.
Promote Legislation for Limitations
According to Kaiser, several states are considering legislation that would limit the percent of cost that could be paid by deductible. Often, specialist deductible will be 80-95% of the therapy cost. By reducing the cost of the deductible, more patients would be able to afford the care they need. It would not negatively impact the cost of visits to other specialists, because their base cost is so much higher to begin with. Unfortunately, insurance lobbyists are against these types of measures because it would increase the amount of money they would have to pay for the services, and some claim it would cause insurance premiums to increase for employers and employees. Another option is to encourage legislation that would reduce the amount of co-payments to no more than those established for primary care providers. If you have seen patients limit treatments due to high insurance costs, consider supporting state and national legislation to change the way physical, occupational, and speech therapy services are billed.
How have you helped patients navigate the insurance maze? Have you found it is more difficult to give patients the care they need with certain insurance companies? Are you actively trying to change legislation to help promote the needs of your patients or do you think current legislation endeavors are the wrong way to remedy the situation?