Health insurance can be confusing.
We’ve answered the questions we get the most below, but we recognize that as unique individuals, circumstances differ. We are happy to work with each of our patient’s particular needs and reach a bespoke agreement to give you the care you deserve.
Q: Do I need a prescription for physical therapy?
A: No! NY state has “direct access,” which means you can come to Bespoke Treatments PT for a diagnosis of any musculoskeletal injury without seeing a medical doctor first.* (Amazing!) If you need care beyond 10 visits (or 30 days, whichever comes first), then you will need a prescription. But we’ll help you find the best plan of action if this should occur.
Q: Do you take health insurance?
A: Yes. We accept any major plan with out-of-network benefits. (Oxford, Aetna, BCBS, United, Cigna) But we are not in-network with any plans. Before you make any brash decisions, we’ll explain everything in a moment!
Q: What’s my co-pay going to be? How much is the bespoke treatment going to set me back?
A: Remember that we know you are unique as an individual; we also know that your health plan is too. Before your first session at Bespoke Treatments PT we will use your details to investigate exactly what your individual plan offers. We will then estimate your payment responsibility* before your first session to ensure total transparency and to protect us all from unexpected costs. *Your insurance company usually refers to this kind of payment as “co-insurance” — your share of the costs of a covered out-of-network service, generally given as a percentage of the amount paid to the provider. For example, they might cover 70% and you’ll have to pay the remaining 30%. But keep in mind, your payment is also affected by whether you’ve met your annual deductible. Which leads us to…
Q: Why is bespoke treatments pt an out-of-network provider? It’ll be cheaper for me to see someone in my network.
A: That’s a fantastic question that we are very proud to answer.
Bespoke Treatments believe in quality over quantity because we care very much about the high service standard and unique care that you receive. We know that it is the Quality of our care that will get you better. As an out-of-network provider, we are choosing to see fewer patients in a day in order to ensure an extremely high level of patient care.
Insurance companies don’t look at patient care the same way we do. They put providers like us through an awful application process to become “in-network.” If we’re chosen, we agree to receive significantly less reimbursement for treatments (as low as $40 for an hour treatment, inclusive of your copay… because we’ll be exposed to a bigger pool of patients. But the only way to offset our operational costs is to see more people in a day. That leads to a “patient mill” style of physical therapy that really upsets us, and undermines our treatment philosophy. We just can’t, and won’t, participate in that.
At Bespoke Treatments PT you will work one-on-one with an experienced, highly skilled, licensed physical therapist who cares about you and what you’re there to accomplish. You will have your therapist’s undivided attention for at least 60 minutes in a private treatment room, focusing on you and only you!
At an in-network clinic, you’ll likely be lined up on a table in an open gym with many other patients while one therapist directs all of you at once. Ultrasound/heat/electric stim/ice may be used as substitutes for individual care and treatment, but those things are just filling your appointment. If you’re only being treated for 5-7 minutes individually, it’s really tough to get better. Your therapist should take the time needed to diagnose the underlying cause of your problem, correct it and make sure you are empowered to address your issue when you are not in treatment. That takes expertise and individual attention. That’s why we are out-of-network.
Q: But I don’t have any out-of-network benefits at all. Now what can I still see you?
A: Of course! We want you to get better, so we’ll work with you. We offer fantastic rates for patients who invest in their health and well being by paying for the treatment sessions out of pocket.