Optimizing Human Potential
FREQUENTLY ASKED QUESTIONS
Some Questions that you may be pondering...
DO YOU TAKE MY INSURANCE?
Many of our patients have the common health insurances used in the United States. Our clinic is not in-network with any insurance companies, therefore, we do not bill insurance directly. You are responsible for payment up front for every visit. We provide a super bill at the request of the patient in order for them to submit claims to their insurance. So this leads to another question:
CAN I BILL MY INSURANCE FOR REIMBURSEMENT OF MY OUT-OF-POCKET EXPENSES?
This depends on the insurance you have, but YES, most NON-Medicare patients can send "self-claims" to their insurance company for their treatments at our clinic. You should be able to print claim forms off your insurance company's website, and send it in with the needed receipts and treatment codes that will be provided upon request at our clinic.
WHY IS INSURANCE NOT BILLED AT STARK PERFORMANCE?
In many ways, insurance companies dictate or strongly influence the treatment that patients receive at “in-network” clinics, and we refuse to allow that to be the case.
We are an out-of-network practice because the business model necessary for an in-network practice to survive rarely ever allows for the high-level care we insist on giving our patients.
Due to progressively worsening reimbursement rates and pressure from insurance companies, the therapists at in-network clinics have to see at least 2 patients per hour (usually many more) and they often use technicians and assistants to provide much of the actual patient care. We do not agree with having patients pay to perform exercises in the clinic that they can easily perform at home or at a gym.
All of our patients receive one-on-one care and hands-on treatment from a Doctor of Physical Therapy in every session. Most sessions are a full hour unless the patient chooses 30 minute sessions. With this long-session,
one-on-one treatment approach, the plan of care for the vast majority of our patients only involves one appointment per week.
When you consider the time savings of fewer trips to the clinic and the value of resolving your pain so much faster than average, the out-of-pocket expense at Stark Performance PT is a huge bargain. On top of that, the out-of-pocket expense for our treatment sessions is sometimes less than a patient would pay at a clinic that accepts and bills their insurance.
HOW IS YOUR PRACTICE DIFFERENT FROM AN IN-NETWORK PHYSICAL THERAPY PROVIDER?
At Stark Performance PT we strive to provide the highest quality of care by spending a full hour one-on-one with patients. Due to progressively worsening reimbursement rates and pressure from insurance companies, the therapists at in-network clinics have to see at least 2 patients per hour (usually many more) and they often use technicians and assistant to provide much of the actual patient care. The care often includes modalities like heat packs and ultrasound, and the majority of a patient's time at the clinic is spent doing exercises they could do no their own time. Furthermore, these types of clinics tend to require patients to attend 2-3 appointments per week.
The care that you will receive at Stark Performance will be provided by a doctor of physical therapy for the ENTIRE treatment every time. Therefore we can improve patient outcomes significantly faster, meaning fewer visits and less time spent away from work, family and doing what you love.
WILL I HAVE TO STOP PARTICIPATING IN MY SPORT/EXERCISE ROUTINE WHILE I AM GETTING TREATMENT?
In most cases working out or exercising while doing physical therapy is perfectly fine. Some injuries require complete rest from activity at the beginning in order for tissues to heal. This also may be a short period of activity modification in order for the treatment to be successful.
HOW LONG AFTER AN INJURY SHOULD I WAIT TO GET TREATMENT?
In general, the longer you wait to get treatment, the longer it will take to fix the injury and get you back to 100%. Moving the tissues back into their pre-injury arrangement becomes harder the longer they have been in a distorted/injured state.
Additionally, the longer an injury has been presents, the more loss of strength that occurs and the more likely that detrimental movement "compensations" will develop that can lead to injury in order areas.
So it's important to get treatment as soon as possible after injury if you want to get better with the fewest possible sessions.
HOW MANY TREATMENTS WILL I NEED TILL I'M 100% AGAIN?
It varies with every patient and is dependent on a large number of factors. What we can say is that, for reasons described above, you will usually need far fewer treatments at Stark Performance PT than you would if you were going to a more traditional PT clinic or Chiropractor.
Pain and dysfunction that has been present for a long time will usually, but not always, take longer to fix than more recent/acute problems. Certain conditions like herniated spinal disks and frozen shoulders will take longer to resolve than something like an ankle sprain. And though notoriously ‘stubborn’ conditions like tennis elbow and plantar fasciitis can sometimes be fixed in a just a few treatments, conditions like these also have a tendency to need multiple treatments.
In general, it is rare that we need more than 5-7 treatments for the average patient, and quite often 2-4 treatments are all that is needed. In an industry where 2-3 treatments/week for 1-2 months is the norm, that’s quite good. But again, factors like age, severity of injury, other health issues, and how long you’ve been in pain can occasionally make the path to 100% somewhat lengthy.
WHAT KIND OF CLOTHING DO I WEAR?
It is best to wear loose fitting athletic shorts for trunk and lower body injuries. For upper body, especially back to neck issues, females should wear a tank top with thin straps and a normal bra, sports bras have thick backs and are difficult to work around sometimes.
DO I NEED A DOCTOR’S REFERRAL?
Thanks to the advocacy of the Florida Physical Therapy Association and American Physical Therapy Association, Florida is a “direct access state.” This means you are allowed to go directly to a physical therapist without a physician's referral first and receive treatment for 30 days. After 30 days, we will need to get a treatment plan signed by an approved healthcare provider.
RATES AND INSURANCE
All treatment sessions are one-on-one with a Doctor of Physical Therapy, and are scheduled for 60 minutes with iniitial evaluations being 90 minutes. The rates for treatment vary, so please call us at 850-912-9203 to inquire about pricing or set up a phone consultation HERE. We are a fee-for-service clinic and we are not in-network with any insurance providers. Upon request, a 'super bill' can be provided that includes the necessary codes to send self-claims to your insurance company. We can provide you with questions you can ask your insurance provider to determine what they cover and what their reimbursement would be.