Taking an Active Role in your Musculoskeletal Health

Patients today must take an active role in managing their own health care. To do this, you need to know about your options and your rights as a patient. Patients across the country are becoming better educated and demanding more options from their medical providers and health insurance companies. The right to physical therapy services is an important option, and it is your right as a patient.

What is Physical Therapy Direct?

State laws provide direct access to licensed physical therapists without a physician’s referral or prescription. That means that as a consumer of healthcare, you can seek medical treatment for your musculoskeletal issues directly from the physical therapist of your choosing. This places physical therapy as a first line provider for your musculoskeletal health.

What does Physical Therapy Direct mean for you?

  • Immediate evaluation, diagnosis, and treatment from your physical therapist for your musculoskeletal injuries without the delay of visiting another healthcare professional
  • Immediate consultation with your physical therapist to determine if therapy is needed or if further examination by another healthcare practitioner is warranted
  • Strong potential for decreased healing time for your injury due to receiving treatment without delay
  • Freedom to choose a physical therapist as you would an MD, DO, chiropractor, dentist, or other healthcare professional
  • Continuity of care as you return to your physical therapist for all of your musculoskeletal needs, including relief from injury as well as prevention and overall wellness

How do I find a good Physical Therapist?

Recommendations from family, friends, colleagues, and other healthcare providers you trust is the best way to find a good physical therapist. We recommend that once you establish a trusting relationship, you continue to view that physical therapist as a permanent member of your ongoing health care team. Good physical health doesn’t happen by accident, and having an expert as part of your health care team can make all the difference.

It is important to know that physical therapists are licensed by the state and require continuing education annually. Much like medical doctors, physical therapists graduate from school with extensive training in rehabilitation and tend to specialize once in practice. Consumers are advised to ask questions of their therapist to ensure their physical needs are met. Common questions may include the following: What is your treatment philosophy? What are your areas of expertise? What experience do you have in my specific condition? Open communication is important with all medical providers, and you should feel comfortable having these conversations with your therapist.

When should I call a Physical Therapist?

  • Headache, neck, and back pain
  • Joint pain (shoulder, knee, hip, foot, ankle)
  • Any injury due to a fall or trauma
  • Poor posture
  • Jaw pain/TMJ
  • Pre- and post-pregnancy issues
  • Rheumatoid and osteoarthritis
  • Osteoporosis
  • Premature aging and decreased muscle tone
  • Decreased ability to walk/general decreased mobility
  • Poor balance
  • Chronic fatigue and fibromyalgia
  • Pain/decreased mobility/decreased strength due to obesity
  • Fatigue/poor endurance due to pulmonary dysfunction
  • Poor endurance due to cancer and related treatments

How do I schedule an appointment and insurance benefits?

Physical therapy is a covered benefit under insurance plans. As licensed medical providers, physical therapists can be accessed directly without a referral or recommendation from your medical doctor for musculoskeletal issues. Insurance coverage for your physical therapy benefits are plan-specific. Most insurance companies do not require a referral from your physician, but some do.

Currently Blue Cross/Blue Shield, Aetna, Auto Claims, and other third party payers will pay for physical therapy services rendered under direct access, however, the benefit is plan specific. Medicare does not pay for direct access physical therapy at this time, but physical therapists can perform an evaluation under direct access. As long as a physician signs off on a treatment plan, we are able to bill Medicare.

We are happy to verify your physical therapy benefits for you prior to scheduling your first visit. Simply contact one of our clinics and we will outline your physical therapy benefits so you can make an informed decision. You will receive information on referral requirements, co-insurance, co-pays, and your total annual benefit. We do offer cash rates for your convenience and for services rendered outside insurance plan coverage, which can be very cost effective.

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