why Functional Wellness uses a cash-based model
There is nothing wrong with seeking out care within your health insurance network. It’s the beauty of having choices and options to fit everyone’s needs.
But let’s be frank: not all care is the same.
There is a difference between going to get your hair cut at a 1-800- HAIRCUTTERY where your hairdresser is booked on the 30-minute mark and bouncing back and forth between clients, versus going to a hair salon that books 60-minute haircuts and can solely focus on you.
Either way, hair gets cut, but how did you feel when you left?
There may not be a huge difference in the skillset of either hairstylist or years in the field - but there are a few things that make or break your experience as a client and overall outcomes that are the foundation to my reasoning in why Functional Wellness is a cash-based private practice.
Time
Time is a two-fold issue: the number of sessions allotted and billable units within sessions. With a cash-based model, there are no session caps or focus on billable units. Most importantly, NO third party who is completely uninformed about your diagnosis or circumstances should be dictating YOUR plan of care.
To maximize billable units, most in-network facilities offer 30-45-minute sessions. In cases when sessions are shorter, therapists often recommend patients come in 2x a week or more, which is quite the commitment on the patient’s end to block off time. Let’s look into how this 30-45 minute session breaks down:
Rarely in real life is anyone running perfectly on time - you or your therapist - even if it’s 1-2 minutes. We’re starting with a 28-38 minute visit.
In pelvic health there can be internal work involved, so shed off 4 minutes on each end to make sure someone can get undressed and dressed. Now we’re down to 22-32 minutes of treatment.
Take off another 4-5 minutes of conversation regarding logistics or scheduling.
Actual treatment: 18-28 minutes.
That has to include time for questions, patient education, and demonstrating home programming.
Time is a luxury in health care, and when your therapist is not hyper-focused on how many sessions you’re approved for and getting the most billable units, there’s a lot more time to focus on you.
Focus on the client
If a therapist is concerned about how much they are receiving from someone’s health insurance company, their focus shifts from client needs to reimbursement. “Will this intervention get covered?” “How much can I get for that?” “How much kickback from insurance companies will I get for this?”
Without health insurance companies looming over sessions, there is no red tape - just high-quality treatment specific to you.
Individual in nature
Creative and individualized interventions such as babywearing, infant-care body mechanics, or activity-specific treatment easily get overlooked by a therapist who is focused on the bottom line. Pelvic floor therapy is anything but cookie-cutter, however, when we have When we remove health insurance companies, interventions are based on client goals and what matters to the client.
“I’d love a real quick cookie-cutter haircut where the professional is focused on something other than what’s best for me.” -said no one ever.
I’ll end with the invitation for contemplation: if you’re willing to pay a little more for a great haircut, why wouldn’t you considering doing the same when choosing a physical or occupational therapist for such an intimate and vulnerable area of the body.
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