360^o Physical Therapy

We can utilize a variety of treatment techniques based on the needs of your body, some of which may include:

• Video analysis of movement and sports activity - if we slow you down and watch carefully, we can often figure out what parts of you are moving poorly and teach them to move properly
• Pain management and central sensitization concepts to address pain management
• Taping techniques for pain relief, postural education, and movement retraining
• Regional Functional Interdependence (this is a fancy way of saying your thigh bone is connected to your shin bone)
• Joint Mobilization Techniques (muscle energy, Maitland, osteopathic, and a variety of others as needed)
• Instrumented Assisted Soft Tissue Mobilization (Graston trained)
• Cupping (think Michael Phelps and his Olympic polkadots)

Nope! The State of California allows you to be evaluated and treated by a physical therapist for 45 days or 12 visits, whichever occurs first, before you need a physician's diagnosis. This enables you to receive therapeutic care quickly and gets you on the path to wellness without jumping through unnecessary hoops. After this period of treatment, we will need a physician's assessment and diagnosis to continue care and to submit claims to your insurance company. We will discuss how this law applies to you and your care individually.

During your evaluation, if we find anything out of the ordinary that I feel should be examined by a physician we can work together to find the proper referral.

Currently, the schedule is set to accommodate individuals on the Peninsula and in San Francisco. If you live further afield than those areas, or need a day of the week I am not typically traveling, just ask. If I can accommodate your needs within reason, I am happy to do so. We can discuss additional fees for extra travel time and off hours if things are really out of the ordinary.

• Pain TEDtalk "Why Things Hurt" with Lorimer Moseley - one of my favorite humans who is also a brilliant researcher in the science and treatment of pain
• Relax the Back - a very easily accessible resource for ergonomic office ideas. Not a be-all end-all resource but a good starting point

You are not wrong. In reimagining the delivery of healthcare services, the goal was to increase convenience while maintaining affordability. My research indicates the cost for a comparable service within a clinic (one-hour session with a physical therapist in an out-of-network clinic) ranges from $270 to $450. If you were to visit a clinic such as Stanford PT with a non-contracted insurance company, their bills can be upwards of $650 per session.

In bringing physical therapy directly to you, you also save the time that is taken out of your life getting to and from an appointment. The process of checking out of work, driving to the clinic, the visit itself, returning to work, and re-engaging in your day, is closer to 1.75 times the cost of having healthcare delivered to you onsite (according to research done by large local corporations who have chosen to provide PT onsite for their employees).

Every insurance company has different requirements and forms. The easiest way to learn about your benefits and requirements for your specific plan is to look online. For your benefits information, search your plan benefits page for the information about 'out-of-network physical therapy benefits'. For claims submission information, typically this information should be found under a tab titled "filing a claim" or similar. There, you can often find the form to fill out online, or print to submit.

Sometimes calling is easier, but I would ask the representative to refer you to the specific location on the website, or ask them to email you the information. They make mistakes just like we all do, and by having the information in print can make your life easier.

Please let me know if you are planning to submit your claim for reimbursement at the time of our first visit. I will be sure to write my visit notes in the language which insurance companies like to read to maximize the likelihood of you getting fully reimbursed. I always take detailed notes, but making sure the fancy insurance words are in there makes both our lives easier on the back end.

The deductible is a set amount of money your insurance requires you to pay before they will cover most medical services. Sometimes insurance plans have separate in-network and out-of-network deductibles, which means you earn credit toward one bucket but not to the other, depending on the care provider and their in- vs. out-of-network status. Deductibles are interesting in a few ways....

1. Early in the calendar year you are going to pay for health care services regardless, until you meet your deductible when your insurance plan coverage kicks in. In this time period, you pay no matter what, so you might as well go with the provider you really want to see who costs a bit more upfront, because chances are you are going to pay that money out now or later when little Johnny breaks his arm and you have a trip to the emergency room.

2. Middle of the year is the sticky time, when you may have met part or all of your deductible and you don't want to receive services that you still have to cover yourself at 100%. This is when judicious use of your health care dollars really is the pragmatic financial path. If Johnny breaks his arm now, rub some dirt on it and grab some popsicle sticks.

3. Late in the calendar year, often times individuals/families have fully met their deductibles and their insurance is paying the expected coverage amounts of all services you receive. At this point, you might as well see the provider you want to see because you are going to receive your maximum health care coverage for the remainder of the year. Use the plan you are paying into for all it's worth! Now Johnny gets a cast made of carbon fiber and it will never smell badly.

Understanding your health insurance plan is an important piece in making health care choices. I am happy to answer further questions on how to navigate this slippery landscape of terminology and regulations.