Does the snow on the mountains get you excited or nervous about the upcoming winter and your ability to enjoy snow sports? Perhaps you’ve tweaked your back while doing fall yard cleanup. Pain or weakness can impact your ability to participate in the activities you know and love in Central Oregon. No matter the issue, if you’re interested in getting better, you’re probably wondering what your insurance will and will not cover.
Did you know that you can choose to see a physical therapist without seeing a physician or other healthcare provider for a referral? Direct access to physical therapy gives you that option for a quick and timely recovery. Let’s discuss:
What is Direct Access?
Direct Access means that anyone needing physical therapy can receive an evaluation and treatment directly from a licensed physical therapist (PT) without first obtaining a doctor’s prescription or referral. The level of access varies by each state and individual health insurance coverage. Oregon is one of 20 states that allows complete unrestricted access to see a physical therapist.
Benefits of Direct Access Physical Therapy Treatment
Researchers have compared the patient benefits of direct access physical therapy versus therapy treatment after a physician’s referral. Their studies concluded that accessing physical therapy treatment without a physician’s referral is safe and cost-effective. Direct access physical therapy also supports a physical therapist’s ability to accurately diagnose musculoskeletal problems and systemic illness based on a patient’s clinical presentation and past medical history. Additional benefits include:
- Faster Access to care: no need to wait to get in for a referral
- Quicker recovery times: knowing what to do early allows the body to heal faster
- Lower Costs: avoiding unnecessary treatments, plus early intervention is associated with positive long-term results and reduced treatment visits
- Freedom of choice: see a physical therapist anywhere, anytime
- Higher patient satisfaction: studies show patients receiving direct access care show higher satisfaction and are more likely to achieve their goals than patients who were referred by their MD or specialist
- Reduced need for medications: patients learn alternative ways to manage their symptoms and take an active role in their healing
- Reduced exposure to contagious disease (flu, Covid-19): avoid trips to ER, urgent care, or primary care offices
When to see a Physician for Pain or an Injury
Physical Therapists are highly trained clinicians who specialize in movement-based care and exercise prescription for a wide range of musculoskeletal and neurologic presentations. They are also part of a greater team of healthcare practitioners focused on providing patients with the treatment necessary for their recovery. A physical therapist’s training and education cover identifying “red flags issues” where physical therapy treatment is contraindicated or may require the need for more advanced medical attention. A physical therapist will refer patients to a physician or specialist for further examination or recommended diagnostic imaging when appropriate.
What to Know About Insurance Coverage and Physical Therapy
Even though direct access through the state of Oregon allows unrestricted access to a physical therapist, there may be additional requirements depending on your insurance plan. Many policies allow you to obtain physical therapy treatment when and as often as you’d like, however, other plans, such as Medicare, require you to be under a physician’s care and the clinic to maintain an up-to-date referral from them during your entire plan of care. If you are curious about your specific physical therapy benefits before your first visit, simply call the customer service number on your card, or review the benefit plan summary most insurance plans issue yearly. Cash-pay patients have no restrictions on visits or treatments.
Your health is a top priority at Alpine Physical Therapy. Don’t let pain or an injury keep you from experiencing every day. Let us help you feel stronger and move better, so you can enjoy all Central Oregon offers. Schedule your evaluation with one of our physical therapists today.