(1) Insurance
At Linchpin Performance, we operate as an ‘out-of-network’ provider, offering a dynamic approach to payment that prioritizes full transparency, convenience and flexibility. Rather than navigating complex insurance processes, you pay for services upfront and receive a detailed receipt or ‘super bill’ for easy reimbursement submission to your insurance company. With your out-of-network plan benefits, you will receive direct reimbursement. To ensure clarity on your coverage, we encourage you to engage with your insurance provider directly. Understanding your insurance coverage empowers you to make informed decisions about your healthcare journey
(2) Why Are We Out of Network
Linchpin Performance stands apart as a beacon of personalized care, meticulously tailored to each individual’s needs. Unlike conventional clinics tethered to insurance constraints, we’ve made a deliberate choice to prioritize your well-being over bureaucratic red tape. Why? Because we refuse to compromise on the quality of care we provide.
Think about it: at insurance-ensnared clinics, therapists are bound by the clock, rushing through appointments like a conveyor belt of patients (2-4 patients at a time on average!!!). It’s a model that sacrifices depth for volume, leaving you with mere morsels of one-on-one attention. But here’s where we break the mold. At Linchpin Performance, we dedicate the entire hour to you and your recovery journey. No distractions. No compromises. Just focused, uninterrupted care that accelerates your healing process.
Now, you might worry about the cost. It’s natural. But let’s debunk that myth right now. Our approach isn’t just about superior care—it’s about efficiency. By targeting the root cause of your issues head-on, we streamline your path to recovery, ultimately saving you time and money in the long run. Plus, we’ve got your back when it comes to reimbursement. Our seamless process ensures you get every penny you’re entitled to from your insurance provider, hassle-free.
So, why settle for mediocrity when you can experience the pinnacle of physical therapy? Choose Linchpin Performance for a journey that’s not just about healing—it’s about thriving.”
(3) The Math is In Your Favor
Let’s dive into the financial breakdown of traditional insurance-based physical therapy versus the out-of-network option:
Example 1: You Haven’t Met Your Deductible
- Out-of-pocket cost until deductible met: You pay 100% of the session cost until you meet your deductible, which could be up to several thousand dollars.
- Co-pay: Usually between $10-$40 per session. Generally 2-3x visits/week.
- Co-insurance (typically 20%): After meeting your deductible, you’re responsible for a percentage of the session cost until you reach your out-of-pocket maximum, which on average is around $8,000 per year.
- It’s not uncommon for insurance companies to retroactively deny coverage for services already provided, leaving patients with unexpected bills months later.
Example 2: You’ve Met Your Deductible
- Co-pay: As above
- Co-insurance (20%): After meeting your deductible, you still pay a percentage of the session cost until you reach your out-of-pocket maximum.
Now, let’s compare this to the Out-of-Network Model:
- You pay the full session cost upfront (HSA/FSA if applicable) and submit a claim to your insurance for reimbursement. The reimbursement rate may vary depending on your plan, but typically ranges from 50-80%. You may have a similar deductible to meet as your in-network benefits before reimbursement kicks in.
- In the out-of-network model, discounts are often offered for sessions bought in bulk, further enhancing its cost-effectiveness.
By opting for out-of-network care, you have more clarity and control over your healthcare expenses and save money. Additionally, by receiving specialized, individualized, and focused care, you have the highest likelihood of reduced need for additional medical interventions such as medication, injections, or surgery, further saving you both time and money.
(4) We Will Help You File Claims
After each session, our biller prepares a superbill tailored for your insurance submission, optimizing your reimbursement potential. While reimbursements aren’t guaranteed and vary based on your plan, rest assured, we’re committed to maximizing your benefits. We handle all paperwork seamlessly and offer support every step of the way to ensure you receive what’s rightfully yours from your insurance provider.
(5) Good Faith Estimate
At Linchpin Performance, we prioritize transparency in pricing, ensuring you have all the information needed to make informed decisions about your care. Upon request or scheduling, we’re happy to provide you with a ‘Good Faith Estimate’ of our cost structure. Contact our office at 502-532-2994 or email us at david@linchpinperformance.com
