Referrals and Billing Info

Referrals​

Texas is currently a limited direct-access state for physical therapy treatment. This means that you can get started with PT without a referral, however after 10 business days following the date of your initial PT evaluation you will need to obtain a PT referral from one of the following providers: physician, physician assistant, nurse practitioner, chiropractor, podiatrist (for foot/ankle problems), or a dentist (for oral/TMJ problems). If you have questions on how to obtain a referral, our staff is happy to assist with this process and answer any questions you may have.  

Billing

BODY WORX Physical Therapy is an out-of-network/cash-based practice, which allows each session to be delegated by your specific needs rather than your insurance contract. This means that we do not take insurance, however we are more than happy to provide the necessary information you need to file to your insurance company for potential out-of-network reimbursement. Reimbursement will vary based on your specific insurance provider and out-of-network PT benefits. 

Payment for PT services at BODY WORX PT are due at the time of services rendered. If you have any questions regarding our billing processes, rates, and/or how to file for insurance reimbursement please call our office manager at 325-261-0043

We know you're considering your options when choosing a physical therapy route, some here are some quick thoughts on the difference between our model and traditional physical therapy. 

Here at BODY WORX, we are a direct-pay physical therapy clinic, which means you pay for our services upfront. Now, most people hear that and think, "Wow, that must be expensive" or "Well, I have insurance so why would I pay upfront?"

Direct pay physical therapy is a very new concept, so we understand where the second-guessing may come from.  BUT, there are so many reasons why we chose to be a cash-based PT clinic --

Direct Pay vs Insurance

  • 60 minutes 1-on-1 session with PT vs 15 minutes and then handed off to aide

  • Look at the whole body to fix the root cause of your problem vs just treating the injury site

  • Sessions based on YOU and your lifestyle vs sessions based on where your pain is and what insurance will cover

  • Use progressive modalities like dry needling and lifting weights vs using hot packs, ultrasound, and bands every session

  • Work with the same PT every session vs going through multiple providers

  • Ability to work on strength training vs just being able to do what insurance will reimburse for

  • Save time with 1 session a week vs multiple 15-30 minute sessions per week

  • 100% of cost known vs hidden insurance fees you pay back months after

  • We can help you submit a claim (superbill) to potentially receive out-of-network reimbursement $$

    ..and the list goes on, and on

In fact, the biggest deterrent for most people is cost -- but we are here to tell you that in most instances insurance-based physical therapy will end up costing you more out of pocket than you think!

For insurance-based physical therapy, most people we see have an in-network deductible of at least $2,000.  This means that you pay out of pocket each time you go to PT until you hit that $2,000 mark. 

Let us repeat -- Insurance will not start helping you out until you hit your $2,000 deductible. Then once you do, your coinsurance will start to kick in and then your price per session will eventually go down. So at the end of the day, you're still paying until you hit your deductible; and those co-pays add up fast. 

In most instances, if you're going to an insurance-based clinic they have you on a twice-per-week plan. This means you're getting 60-minutes total per week of PT, but paying your co-pay twice. For most people, that's over $70 dollars per week for two shortened sessions, accompanied by several other patients and a therapist who is just trying to survive seeing 22+ patients a day.

Insurance is super confusing and is one of the reasons I'm glad we didn't go down that route. I've heard multiple horror stories of people going to physical therapy for 12, 24, or even 6 months and after getting discharged being hit with multiple hundreds of dollars bills that they were not expecting.  So, they paid their co-pay each time, PLUS an unexpected medical bill at the end from their insurance company.

All in, that's almost $3K worth of insurance physical therapy in which you didn't get proper care, and as soon as you go back to your active lifestyle the injury returns. This is frustrating to acknowledge, but unfortunately, that's the reality. 

At the end of the day, our Cash-Based Model might be more expensive up front, but in the long run, you get the care you deserve, become pain-free faster, have lasting results, and ultimately save money. In our Cash-Based Model, you know what you owe up front, and that's it!  

Plus -- you probably have out-of-network benefits that you can utilize for reimbursement about a month into your PT plan.  So, not only will you not get hit with a bill later on, you may actually get a check from your insurance company in return!! Many of our patients have received 30-100% reimbursement!