Without a prescription, insurance may not cover the cost of care
If one of your clients has been in a serious accident and is suffering from chronic pain, a variety of treatments like massage therapy and physical therapy, as well as chiropractic medicine can often have an incredibly positive impact on their quality of life. However, many insurance companies (whether they’re your client’s insurance or insurance carried by a liable party) won’t cover the cost of certain treatments, no matter how helpful they are, unless a patient is given a specific prescription first.
Keep reading to learn more about how insurance companies assess various types of treatments in different situations, and the steps your clients can take to make sure they’re not paying out-of-pocket.
How a prescription for non-physician pain treatment factors into insurance settlements
Ensuring your client gets a physician’s prescription for any non-physician treatment is important if you are currently negotiating an insurance settlement for them. For example, if your client suffers debilitating back pain after being hit by another driver, and goes on to receive non-physician pain management treatment (like physical therapy or massage therapy) without a prescription, the other driver’s insurance company may not use a high multiplier when calculating the cost in any settlement they offer your client. Worse, without a prescription, they may be able to get away with not factoring in some types of care at all.
Where should someone have physical therapy?
If your client’s physician indicates that physical therapy will need to be a part of their pain management and recovery process, or prescribes them a specific physical therapy regimen, should they get therapy inside or outside the doctor’s office or facility? The answer: if it’s available, the patient should opt to get physical therapy inside an office that has a physician on staff.
Insurance companies, especially when calculating a settlement, have a tendency to believe that physical therapists might over-treat a patient unless under the direct supervision of a physician. Therefore, they are less likely to discount physical therapy bills as part of a settlement if the therapy is conducted under this supervision.
Chiropractic work can also be essential to deal with pain from an accident or injury, and it’s important to make sure that the chiropractor keeps excellent files and records so they can be used in any settlement discussions or other insurance negotiations.
Make sure your clients get the care they need
Today’s pain management experts know that a physician’s guidance smooths the process of obtaining a full spectrum of care, and doctors also understand that they can’t do everything. The nation’s top pain specialists are increasingly relying on massage therapists and physical therapists, as well as chiropractic physicians to provide specialized services or do the-day-to-day work of rehabilitating a patient while they monitor and assess progress at regular intervals.
If your client has been seriously injured, the last thing they want to worry about is how to pay for medical treatment. With insurance policies and regulations becoming more complex, it’s essential to inform your clients of all their treatment options (and how each may affect them financially) so they will be fully covered.
At Pines Spine and Joint, we understand that an innovative, multi-disciplinary approach is often ideal to treat patients with serious pain – and our experienced and caring staff of physicians and therapists are passionate about creating results that change lives. Whether you’re an attorney trying to find a suitable pain management practitioner for your clients or an individual in need of treatment, Pines Spine and Joint is here to help. Contact us at 954-589-2319 (East Pines office), 954-430-8000 (West Pines office), or through our online form today.