As of 2015, Michigan consumers have DIRECT ACCESS to physical therapy. This means that you are not required to have a physician’s referral in order to come to PT! You can come right in and ask for an evaluation for your injury or condition, and we can get you scheduled without a doctor’s visit or a prescription for therapy.
This can get tricky with insurances, however. In Michigan, Priority Health, United Healthcare, Aetna, and some Cofinity insurances will process claims without a doctor’s referral (prescription for therapy). Other insurances, like Blue Cross Blue Shield, Blue Care Network, Medicare, Priority Health-Medicare, and Medicaid, all require a prescription from your doctor.
So if you have Blue Cross Blue Shield and want to come straight to physical therapy, where does that leave you?
Often, if your doctor knows about your condition, you can call his or her office and request a prescription for PT to be faxed to our office without having to go in for a doctor’s visit.
If your doctor is unaware of your condition, he or she will likely want to see you before coming to therapy.
At this point you are welcome to either (1) start treatment at our self-pay rate, or (2) if you’d like it billed through insurance, you can come in for a free 15 minute consultation before you see your doctor. If you do this you can have a therapist evaluate your injury or condition and recommend if therapy would be a good option for you. If they believe we can help you here at Hudsonville PT, then you could go visit your doctor and get a prescription, after which we would officially start treatment.
The purpose of direct access is to alleviate cost by allowing quicker access to conservative care. Michigan was one of the last states to pass this law, and other states have shown that this model reduces the average cost of treatment and lends to improved outcomes.
Direct access is not as easy as it sounds because of the insurance rules surrounding it, but we work hard here to make physical therapy accessible to everyone.
Remember you can always stop in to set up a free, no-strings-attached consultation, and we are available to help answer your insurance questions the best we can!
Call us at 616-662-0990 if you have questions about your insurance plan or would like to set up therapy!
Author: Lisa Bartz
What do you think the primary treatment option is in helping people recover from persistent pain (according to the most recent research)? Would you guess medicine or a specific pain drug? Relaxation techniques? The answer may surprise you. The following post explains some of the mechanisms behind the pain experience. Some of the concepts may seem counter-intuitive. That’s okay! We expect a certain amount of resistance when talking about these concepts due to the relative newness of the research. I know I was challenged, and physical therapy is my field of study.
Let me begin with an analogy. If you sprained your ankle, would it hurt? Of course, I would lose all credibility right now if I told you, “Nahhh, ankle sprains aren’t painful; suck it up”. Let’s now pretend you are crossing the street with your ankle sprain, and an oncoming bus is headed straight for you. Do you run out of the way and forget the ankle, or do you continue to limp and grab your ankle sprain in pain? My guess is most of you would say, I would run out of the bus’ way and forget the ankle sprain for the moment. Why is this important? It shows that the body and brain are capable of decreasing pain presentation when another outside threat is more important. This analogy demonstrates how pain is based on perception of threat.
Now, let’s go back to my original question: What is the primary treatment option in recovering from persistent pain? Pain education is actually the number one and first line treatment we as physical therapists use to help you get rid of your pain. Surprised? If we can reeducate you in how your pain is perceived, we can actually treat, reduce, and often eliminate it! Let’s continue with some more reasons why pain education is so important.
Have you ever examined your body and noticed a random bruise? Do you remember how you got the bruise? My guess is that at some point you randomly bumped yourself. Now this creates local “tissue damage”, but does it hurt and bother you continuously? No! You are able to move on from it, and continue with your day-to-day life. This analogy demonstrates how tissue damage does not necessarily equal pain. Did you know two thirds of individuals over seventy years old have rotator cuff tears, and they don’t even know it because it doesn’t hurt? Likewise, there is only a 50% correlation between knee pain and arthritis. That means that the correlation is quite weak. Also, disc herniations are most often reabsorbed by 50% in 6 weeks, and completely healed at a year. The takeaway message from these examples is that tissues heal. It is encouraging to know that we can treat the arthritis and disc herniations with pain education, exercise and medicine, rather than surgery!
So where does that leave those who suffered an injury, and now years later are still in pain from it? It means there are treatment options. Starting with a comprehensive evaluation, a PT may be able to help decrease your pain, even in the presence of MRI findings like: bone spurs, osteo-arthritis, rotator cuff tears, meniscal tears, ACL ruptures, degenerative disc disease, disc herniations, and etcetera. Persistent pain works with your brain in a unique way that can be treated with pain education, exercise, relaxation and medicine. Often times calming persistent pain starts with calming your brain to body connection down. This is where education and exercise can help to turn down a ramped up system. The bottom line is, there is hope!
Please feel free to comment or email firstname.lastname@example.org and as always, thanks for reading!*
Author: Mike van Der Laan PT, DPT
*Credit to the following for content and analogy use:
“Teaching People About Pain” by Adriaan Louw PT, PHD, CSMT
Steve Bartz, PT