What is a health savings account and a flexible spending account? What does it entail?

Do you know what a Health Saving account is and what it entails?

Do you know what flexible spending accounts are and how to use them?

I asked a colleague and friend of mine, Robert Washick, MBA, to help and write a guest blog so the public and patients can have a clear understanding of what Health Savings Account and Flexible Spending Accounts  are and what they entail.   Many companies now are setting their employees up with these accounts to use for health care services.

We all want more money and many of us miss out on two of the best tax advantage plans available, HSA (Health Savings Account) and FSA (Flexible Spending Account)or do not use them to their full potential.

Both of them allow funds to be put into an account and not taxed going in or coming out, as long as it is for valid IRS approved services, such as medical, dental, vision and prescriptions costs.

To simplify what they are I have the following guidelines:

HSA- Health Savings Account

1.                   Must be enrolled in a qualifying high deductible plan (off exchange)

2.                   Employer and/or individual funded and is entirely owned by the individual, even if terminated

3.                   Funds deposited are not taxable when deposited nor when spent on approved services

4.                   Funds roll over and in some cases can be put into investments within account for higher potential gain in value

5.                   Funds are available once deposited

6.                   Since you have access to the funds for you and your dependents and there is no concern of forfeiture, put as much as possible into this account that meets your household’s needs

FSA- Flexible Spending Account

1.                   No mandatory plan requirements

2.                   Minimum and Maximum guidelines are provided by IRS and Plan decides within those limits

3.                   Typically Employee funded through payroll deduction, but Employer can fund as well. When terminated only funds and claims up to that date can be utilized, unless COBRA is taken or employer allows extension

4.                   Funds are not taxable when deposited nor when paying for valid services

5.                   Currently, there is no rollover and any funds remaining are forfeited to the plan – Be careful to watch your balance

6.                   Plan year specific, must incur within plan year and spend all funds by end of runout period or available funds will be lost

7.                   All funds are usually available from first day of plan year

8.                   Make sure to determine how much you will spend and deposit as close to that or more as meets your household’s needs

 By Robert A. Washick, MBA

Robert Washick

VP/CEO

Professional Benefit Administrators, Inc.

407-671-7331

800-762-4130

fax: 407-671-1580

Thanks Robert!  Hopefully this blog post clears up any misunderstanding of what these accounts are.  Our next post will review what you can use these accounts on and how to use it.  Can you use these accounts at Pursuit Physical Therapy???  Yes and an example of this will be in the next post.

Who has the BEST One-on-One patient care in Orlando, FL? Pursuit Physical Therapy and you can save money!

If you are looking for better patient outcomes, faster results, in fewer visits thus saving you money...Pursuit Physical Therapy is the place for you!

At Pursuit Physical Therapy "We don't meet your expectations of patient care, we exceed them for our patients!"

I have no doubt that my "self pay" and "cash based" model is far better than standard medicine and other standard insurance clinics including:



1.  A better One-on-One care experience for my patients
2.  Better quality of care:  Better results in fewer visits!
3.  No waiting period at the office
4.  Personalized care that is tailored to your needs
5.  Personal relationship with your doctor of physical therapy
6.  No waiting periods to be seen! Scheduled within days of call
7.  Save the patient and the healthcare system money?????

But how do I, as the patient, save money?

If you have a high deductible, high co-pay, flexible spending account, health savings account, or just need to get pain free in fewer visits, this is the post for you.  Not only will your savings be in less money spent, but less time spent receiving care, and better outcomes for a better quality of life.  These are examples of how you can save money in a "self pay" or a "cash based" system.

PATIENT 1: SELF PAY PATIENT WITH ACUTE KNEE PAIN FROM RUNNING

Patient began having knee pain when running and consulted me regarding her pain.  No significant past medical history or no red flags that warranted a referral to a physician.  No need for diagnostic imaging at the time of evaluation and treatment started on the evaluation day.  Patient left evaluation with a decrease in pain already.  I followed up with patient 2 more session within a week with home exercise program being updated each time, and patient was able to return to running pain free in 2 weeks.

Cost:  primary physician appointment, copay plus x-ray, plus orthopedic physician eval plus copay, plus standard physical therapy eval plus co-pays plus treatments 2-3x a week for 4 weeks =  a lot of money out of pocket and with insurance 

Cost: 3 visits at Pursuit Physical Therapy and back to running pain free in 2 weeks $450

PATIENT 2: CHRONIC FOOT PAIN WITH FLEXIBILE SPENDING ACCOUNT

The patient has been complaining of chronic foot pain for years and has already been seen by physician, foot specialist, chiropractor, and physical therapy.  Who knows how much money he has spent with deductibles and co-pays already.  He has already had x-rays and MRI and physician wanted to do surgery but patient does not want surgery.  Patient states heel pain and Achilles pain is not allowing him to perform job task, unable to run, and train.  Again no immediate red flags are present so no need for referral.  Patient has already had diagnostic imaging.  Due to chronic nature, the resulted outcome will take longer but patient should still receive great outcome.  Patient signed up for Running Injury and Heel pain Program for $1500.  After 9 visits, patient has returned to running pain free and continues to respond well.  

Cost of previous healthcare:  > thousands of dollars, deductibles, co-pays, etc

Cost of Pursuit Physical Therapy Running Injury Program = $1500 and pain free return to running in 9 visits.  Who knows how much money and time could have been saved if he came to Pursuit Physical Therapy first???

Not only is Pursuit Physical Therapy a cash based clinic, but many physicians are going cash based also.  The below examples were taken from a physician self pay-conceriege medicine blog.  Just to show you how your physician can help you save money also with self pay services!  

PATIENT 3: SELF-PAY (HAVE HIGH-DEDUCTIBLE AND HEALTH SAVINGS ACCOUNT).  AGE 10

Pt fell and injured arm.  Mom sent message to me over weekend wondering about ER visit.  I told them to come in on Monday and I’d evaluate.  Evaluation was not conclusive, so I sent for x-ray, which showed small fracture.  I suggested ortho, but mother messaged me back saying she talked to a friend who was an ortho and they said to just splint this.  I checked on the recommendation and agreed.  Child was in splinted, had repeat x-ray which was better, and given permission to do sports again.

In my old office, without messaging mom would likely have chosen to go to the ER.  If not, would have seen me and would not have communicated with me about her friend’s advice (and I wouldn’t have had time to listen), so cost would have been quite a bit higher.

Cost: 2 x-rays of the forearm – cash price of x-rays $80 each, so total cost of $160

Cost savings: Avoided ER visit and specialist visits.

PATIENT 3: SELF-PAY.  AGE: 40′S

History of migraines, better with Topamax as a prophylactic drug.  Can’t take it due to monthly cost.  I found a cheaper cost, but then the price went up dramatically.  Pt came to me saying they had to stop the medication, as it was costing more than $120 per month.  I personally called pharmacy, who said that the cost for them was high, but then noted another local pharmacy had it on their $4 drug list and that they would match anyone’s price.  I passed this on to the patient.

In my old office would have required payment for an office visit to talk to me about this, and would not likely have had time to research the cheaper price.

Cost: $4 per month.

Cost Savings: $116 per month and significantly improving quality of life.

PATIENT 4: COMMERCIAL INSURANCE.  AGE: 40′S

Significant head injury with out loss of consciousness.  Pt had some change in mental status (dazed), some nausea, dizziness.  Came to my office directly.  I evaluated, determined low risk for subdural bleed, more likely concussion injury.  Ordered noncontrasted CT of head and stayed in office for 2 hours before test could be done.  We re-evaluated over time and progressively got better.  CT scan was negative.  I called and did phone follow-up over the next few days and pt recovered completely.

Cost:  CT of head: $300

Savings:  ER visit and workup for head injury with altered mental status.   Cost: ?

The examples above show the cost benefit in time, money, and outcomes that a cash based system can provide.  At Pursuit Physical Therapy we pride ourselves in showing better outcomes, in fewer visits for our patients.  In the long term:  saving them money, saving them time, and returning to the activities they love and enjoy.  Visit PursuitTherapy.com for more information or call us at 407-494-8835 and schedule a consultation today.

What is a treatment visit like at Pursuit Physical Therapy? The 1# Cash Based Clinic in Orlando, FL for One-on-One Patient Care

Have you ever been treated at a clinic and been upset that you only saw the physician for 5 minutes and you had to wait 1 hour to be seen?

How about, you look over at another patient receiving one-on-one care by a physical therapist during your treatment, and you are double booked with another patient or as you are being treated by the tech?  Asking yourself, why am I not being treated with One-on-One care?

Well, this does not happen at Pursuit Physical Therapy.  When you are scheduled for your appointment, you are seen at that time.  No waiting periods!  For example, when you arrive at 1pm for your 1pm appointment, you walk up the stairs to Pursuit Physical Therapy and your physical therapist is waiting for you in the treatment room ready to get started.  No need to wait hours to be seen and sit in a waiting room.  You don't have large waiting rooms waiting to be seen, with a huge facility with equipment and multiple treatment tables with 20+ people walking around you.  You walk into the treatment room and you see 2 chairs, 2 treatment tables, with a relaxing atmosphere (with great music being played!  as per a previous patient!), no other patients or random people, just One-on-One care as it should be.

As treatment begins, you don't need to worry about bringing you back to warm up on machines, or trying to find a treatment table as your PT is also working with someone else still.  Here it is only One-on-One care and there is always a table open for your treatment.  You and  Dr. Ron Miller, the Doctor of Physical Therapy and a Board Certified Specialist, are the only ones in the room as you receive the personalized specialist to patient treatment you deserve.  Every visit is you with the specialist! no techs and no assistants!

Have you ever been seen for 20 minutes with your PT, and then they passed you on to another person to go do exercises?  You find yourself asking, but I came to see you not your assistant?  But then the PT's, next patient is coming in already, so you can't do anything but go along with it.  Here at Pursuit Physical Therapy you have the full hour of One-on-One care so you will never be passed on the a less qualified staff.  Every visit is with a board certified specialist for the full hour.  The last several minutes of each session is spent answering any questions you may have about your treatment, your symptoms, your home exercises, etc.  So you will fully understand your pain, your diagnosis, and what is expected with your plan of treatment.

At Pursuit Physical Therapy, you should leave feeling better with less pain every session.  

Our goal is: 
1) to resolve your pain in as few visits as possible, and 
2) to prevent is from coming back!

Many patients report evening feeling pain free in as few as 2-4 visits.  Look and see what our patients are saying about us HERE.

At standard clinics, when you finish your treatment, you are leaving the facility and they ask you for your $25-50 copay, and you ask yourself  "do I have to pay this everytime?"  after they try to book you for 3x a week for 4 weeks.  Thats $300-600 in copays already and that is not even covering the actual bill.  Not to mention, it is not uncommon to receive a random medical bill 3 months after your treatment is completed, saying that you owe $500-$1000 more!  Here at Pursuit Physical Therapy, there is no copays, no worries about deductibles not being met, or any miscellaneous bills being sent to you.  You know exactly what you are paying for and how much the bill will be with your treatment.  Also, many of our patients are getting reimbursed by their insurance company or getting it applied to their deductible if it has not been met yet.

Overall, its cheaper, more cost efficient, better quality of care, getting you better and pain free in fewer visits!  Giving you the great quality of health care you deserve!  So don't settle for poor health care or just hope your pain goes away.  Call Pursuit Physical Therapy today at 407-494-8835 or visit us online at www.PursuitTherapy.com and get pain free today!

Have you ever received a medical bill from the hospital and your insurance company denied coverage? Should have gone with cash based medicine!

Have you ever received a medical bill for services you thought was covered by your insurance company, but they end up not covering it?

Do you know how much the hospital charges for services?  YOU WILL BE SHOCKED AT THIS!

How much will the hospital bill you vs the insurance company???

These are all great questions that most of the public is not aware of.  If you want an answer to these question, READ THIS EXAMPLE of a second year medical students case when getting a simple blood test performed.  This is a great example of the over billing of hospital services, lack of quality with insurance companies denying coverage, and what you should do in this case.  This is why for simple health care services, a cash based or concierge medicine services will save you money, be more cost effective, and get better results.  If you have low back, pain with running, or a dealing with acute pain from activities, Pursuit Physical Therapy will get you the results you want in fewer visits.  Visit us at PursuitTherapy.com for more information about our specialty programs, our staff, and what services we offer.

Fee for service physical therapy and concierge medicine in Orlando, FL? Pursuit Physical Therapy is the place for you

Here are 2 common questions we are frequently asked about concierge health care:

What is concierge medicine?  (also known as direct care) is a relationship between a patient and a primary clinician in which the patient pays an annual fee, a retainer, or a per session fee. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide One-on-One enhanced patient care. Other terms in use include boutique medicine, cash based medicine, fee for service, retainer-based medicine, and innovative medical practice design, membership medicine, concierge health care, cash-only practice, direct care, direct primary care, and direct practice medicine.

Why is Pursuit Physical Therapy a Cash Based Practice?

"The reason Pursuit Physical Therapy is a cash-based service is because there is no way to treat patients the way that we feel is most affective and accept insurance, without going bankrupt. Insurance companies only reimburse about half what is billed. In order to make a profit, clinics that handle insurance have their patients be seen by assistants and less qualified clinicians. They are also forced to see multiple patients at the same time, so if you would go to an insurance based clinic, you will be double or triple booked with another patient. We spend 60 minutes of one-on-one time with each one of our patients, primarily using manual therapy that has been shown to show superior outcomes and better results than standard care. No physician script is required so we can treat you now, and you do not have to wait weeks to be seen or treated.  While you are being treated here, you will not be charged for exercises that you can easily do at home on your own. With our approach, we feel confident that we can get you better in less than half of the number of visits they would need at an insurance based clinic. With the time savings of fewer clinic visits, and the value of feeling better sooner, most patients feel the out-of-pocket expense is more than worth it."

Here are two examples of how much it will cost you for a cash based physical therapy service.  This was a earlier Pursuit Physical Therapy Blog post that compared the cost of insuranced-based therapy vs. cash-based therapy.  This was a great post by Dr. Jarod Carter how he justifies a cash based physical therapy service those without insurance, those with high deductibles, and those with insurance.   For more information about Pursuit Physical Therapy, our services, and are specialty programs call us at 407-494-8835 or visit us at PursuitTherapy.com.

Small business owners and employee health insurance. Whats the future?

Even though the Affordable Care Act (ACA) employer mandate has been delayed a year, heathcare costs remain the number one economic concern for U.S. small businesses.  Most small business owners foresee their insurance costs to increase with the ACA.  In the future, many small businesses may be less likely to provide health insurance for their workers and many small business owner’s may even opt out of providing health care to their employees. 

Pursuit Physical Therapy may have the answer for many of these small business owners that will allow them to save money, maximize cost effectiveness, and ensure that their employees are receiving high quality patient care!  Call Pursuit Physical Therapy today at 407-494-8835 or visit us at www.PursuitTherapy.com for more information about how to save your small business money!