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Insurance and Pricing FAQ

Insurance and Pricing FAQ 1080 1080 ResilientRx

When searching for the right physical therapy clinic, many prospective patients will want to know whether or not that practice takes their insurance. 

In fact, it’s such a common question that we receive at ResilientRx, we thought we’d make this video to help you gain a better understanding of how the insurance process typically works with PT.

ResilientRx is an out-of-network physical therapy provider. This means that we do not work directly with your insurance, but can give you a super-bill if you have out-of-network benefits. Let us break down insurance because it can be confusing. Sometimes going through your insurance can be much more expensive, but many people are not aware of this.

What is covered anyway?

In traditional, insurance-based PT clinics, also known as in-network clinics, there can often be limitations depending upon the specific carrier and plan a patient has. Each code and treatment plan has to be the exact codes that your insurance covers, which does not commonly happen.

For example, there may be certain situations where some services are not covered, such as dry needling. You could receive additional bills long after you’ve completed physical therapy or only a certain number of visits authorized by the insurance company.

And when certain services aren’t covered, or visit counts are limited, there are many times when the physical therapist has to get on the phone with someone from the insurance company, to justify medical necessity for continued services. 

This takes precious time away from what matters most: caring for our patients.

Transparent Pricing 

Since ResilientRx is out of network with all insurance carriers, we have the ability to have transparent pricing. There are no surprise bills that you’d ever receive later on. You may think going in-network will be less expensive, however it is not uncommon for certain codes to not be approved which means that on paper it is “covered” when in reality it may get denied and you have to foot the bill months later.

And we have the freedom to work with our clients on their own time, without the insurance company placing restrictions on services or the number of visits.

Below are our prices, however we do offer packages that are good for a year which can discount the rates. Please note all evals are 60-90 minutes to allow for a full evaluation and assessment for future visits

Pricing:

Dr. Mary: $160: 30 min; $225: 60 min; $299: 90 min (Orthopedic and Pelvic Floor)

Dr. Arista: $199: 60 min; $275 for 90 min (Orthopedic and Pelvic Floor)

Dr. Nick: $120: 30 min, $180: 60 min, and $250: 90 min (Orthopedic)

Deductibles

Let’s talk briefly about deductibles. A deductible is a specific amount of money that the patient must pay before an insurance company will pay for a claim. 

If you have a high deductible plan, let’s say $5000, then you may be paying out-of-pocket anyway for each visit during your entire course of PT.

Let’s say your copay (the amount you owe every visit) is $50. 

In the traditional in-network model, you are often coming 2-3 times per week and spending $100-$150 weekly.

If you go to a hospital based PT clinic, sometimes the charges can be upwards of $400/visit because they charge hospital rates even though you are not technically in the hospital.

And we’d argue that if you are not seeing a physical therapist 1:1, your visits tend to be less efficient and it may take you longer to get better.

More Efficient care

Since we only offer 1:1 care with Doctors of Physical Therapy, we feel our visits tend to be more efficient. This means our clients come less often and get better faster.

Less expense in the long-run

Less time away from work or home

Better quality care.

What’s the main takeaway?

We work for YOU and not the insurance company.

We hope you found this video to be helpful in answering any questions you may have about insurance.

Feel free to reach out to us and we’ll be happy to walk you through this process and answer any questions you may have.

The Benefits of Pilates

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Have you tried Pilates? It could be the perfect complement to your current workout regime, or the start of one. 

Pilates may be a bit intimidating, especially when you see the equipment available in most studios. But that doesn’t mean Pilates is out of reach for you —  it’s great for people of any fitness level! With the right instructor, you can actually see a number of benefits. But first…let’s clear something up: What exactly is Pilates? And why would you want to give it a try?

What is Pilates?

Founded by Joseph Pilates in the early 1900s, Pilates was originally created for dancers and athletes. Today, though, Pilates is for everyone! That’s because Pilates focuses on lengthening and stretching all major muscle groups, centered around the core then working outward. The exercises bring the body and mind together to improve flexibility and strength throughout the entire body. 

Benefits of Pilates

Pilates is both a therapeutic and preventative exercise, perfect for anyone who wants a great workout or who is looking to recover from an injury. It brings awareness back to the breath and body, while strengthening muscles, starting in smaller areas that “normal” workouts don’t necessarily hit. We also love Pilates because it can help you elongate your spine muscles and body as a whole, which can improve posture, reduce pain, strengthen muscles, and (of course!) improve mood. 

But let’s dig into all of the technical benefits of this amazing exercise method:

Flexibility and mobility

Flexibility is the amount of stretch in a muscle, whereas mobility is the range of motion in a joint. We strive for mobility in the body, but you must have a balance of flexibility and strength to really improve your mobility overall. The great news is that Pilates helps to address both. The slow, yet fluid and controlled movements in Pilates exercises combine both strength and stretching at the same time. Plus, it feels amazing!

Core strength

When you think of your core, most of us think about just our abs, but your core is so much more than that. The core muscles include the diaphragm, deep muscles of the back and abdominals, and pelvic the floor. They support a strong back, good posture, and every movement of the body. 

With its emphasis on the core, Pilates helps to improve core strength which then has a cascading impact on every other muscle in the body. Core strength has been shown to be vital in reducing back and hip pain, pelvic floor dysfunction, and supporting “explosive movements,” like running or jumping. 

Muscle tone

As you strengthen your core with Pilates work, you will notice its impact on other parts of your body, too. For example, lower back pain which can be reduced or relieved through Pilates workouts.

Of course, this also means that you’ll notice more definition in your muscles, from your arms and legs, to smaller muscles along your side, on your shoulders, and more. It’s not just about “ripped muscles,” though. With Pilates, improving overall muscle tone can make such a difference in your daily experience — creating a body that is stronger and more flexible, reducing overall pain and improving mobility.

Injury prevention and rehabilitation

Keeping the body well-balanced is crucial for all injury prevention. Pilates helps to balance the body’s muscles so they are supple and strong. For athletes specifically, research has shown that Pilates is effective for reducing sports injuries during play, as it focuses on dynamic strength that is necessary for quick movements. 

The movements in Pilates are also considered low-impact, thanks to equipment like the reformer and the cadillac, which absorb most of the weight of the body. This means that people with joint and muscle pain or past injuries can heal without additional irritation. What’s more: as your core and strength overall improves through practicing Pilates, increased stability in the body helps to protect joints while running, jumping, or simply doing activities of daily living. This makes Pilates the perfect addition to a physical therapy regimen.

At ResilentRx, we integrate Pilates into our practice with each and every client who comes to us for physical therapy. Our Pilates instructor, Amberly Jayde, has the unique opportunity to work with our clients, knowing their past injuries and history with PT, which helps her address their specific needs during Pilates sessions. 

Sleep and stress reduction

Quality sleep is something we talk about a lot at our practice, as it is a huge factor in preventing injury and helping the body recover. Practicing Pilates regularly has been shown to lead to better sleep along with helping reduce overall stress, taking you out of that “fight-or flight” feeling.  

While general exercise helps reduce stress as it increases endorphins, Pilates also utilizes breath control. Not only does breath work address stressful feelings in the moment, but it balances the body’s autonomic nervous system which reduces the development of anxiety or depression. By integrating breath work with movement, taking time to practice Pilates can really improve your overall mental wellbeing.

Let us help

Remember, everyone’s health journey is different, but Pilates can be beneficial for you — no matter your athletic ability or fitness level.

If you are having pain that limits you in your day to day life, reach out to us for support. Our team of PTs have extensive training that addresses anything from athletic injuries and pelvic floor dysfunction to knee and hip pain. Combined with our in-studio Pilates, you’ll find whole-body care and relief. Book a free phone consultation today!

PH Scale

Why do I keep getting yeast infections?

Why do I keep getting yeast infections? 1024 540 ResilientRx

Chronic UTIs, bacterial vaginosis and yeast infections can occur for a variety of reasons.

In order to understand why chronic vaginal infections occur, we need to review the pH scale.

The scale goes from 0-14:

  • 0 being acidic
  • 7 is neutral
  • 14 being alkaline (or basic)

In its natural state, the vagina is more acidic, with a pH of about 4. Changing the pH of the vagina can have a direct effect on the vaginal environment which can cause a variety of symptoms.

Here are a few things that can change the vaginal pH:

  • Sperm: This is more basic, ~7 pH. Some may think they are allergic to sperm, but in reality that their vaginal pH is off which is causing a reaction to the sperm.
  • Stress: Increased blood sugar
  • Soap
  • Detergent
  • Lube
  • Diet: Foods high in sugar
  • Douching
  • Wet clothing
  • Tight clothing: Clothing that traps moisture
  • Medications: Like antibiotics
  • String from the IUD
  • Decreased estrogen: Menopause, breast feeding and taking oral contraceptives decrease estrogen, which decreases acidity (Harvard Health Publishing, 2019)

Decreased acidity in the vagina can cause:

  • Dryness
  • Yeast infections
  • Recurrent UTIs
  • Bacterial vaginosis
  • Pelvic pain

Maintaining healthy bacteria in the vagina is important in reducing risk of infections.

Lactobacillus is the most dominant bacteria in the vagina (over 70% in asymptomatic reproductive age women). It also produces lactic acid which causes the acidity in the vagina and this is what keeps the vaginal environment in equilibrium. Loss of lactobacillus is linked to chronic bacterial vaginosis (Tachedjian, et al., 2017).

In addition, bacterial vaginosis (BV) can cause issues with fertility.
“Bacterial Vaginosis is three times more common in infertile women than fertile women” (American Pregnancy Association, 2020). BV, and other infections in general, can decrease fertility in a number of ways:
  • Increasing inflammation and immune system activity, making a toxic environment for reproduction
  • Causing damage to sperm and vaginal cells
  • Interfering with the production of healthy cervical mucus during ovulation
  • Blocking the fallopian tubes through scar tissue damage from infections, so that sperm and egg can’t meet” (American Pregnancy Association, 2020).
If you are experiencing chronic pelvic infections, you may want to consider looking at some of the suggestions above to see if restoring your normal vaginal pH can help reduce your chronic infections.

Tips to reduce chronic pelvic infections:

  • Only wash your vulva and vagina with water
  • Try to use unscented detergents without harsh chemicals
  • Try a low sugar/carbohydrate diet
  • Reduce your stress levels
  • Air out your vagina: Try going without underwear to reduce bacterial growth from excessive moisture
  • Avoid tight or wet clothing for long periods of time
  • Talk to a pharmacist or your physician about a vaginal probiotic, especially if you are taking an antibiotic
  • Change out your tampons regularly.
  • Don’t douche

As always, you should consult with your physician first.

Written by: Mary Grimberg PT, DPT, OCS

Sources: Harvard Health Publishing. (2019, March). Vaginal yeast infection. Retrieved February 3, 2021, from https://www.health.harvard.edu/a_to_z/vaginal-yeast-infection-a-to-z

Tachedjian, G., Aldunate, M., Bradshaw, C., & Cone, R. (2017, April 20). The role of lactic acid production by probiotic lactobacillus species in vaginal health. Retrieved February 3, 2021, from https://www.sciencedirect.com/science/article/pii/S0923250817300839#bib18

American Pregnancy Association (2020, October). Bacterial vaginosis and fertility. Retrieved February 3, 2021, from https://americanpregnancy.org/getting-pregnant/bacterial-vaginosis-and-fertility-68826/

Running Outside

Quarantine Workout Plan

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Have you felt disconnected from your body since COVID-19 hit? Have you been experiencing increased stress affecting your mental health? Judgement around your body?

You are not alone!

We all remember in March of 2020 when COVID-19, something that previously felt so far away, truly hit us at home. We were told to shelter in place, removing us from our regular ways of self care and joy.

Gyms shut down, the demand for at home exercise equipment skyrocketed and then effectively sold out (some still not available today!) and we were left wondering what we’d be doing at home for coming months.

Mental Health, Fitness + Self-Care

When expenses and mental health are challenged many people lose their ability to find an outlet in fitness affecting not only their strength, but their motivation and mental health.

We’ve heard this time and time again- when there are disruptions like COVID-19, “our normal capacities to regulate stress” are undermined. Unfortunately, social connection and physical wellness through movement are protective factors when it comes to our well-being (Katella, 2020) and they took a big hit. It is important to be kind to yourself and continuously remind yourself that you are not alone and you have the ability to return to where you were prior to the pandemic or find a new space of contentment or even joy as you explore new ways of moving and being.

Here at ResilientRX, we are seeing an influx of clients who are significantly distressed about their exercise performance. Many people are sharing that they are the weakest they have ever been in their lives. This has caused not only physical distress, like exacerbating old injuries, but also mental stress as judgment and worry creeps in- “Can I get back to where I was?” or “How can I find calm when my body feels out of alignment or pain and I can’t use my regular emotional outlet?”

Give Yourself Mental Space + Grace

One way to ease yourself back in is to be gentle and give yourself grace. Trying to go back to where you were in February or March may set you up for a future injury and disappointment. This could further exacerbate not only your physical inability to move your body but also your mental fortitude to commit to it.

Yes, many of us have experienced changes in our bodies. Know that it doesn’t change your value as a human. Whether your goal is getting strong, moving your body safely or getting back to your pre-pandemic way of movement and joy, it can happen.

How to safely return to exercising:

Running:
  • Start with walk-jog intervals.
  • This allows your body to slowly adapt to the impact.
    • For example, if you used to run 3 miles a day, try walking for 2 minutes and jogging for 1 minute. Try this for about a mile or so. Give yourself a day to recover, and see how you feel.
  • Are you sore? Maybe try just walking or riding a bike to allow your body to actively recover.
  • Are you experiencing joint pain? Try decreasing your distance or decreasing your jogging time and try again.
Weightlifting:
  • Try to wean back into your workouts with higher repetitions and lower weight. This allows your body to slowly adapt to the weight changes. Try out a few different things:
    • For example, if you were lifting 100 lbs prior to COVID-19, try ¼ of the weight first to see how you feel. Try doing higher repetitions of the 25lbs and see how you feel the following few days.
  • If you feel no difference, then increase your weight
  • If you feel pain in your joints, try to decrease the weight
  • If you feel just sore, try to stay at that weight for a week or so and slowly increase the weight.
HIIT training:
  • Before adding impact or high intensity interval training, make sure you have a base level of strength.
  • If you can perform a push up, a full body plank and a squat with proper form and without pain, you likely can start pushing yourself with interval training or impact.
  • If you cannot do these yet, try slowly working up to these exercises.
  • If you cannot do a push up or a plank, over a couple of weeks, try a push up or plank on a wall first, then on a counter, then on a chair then on your knees.

Always check in with yourself and ask:

  • Am I sore in the muscles that I am targeting?
  • Is this pain in my joints? If so, decrease your weight and/or correct your form

If you have any specific questions about your exercise routine, we would be happy to do a telehealth or in person visit. Our goal is to help you meet your goals and to empower you to understand your body so you stay active, pain free and stress free.

We are here for you and you are never alone! ResilientRx is your team and we are here to help you overcome this crazy time! Click HERE to book an appointment.

Have some questions? You can book a phone consultation HERE.

Written by: Mary Grimberg PT, DPT, OCS & Francesca Budesheim, MSSW, E-RYT

Sources:

Katella, K. (2020, August 05). Taking Your ‘Mental Health’ Temperature During COVID-19. Retrieved January 07, 2021, from https://www.yalemedicine.org/news/mental-health-covid-19