How One Physical Therapist Escaped the Health Insurance Beast

The Business of Private Pay Physical Therapy

Better is handling more and more physical therapy claims and one of our strongest advocates is this field is Yves Gege, Founder and CEO of Made2Move, a growing private pay practice with locations in South Carolina. Physical therapy presents unique challenges working outside the insurance based model and we wanted to learn more.

A Beautiful Thing

Yves Gege has very personal reasons for getting into physical therapy. He had a special needs little sister who needed a physical therapist.

“I was 10 years older and she had cerebral palsy along with multiple other developmental delays, and I saw the special bond she had with her physical therapist and thought that it was amazing to see that kind of connection — a beautiful thing! And that’s the kind of connection I want to make with other people. So, I decided physical therapy was the profession for me.”

Also, as a soccer player, he had his own experience with injury and recovery.

“I had multiple injuries including knee dislocations and had a physical therapist who I admired a lot. He took the time and showed me anatomy, what was going on, and I thought this is a really amazing profession.”

Finally, Yves admits he is not the type to sit behind a desk in an office.

“I have way too much energy. It was a way for me to stay on the go, stay on my feet and keep my body moving — and serve people which I’m very passionate about.”

Moving from Insurance to Private Pay

Yves graduated with a master’s in physical therapy and started his career running an insurance based practice in an orthopedic hospital setting. He did not enjoy the experience.

“My physical therapists were very unhappy, and very underpaid. Also, they had to see a very high volume of patients in order for the business to make money.”

The problem for Yves was having to deal with the “health insurance beast”, as he calls it. The low amounts the physical therapists were paid per patient by the health insurance companies put immense pressure on them to see a high volume of patients in order for the business to make money. Also, the billing process caused further problems.

“Insurance companies are very difficult to deal with and we lost a ton of revenue due to accounts receivable for money that would never get paid.”

However, most importantly, Yves felt that the insurance-based practice was not allowing him to do the best job possible.

“I couldn’t really serve a patient very well if I couldn’t spend a significant amount of time with them. I wanted to give every patient I saw the same experience that I had as a kid. I couldn’t do that in an insurance-based model so I decided to build an out-of-network private pay model instead. That way my patients receive the best version of myself.”

Patients will pay for Physical Therapy

So Yves changed his practice. Founding Made2Move took Yves out of the insurance-based system and into a very different private pay environment. However, it was not as difficult he imagined and he feels that too many physical therapists do not use private pay because the existing system is so established.

“The way it is done is that patients go see a doctor and are prescribed physical therapy. We treat them two or three times a week or whatever the protocol entails, seeing anything from 15–30 patients a day, and that’s just how it is.”

However Yves is a powerful advocate for the alternative and sees it as a question of financial self-confidence.

“The biggest barrier for physical therapists is that some feel that clients will not pay cash. They don’t see how valuable they are. I’m super passionate about this. We are much needed in this world and just as valuable as any other healthcare practitioner.”

This was the impulse that drove the creation of Made2Move, the belief that patients would be willing to pay for healthcare they needed. The practice is very patient focused.

“We like to empower our patients so that they don’t feel they’re broken or fragile or weak. We continue to emphasize that the body is very strong and resilient. It is very adaptable and there are real alternatives to surgery and pharmaceuticals and shots and we want to be the ones to provide those alternatives and show them that the body can heal itself.”

Yves has an approach that takes his patients out of the doctor/surgery route and looks for alternatives.

“For example, say we have a patient with a rotator cuff tear in the shoulder. One route would be go to a doctor to get a MRI, cortisone shots and even surgery — and not really address anything else. We take time with them, understand where the patients come from, what kind of training they’ve done, how much they move or don’t move. After we get their story, we show them what’s going on with the anatomy, typically provide therapy as exercise or manual treatments, to get them stronger.”

Filling their appointment book hasn’t been a problem but Yves has changed his client outreach. He has build the practice to be part of the community, running workshops in local gyms.

“I meet with many health and fitness professionals to show how we work. We go to a Cross Fit gym and do a workshop on shoulder health or we do workshops for women on staying healthy or getting back to working out after having a baby. We also do a lot of online marketing — and the biggest thing is we grow because of word of mouth. We do a good job and the patients tells their friends — and so we have a full schedule!”

To build on his success, Yves has also founded a seperate startup, PT OnDemand, a practice management software serving the private pay physical therapy community.

“I had to use different software for scheduling, that was different from my electronic health records software, my home exercises programs, and list goes on and on. And I decided that if there was nothing out there in the PT community, I would try to build it. That’s how PTOnDemand was born — a platform where a physical therapist can manage their office, where patients can login and schedule appointments online, receive their superbills automatically.”

How Better Helps Yves

Yves discovered Better by going down the “internet rabbit hole.” He came across a tweet from Halle Tecco (an investor in Better) that said,

“Better is really helping out-of-network patients get their cash!” and I thought “What! That sounds amazing!” This is something my patients desperately need because our practice doesn’t handle any insurance. We just give our clients superbills. So I followed the link, read more about Better and then reached out, let them go after the animal that is the insurance company on behalf of my patients so they can get more easily reimbursed. Very excited to find it. It was awesome.”

His patients responded very positively.

“My patients were really happy. They all understand that insurance companies are uber-complex and difficult to get a hold of. You have to send multiple faxes, talk to multiple people so as soon as they find out that “There’s someone who’ll handle this for me?” For free if it goes towards their deductible and only 10 percent if they get reimbursed.”

“Better has been a no-brainer for a lot of my patients. Anyone who can claim back money is really excited about the app.”

Yves concludes by pointing out how Better doesn’t just help his patients but also helps his business.

“We put all of our value in patient treatment, and don’t focus on the insurance beast. That’s why I like Better. We refer our patients to the app and Better take care their claims. If they have out-of-network benefits, then it’s cheaper for them to come to us.”

If you’re a physical therapist who wants to learn more about private pay practices, check out PTOnDemand or Yves’s Facebook group for PT Entrepreneurs. Better is really looking forward to working with Yves and Made2Move in the future and helping physical therapy clients get paid back by their health insurance.

Do you need Better brochures for your practice? Request them online or get in touch with your questions at providers@getbetter.co