Direct Access- It’s Physical Therapy Without a Physician Referral.
Maybe you have nagging knee pain every time you run more than a mile. Or you woke up with a kink in your neck. Perhaps you’ve been dealing with low back pain for years and have never tried physical therapy.
Direct access could be for you.
Louisiana is now a “DIRECT ACCESS” state. As of June 2106, legislation in Louisiana was passed allowing licensed physical therapists to evaluate and treat patients without first seeing a physician. As a “Direct Access” patient, you do not need a prescription from your physician to receive out-patient physical therapy. You may start treatment the minute you feel pain!
As a “DIRECT ACCESS” provider, physical therapists can utilize their skills and training to the fullest, to offer interventions for, and prevention of impairments, functional limitations and disabilities related to movement and the restoration of function. Our expert physical therapists proficiently evaluate a patient’s condition and identify ways to resolve and or improve musculoskeletal and neuromuscular issues. These therapists are also trained to recognize the red flags and other indications which make a referral to another appropriate healthcare provider necessary.
Physical therapists are also well-qualified to recognize when patients demonstrate conditions that should be evaluated by other healthcare professionals. We will suggest a referral to other health care professionals if necessary. In addition, with your permission, we will send our results to your physician and will work in conjunction with him/her.
Direct Access Advantages
Reduces healthcare cost for patients and for Louisiana.
Direct access states have found that patients have 86% fewer visits on average than referred patients and no unnecessary co-pays or imaging).
Reduces opioid use through the use of mechanics, not pain pills.
Louisiana is one of 13 states with the highest number of painkiller prescriptions.
Keeps more Louisiana physical therapy students in Louisiana’s workforce.
On average, PT schools lose 20% of graduates to out-of-state jobs. They are trained to practice in direct access states (national board exam), and this bill will now keep them at home in Louisiana.
Strengthens the collaborative and innovative health care system in Louisiana.
Allows for prompt attention and service.
Ability to choose your physical therapy provider.
Referral not required.
Frequently Asked Questions
What Is Direct Access?
is the ability to see a physical therapist without first obtaining a referral from a physician
How Does Direct Access Work?
You may come directly to ELITE Physical Therapy to receive an evaluation and treatment for any pain. That means we can treat that acute or chronic shoulder, elbow, wrist, hand, neck, back, hip, knee, ankle, or foot injury right now! Upon completion of your Physical Therapy Evaluation, we will determine your treatment plan. If further diagnostic tools (e.g., x-ray, MRI, etc.) are needed to ensure proper care, we will communicate our findings with the physician of your choice.
Who is eligible to be seen via Direct Access?
Should I use Direct Access, or see my Physician first?
allows you to use Physical Therapy as an entry point for your healthcare needs. Your physical therapist will evaluate your condition and develop a game plan for you. Our team works as part of the entire medical team to provide the most appropriate treatment plan. If the appropriate care is outside our scope of expertise, we will refer you to the proper healthcare provider.
Why Choose ELITE for Direct Access?
With decades of combined physical therapy and occupational therapy experience, we understand that independent of our technical skill and clinical expertise, each person that walks through our door requires a compassionate approach that puts them ahead of their diagnosis. We promise to do just this...to treat you like our family, and to care for you like one of our own.
How do I schedule an appointment and insurance benefits?
Physical therapy is a covered benefit under insurance plans. As licensed medical providers, physical therapists can be accessed directly without a referral or recommendation from your medical doctor for musculoskeletal issues. Insurance coverage for your physical therapy benefits are plan-specific. Most insurance companies do not require a referral from your physician, but some do.
Currently Blue Cross/Blue Shield, Aetna, Auto Claims, and other third party payers will pay for physical therapy services rendered under direct access, however, the benefit is plan specific. Medicare does not pay for direct access to physical therapy at this time, but physical therapists can perform an evaluation under direct access. As long as a physician signs off on a treatment plan, we are able to bill Medicare.
We are happy to verify your physical therapy benefits for you prior to scheduling your first visit. Simply contact our clinic and we will outline your physical therapy benefits so you can make an informed decision. You will receive information on referral requirements, co-insurance, co-pays, and your total annual benefit. We do offer cash rates for your convenience and for services rendered outside insurance plan coverage, which can be very cost effective.
Which Insurance Plans Cover Direct Access?
Although insurance is always changing Cigna, Blue Cross Blue Shield and many private health insurance companies are covered under Direct Access. As long as the physical therapist establishes a plan of care for the patient, care is covered under Medicare. Just keep in mind that for continued treatment, the physical therapist must have the plan of care approved and signed off by your physician.
What if MY Insurance Company Requires a Referral for Physical Therapy?
If you want to see a physical therapist, but your insurance company requires a referral in order to cover the care that you will receive, you will need to obtain that referral. The only exception to this is if you are willing to cover the costs of physical therapy yourself.
To obtain the referral, make an appointment with your primary care provider.
Acceptable providers include a physician, a physician’s assistant, or a nurse practitioner. Discuss the issue you are having and express an interest in physical therapy.
If the medical provider approves, they will provide you with the referral needed by your insurance company. If not, they will inform you of other options you have at your disposal.
We encourage patients to come by and set up an appointment, even without a doctor’s referral. And if you don’t have a doctor, we have great relationships with many specialized practitioners in the community we serve and can help connect you to a trusted local physician.
Give us a call at 318-443-3311 to make your appointment today!