Do you take insurance?
Our payment model is cash-hybrid, meaning we collect payment up-front, bill your insurance if possible, and then lower your rate when you meet your deductible and your insurance begins partial coverage. We reimburse any overage you may pay. This is different than the traditional insurance model.
Rates are $199 upfront and decrease to $149, $99, or $49 with out of network plan coverage. We will know this after the claims come back.
Do I need a prescription or referral from a doctor?
PT is “direct access” in NY State, meaning you can come in without one. We do ask that you get one if you are under the care of any doctor, just to protect you in the event your insurance asks for proof of “medical necessity.”
Why aren’t you in-network?
Our model of hands-on, one-on-one attention cannot sustain in-network rates from insurance. We have to pay our clinicians and rent, and that’s impossible with in-network rates. When you go in-network, your therapist’s time and care will be divided. It’s simple math, quality vs quantity.
Why do I have to pay when I have insurance/ Why don’t they cover it from the start?
All insurance plans have a deductible, which they determine. Until they determine that you have met this amount, they will not start partial coverage. Keep in mind that insurance companies are unregulated private companies, they are not “healthcare.”
What do you mean “they determine that you have met this amount”?
Insurance companies also use a term called “Allowed amount,” which is again, not a “set amount.” The allowed amount is how much they determine they are going to put towards your deductible. The allowed amount is also where the insurance company will start their percentage of coverage. Confusing? Yes. Predictable? No.
When I come in do I see the same therapist every time?
Absolutely. You will have one main clinician in charge of your care. They will work with you to achieve your goals. As you progress with strength, you will see Greg Laraia, ATC for higher level strength programming. Occasionally, you will be asked to see another therapist if yours is out, in which case the covering therapist will be briefed from your main clinician on your case.
What if I am unhappy with my clinician/ care/ experience?
At Custom, we want your experience to be wonderful, not just ok. If it is not, we want to know about it and make it right. You can speak to our office manager on-site Cristina Tummillo, or email Wendy@nycustompt.com to contact our owner Wendy Winn and you will receive a response to your issue within 24 hrs!
How long do I have to come for?
This is 100% dependent on the chronicity of your problems and your goals. Your therapist can answer this question and let you know what you are currently working on, every visit!