Being out-of-network means that the clinic has not entered into a contract with individual insurance companies (in-network). Therefore, the clinic is not confined to the restrictions of an in-network insurance.
In an in-network clinic, there will be limitation on the time and the number of visits according to your ‘diagnosis’ and be limited to treating only the symptom according to the referral.
In an out-of-network clinic, there will be one-hour, one-on-one time with a physical therapist and be able to decide the appropriate number of visits depending on patient’s needs, and provides a holistic quality care that considers patient’s whole-body function.
Out-of-network clinics has higher treatment cost each visit compared to the in-network clinics. However, in an in-network clinic patients have a deductible/co-pay of about $30–$70/visit and most in-network clinics see patients 2-3x/week. If you come 3x/week for $70/visit you are paying a total of $210. Your direct one-on-one time with a therapist is only 15-30 minutes and be passed on to do exercises with the physical therapy aids and finish with ultrasound/electrical stimulation/ice/heat. You will also have to make 2-3 trips/week to the clinic. Considering the time and cost effectiveness, some patients prefer an out-of-network clinics.