The Conversation Most Physical Therapists Won’t Have With You

Does this feel familiar: you call a clinic, ask if they take your insurance, and they say yes.

What you realize later is that “taking your insurance” means your insurance company has negotiated what care you can receive, how many visits you’re authorized for, and what treatments your therapist is allowed to provide. Your insurance isn’t just paying the bill. It’s running the clinic and your treatments.

At One80 Physical Therapy in Loveland, we made a deliberate decision after 20 years in practice: we will only work for our patients, not insurance companies. That means we’re out-of-network with all insurance plans — and for most people, that leads to a better experience, faster results and a smarter financial decision.

What “In-Network” Means for Your Care

When a physical therapy clinic accepts your insurance, they’ve agreed to a contract. That contract sets the rules. And those rules are not designed with your best outcomes in mind.

Here’s what those contracts typically mean:

• Visit limits: Your insurance authorizes a set number of visits per diagnosis per year — often 10 to 20. Your therapist must work within that ceiling regardless of what you need.
• Treatment restrictions: Many plans require prior authorization — a process that can take days or weeks and is frequently denied.
• High patient volume: In-network reimbursement is lower now than ever. So, clinics must see more patients per hour to stay profitable. Most therapists have 3 to 4 an hour. Your actual one-on-one time may be 5 to 10 minutes per session.
• Cookie-cutter protocols: Insurance companies approve treatment based on diagnosis codes, not on individual needs. Your plan of care is typically a standardized protocol regardless of your specific needs.

This is a system designed to control costs, not to produce the best outcomes for you.

The Math That Surprises Almost Everyone

Most people assume that going out-of-network means spending significantly more money. The math often tells a different story.

Consider a typical injury (a shoulder problem, a knee issue, low back pain) treated at a conventional in-network clinic:

• Average visits: 10 to 15 per injury
• Average co-pay per visit: $40 to $55 (after your typically high deductible is met)
• Total out-of-pocket: $450 to $750 minimum, plus time,
• plus deductible costs, plus the real possibility of not getting much better.

The same injury treated at One80:

• Average visits: 2 to 4 per episode of care
• Per-visit rate: $105
• Total out-of-pocket: $210 to $420

Fewer visits. Less time. Lower total cost. And, most important,

RESULTS that fix the problem for the long run.

Don’t forget, if you buy a punch pass, your per visit payment can be up to 20% less.

What about a complex post-surgical recovery or a chronic issue that needs more attention. The visit count may be higher, for both in and out-of-network treatment. We will always give you an honest assessment at your evaluation so you can plan with accurate information.

You May Be Able to Get Money Back From Your Insurance Company

Here’s something many patients don’t know: if your health insurance plan includes out-of-network benefits, and many do, you can direct reimbursement from your insurance company.

We also accept HSA and FSA accounts — so if you have funds set aside in a health savings account, your One80 visits are an eligible expense.

No Referrals, Authorizations or Waiting.

One of the most underappreciated advantages of true direct access care is the elimination of the referral and authorization process. In a conventional insurance-based model, getting to a physical therapist often requires 1-3 weeks due to:

• A physician visit to obtain a referral
• Submission of that referral to your insurance for authorization
• A waiting period — sometimes days, sometimes weeks — while the authorization is processed
• Possible denial and appeal process

At One80, you call, you schedule, and you come in. No referral needed. No authorization required. If you’re in pain today, you can start getting better today.

For busy parents in Northern Colorado — juggling work, kids’ schedules, and their own health, this is a huge bonus. One phone call and you’re on the calendar.

What the Out-of-Network Model Lets Us Do Differently

When we’re not constrained by insurance rules, we can practice the way we see fit: one patient, one therapist and treatment focus on root cause and individualized care.

We are not limited to approved treatment codes or billing units. This means we have plenty of time for you and never have to hand you off to an aide.

Every session at One80 is one-on-one with a Doctor who is a certified One80 Provider. Every treatment plan is built around what your body needs, and every visit is oriented toward the single goal of permanent resolution — not temporary relief that just gets you through the day.

This is not a luxury model. It is simply what physical therapy looks like when the insurance company isn’t in the picture.

Frequently Asked Questions

I have great insurance. Why wouldn’t I use it?

Great insurance pays well for many things. Not for physical therapy. The structure of in-network care means less hands-on treatment, more symptom modifications, and more visits to achieve the limited to no outcomes. The question to ask is whether in-network PT will resolve your problem. If it doesn’t, you’ll eventually end up paying out of pocket… for nothing.

What if I’ve already met my deductible for the year?

The relevant question is: will in-network care resolve my problem? If you’ve already been through a round of conventional PT without lasting results, the answer is no — even free treatments wouldn’t be worth it.

Can my kids be treated at One80?

Yes. Our visit packages are household-based, meaning the whole family can use them. For active families in Northern Colorado with kids in sports, this makes One80 an efficient option for the entire household, and gets your cost per visit closer to your in-network payment.

Do you offer any package pricing?

Yes. We offer a la carte visits as well as multi-visit packages, 90% of our patients take advantage of these, that reduce the per-visit cost. Because our packages last for 12 months, this structure also lets you save visits for when you need them most. Call us at (970) 593-9300 for current pricing details and to discuss which option fits your situation

📞 No referral needed. No authorization required.

Call (970) 593-9300 for a FREE consultation.

Sources

1. Pew Research Center — Health insurance coverage and out-of-pocket costs in the United States, 2023.
2. Jette DU et al. Physical therapy episodes of care for patients with low back pain. Physical Therapy, 2009.
3. American Physical Therapy Association — Direct access to physical therapy: state-by-state summary: https://www.apta.org
4. Mitchell JM. Downstream effects of insurance contracting in physical therapy markets. Health Economics, 2018.
5. IRS — HSA eligible expenses, Publication 502: https://www.irs.gov/publications/p502