Understanding Out-of-Network Benefits: How to Get Reimbursed for Physical Therapy

When people hear “out-of-network,” they often assume it means “not covered.” But that’s not true. Many insurance plans include out-of-network benefits, which allow you to get reimbursed for services at a clinic that isn’t directly contracted with your insurance — like Valley Knights Physical Therapy.

Here’s how it works, why it matters, and how you can make the most of your benefits while getting the quality care you deserve.

What Does “Out-of-Network” Mean?

When a clinic is “in-network,” it has a contract with your insurance company to accept their rates. “Out-of-network” means the provider doesn’t have that contract — but you can still submit claims for reimbursement, depending on your plan.

At Valley Knights PT, we’re an out-of-network, cash-based clinic, which means you pay directly at the time of service. Then, if your plan includes out-of-network benefits, you can get reimbursed for a portion of your visit cost.

Why It’s Worth Going Out-of-Network

While it might sound easier to stay in-network, the quality and flexibility of care you receive out-of-network are often far superior. Here’s why:

1. One-on-One Time

Every session is spent entirely with your physical therapist — not a tech or aide. That personal attention means better assessments, customized treatment plans, and faster progress.

2. No Insurance Limitations

We don’t have to wait for approvals or follow arbitrary visit limits. You and your therapist decide what your body needs — not the insurance company.

3. Better Outcomes, Fewer Visits

Because care is hands-on and highly individualized, most patients improve in fewer total sessions, saving both time and money.

4. Simple, Transparent Pricing

You’ll always know exactly what your session costs — no surprise bills or “adjustments” weeks later.

How to Use Your Out-of-Network Benefits

If you have a PPO plan or certain employer-based insurance plans, you likely have out-of-network coverage. Here’s how to use it:

1. Ask your insurance company: Call the number on your card and ask,

○     “Do I have out-of-network physical therapy benefits?”

○     “What percentage of each visit is reimbursed?”

○     “Do I have an out-of-network deductible?”

*At Valley Knights Physical Therapy we can even do an eligibility look-up for you!

2. Pay at your appointment: You’ll pay Valley Knights PT directly at the time of service.

   
   

3. Submit your receipt: We’ll give you a detailed superbill (itemized invoice) to submit for reimbursement.

   
   

4. Get reimbursed directly: Your insurance company sends the reimbursement check straight to you.

   
   

It’s simple — and it gives you freedom to choose the therapist you trust, without being limited by a network list.

The Bottom Line

Out-of-network benefits were designed to give you options — and at Valley Knights PT, that means more personalized care, better results, and a therapist who’s 100% focused on you.

You may already have coverage for care that fits your goals better. If you’re not sure what your plan includes, we’re happy to help you check your out-of-network benefits and walk you through the process.

📞 Contact us today or visit valleyknightspt.com to learn how easy it is to use your insurance while still getting top-quality, one-on-one care.