frequently asked questions
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Sports Medicine Physicians are highly trained orthopedic specialists who understand the human body in motion, better than any other medical specialty. Their unique training and focus on the complex musculoskeletal system (joints, muscles, bones, tendons, cartilage and other connective tissues) means they can diagnose, treat and manage not only injuries sustained, but also illnesses and ailments associated with aging – such as osteoarthritis.
While they are ideally suited to treat athletes, they are also an ideal provider for individuals seeking to maintain a healthy, active lifestyle – creating comprehensive treatment plans for anyone who has experienced a decrease in mobility and / or an increase in pain. Unlike other specialties, Sports Medicine Physicians emphasis non-surgical intervention, offering a range of treatment options, tailored to each patient.
Sports Medicine Physicians diagnose and treat a wide range of conditions related to the musculoskeletal system – from injuries and strains to aging joints and arthritis.
Common complaints that we address are joint and muscle pain, tendonitis, rotator cuff issues, knee, shoulder, neck and back pain, as well as osteoarthritis. Many of our patients visit us when they notice that they are no longer able to comfortably engage in activities they once enjoyed, be it running and hiking to simply being able to walk up stairs.
It is also common for a patient to experience pain in an area of the body, that is not in fact the source of the pain – many times as the body compensates for an injury, aging or muscle weakness, it can create issues in other parts of the body. Sports Medicine Physicians are trained to view and treat the body as a complex interconnected system – not isolated parts.
While both Sports Medicine Physicians and Orthopedic Surgeons specialize in orthopedics, the branch of medicine that focuses on the care of the musculoskeletal system – both specialties approach this care in different ways.
Sports Medicine Physicians are trained to diagnose, treat and manage the complete health of their patients with an emphasis on non-surgical treatment of musculoskeletal conditions – offering comprehensive treatments plans that can include everything from physical therapy and rehabilitation, to non-surgical procedures (such as PRP and Trigger Point Injections) and referrals to surgery if necessary. Orthopedic Surgeons on the other hand, specialize in the operative treatment of musculoskeletal conditions.
At KYNETIC HEALTH, we believe in offering our patients the fullest range of available treatment options and working with them to achieve the best possible outcome – for less than 3% of our patients, surgery may be necessary. In those cases, we work closely with an Orthopedic Surgeon and follow your recovery from the beginning.
Perhaps the most significant difference between a Sports Medicine Physician and a Physical Therapist, is education. Sports Medicine Physicians are board certified medical doctors that specialize in diagnosing and treating musculoskeletal conditions, requiring them to complete at least 8 years of study. Physiotherapists / Physical Therapists on the other hand are required to only complete 3 years of study.
As experts in the field of human anatomy and the musculoskeletal system, Sports Medicine Physicians can diagnose patients in a number of ways, including observing how a patient walks, stands, sits or runs, as well as using advanced diagnostic tools such as x-rays and MRI’s.
Physiotherapists can observe how a patient moves and can document patient complaints – but they can not diagnose a musculoskeletal condition.
It is not uncommon for a Sports Medicine Physician to prescribe Physical Therapy as a form of treatment, especially when a patient is suffering from a lack of flexibility or muscle weakness. In these cases, the Sports Medicine Physician will provide the Physical Therapist with a thorough diagnosis and request treatment in the form of exercise, massage and/or heat – all of which will be overseen by the Sports Medicine Physician.
PRP or Platelet-Rich Plasma is the process in which we use your body’s blood cells – to heal you. We have all observed a clot form where there is a cut in the skin, but platelets in your blood do so much more – they begin the body’s own process of repair. When platelets activate to form a clot, they also release chemical messengers that initiate and organize proteins, intent on repairing the damaged tissue.
Using ultrasound guided injections and precisely placing PRP into the site of an injury can initiate the healing process and many published studies have shown that it is safe and effective in treating a wide spectrum of ailments, including but not limited to : osteoarthritis (arthritis due to aging), tendinopathies / tendinosis (the breakdown of collagen in a tendon), damage to ligaments and tendons, as well as knee and shoulder pain.
While some injuries do require multiple injections, most of our patients notice a significant improvement in pain and function after just 6 – 8 weeks of their injection. As a result of PRP treatment, the vast majority of our patients have successfully avoided having surgery. At Kynetic Health we are committed using the safest, most innovative treatments in order to help you get your active lifestyle back.
Unfortunately at this time, few insurance companies cover PRP. Outside of the treatment for diabetic wounds, PRP is only covered by Tricare Prime – available only to active duty and retirees from the US Military, and only for procedures related to the knees and elbows.
The out-of-pocket cost for the procedure generally starts at $2,000 – a significant expense for anyone. However, the results achieved by this procedure result in the overwhelming percentage of our patients avoiding surgery, regaining much of their mobility and significantly decreasing their pain – permanently. This out-patient procedure also means that our patients lose little to no time from work due to recovery.
The short answer is: not at all insurance plans.
We began our practice during the height of the Covid-19 pandemic because we believed that we could provide an effective alternative to traditional pain management and surgical orthopedics – that we could provide innovative treatment options for our patients. That we could help the people in our community lead healthier and longer lives.
What we weren’t prepared for, was how hard we would need to work each and every day to convince health insurance companies to allow us this privilege. After two years, we have been faced with a decision – compromise our quality of care to continue playing in the insurance companies’ sandbox or take back the reins and be the kind of medical practice we set out to be.
As of September 01, 2022 we will no longer accept commercial health insurances. We made this difficult but necessary decision because we did not want to compromise on patient care in order to appease an insurance company – a practice with long wait times, rushed appointments and a burnt out staff.
Health insurance companies not only dictate how much time we can spend with our patients, what treatments we can offer (and when), but what each the ultimate cost is to the patient themselves. They determine what is an allowable charge – not the provider offering the service. We have as much control over what an insurance company charges you as we do over what they reimburse us – none.
For most patients with high deductibles, your out of pocket expenses may easily exceed $7,000 before your health insurance ‘kicks in’ – with no insight into what something costs until after you have received treatment and are faced with a hefty bill. Our approach allows us to be upfront and transparent about the cost of our medical care and we will work with patients to create a fair payment schedule.
Patients with a Health Savings Plan may be able to use it to cover their expenses and patients with commercial health insurance may be able to submit their receipts for reimbursement. We strongly encourage you to contact them before scheduling your appointment.
Quite simply it is medicine delivered directly to the patient without interference by an insurance company. It is unfortunately not enough for a physician to have graduated from medical school, successfully completed their residency and fellowships, and have worked for decades in their field in order to determine what is medically necessary for their patients without having to seek approval from an insurance agent – living or animated. Insurance companies determine what is reasonable and necessary – not because they have an understanding of a patient’s individual medical needs, but because it is what is written on a computer screen in front of them.
With direct medicine, we are able to offer our patients treatments that we believe offer them the best chance of success at a price we believe is fair. No authorizations required, no risk of denials and unexpected charges. At Kynetic Health, our patients pay for our time and they get our full attention.
We do not base our prices on itemized codes, but by the time we dedicate to each patient at each visit. This means you do not have to worry that an extra question could mean an extra charge. For complete transparency, we make our fees readily available for all our current and prospective patients – view a current list of our fees here. Please note that the prices listed are based on singular, individual treatments – should a treatment plan be recommended with multiple visits, we will bundle those appointments with a cost savings to our patients.
We have three appointment types based on the time spent with your physician – all of our physicians have a limited panel of patients and are all specialty trained. We do not double book appointments and we do not rush from appointment to appointment – your time is your time.
Very few insurance plans come with no out-of-pocket expenses to the patient, despite the fact that most of us believe our health insurance coverage will do just that – cover our medical expenses. Most commercial insurances come with a co-pay, coinsurance and / or deductible – the amount of which is almost always determined after services are rendered and a patient receives their statement in the mail. For many patients, it is these unexpected costs that make healthcare unaffordable.
Instead, we are able to let our patients know in advance what their treatment will cost and work with them to structure a manageable payment plan. For those with a Health Savings Plan, these expenses may be covered and for those with insurance, your insurance company may reimburse a portion of these costs. We encourage you to contact your carrier for more information.