Out-of-Network Provider: Why I Choose a Cash-Based Model

The Problem with the Insurance System

It’s no secret that our healthcare system is imperfect. Most of us have experienced the headaches of insurance companies not covering services, charging massive copays, and lacking transparency with their prices and policies. We’ve also felt the frustration of short appointment times and feeling like we’re not being truly heard.

It’s frankly a mess, and it’s even more convoluted on the provider’s side.

Why Reimbursement Rates Matter

Insurance companies have been steadily decreasing the amount they reimburse providers for their services. Because of this, healthcare providers are often forced to shorten appointment times and see more patients per day just to stay financially viable. This high-volume approach is exhausting, unsustainable, and a leading cause of burnout among providers.

The Rise of Cash-Based Clinics

This trend is one of the reasons why you may have noticed more cash-based clinics popping up, especially in states like Colorado, where reimbursement rates are especially poor. You might have come across “concierge doctors” offering membership plans in exchange for reliable, comprehensive care. Similarly, if you're looking for a specialist physical therapist, you might find that they don’t accept insurance and instead operate as a cash-based practice.

For example, Lavender Roots operates in this way!

“Why Don’t You Accept Insurance?”

One of the top questions I get when talking about my business is:
“Why don’t you accept insurance?”
It’s a fair question—and I’m always happy to explain my reasoning.

More Time, More Attention, Better Care

By operating as a cash-based provider, I’m able to offer hour-long (at least!) one-on-one appointments with every patient. I’m not required to conform to arbitrary insurance rules or get authorization to provide certain treatments. I can treat what needs to be treated, when and how it needs to be treated.

I’m deeply passionate about providing individualized, whole-person care. For example, if someone comes in originally for pelvic floor dysfunction and later starts having knee pain, I can seamlessly switch focus and treat both conditions. That kind of flexibility and personalization simply isn’t possible within most insurance models.

I also love having the time I need with each patient – time to listen, educate, assess thoroughly, and adjust the treatment plan as needed.

A Sustainable Career Choice

I chose this model not only to improve patient care but also because it’s a sustainable choice for me as a provider. In previous roles, I was seeing up to 14 patients in a single day, and that’s not even considered high for many outpatient clinics. Some PTs see 20–25 patients per day.

There’s just no way to give 100% to that many people and still maintain high-quality care.

Now, I typically see only about five patients per day, which gives me the energy and focus to fully address each person’s needs. It also allows me to:

• Follow up with patients outside their appointment times

• Answer questions thoughtfully

• Stay current with research to provide the best evidence-based care possible

When Insurance Does Make Sense

There are certainly situations where using insurance makes more sense. For example, post-surgical rehab often requires physical therapy 2–3 times per week for several months. In these cases, patients should absolutely use their insurance and work with a generalist PT.

When Cash-Based Care Is Worth It

However, if you're looking for specialized care, whether it’s pelvic floor therapy, return to running, climbing-related injuries, or another niche area, then investing in a cash-based provider is usually worth it.

A generalist PT working within a 30-minute session simply isn’t going to be able to give you the same level of individualized, expert care. You deserve more than a rushed visit and a generic handout.

Investing in Yourself

Choosing a cash-based provider is ultimately an investment in your health and wellness. It allows you to partner with someone who is with you every step of the way, who has the time, space, and expertise to treat you as a whole person.

If you have any questions about how this model works or want to learn whether it’s the right fit for you, I’d love to connect.