Cash vs. Insurance: The Dangers of Comparisons

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The best way to market your out-of-network practice isn’t about insurance at all

By Stephanie Telibasa, PT, DPT

There’s a new trend of out-of-network (OON) physical therapists marketing their services online using comparison charts. One column will list all the drawbacks of going to a traditional in-network therapist and the other will list the benefits of seeing an OON provider. Examples like this are popping up on social media, physical therapists’ websites, and even on sponsored ads targeting patients.

These charts are not effective at bringing in new patients, and they could be doing more harm than good (Figure 1).

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As a profession that prides itself on evidence-based care, these infographics lack data. Without a citation, I can only assume that the information was based on personal experience working in an insurance clinic and then transitioning to a cash practice. However, by using big general titles, “insurance” vs. “cash-based,” we are making bold statements to patients that all insurance clinics will have these faults and all cash-based clinics will have these benefits.


In reality, we don’t even agree as a profession on the definition of a 1:1 session. I posed the question “How do you define 1:1 PT?” inside a physical therapy Facebook group and the range of responses were from “the patient getting your undivided attention” to “45 min direct patient care” to “as long as one staff member (PT/PTA/MD/DC/aide) is attending one patient.

One-on-one physical therapy is not a uniform term, nor is it exclusive to cash-based models. Another physical therapist brought up the point that some insurance-based clinics are set up to allow for a full hour with each patient, commenting “…most hospital-based outpatient clinics are one patient an hour with one-on-one time.” I only mentor one-on-one physical therapists and have seen in-network, out-of-network, and cash-based models be successful in providing quality care.

Good practice is to avoid generalized claims in your marketing. Make statements specific to your practice that can be backed with data.


Here are four reasons to stop marketing your practice with statements like, “Cash PT is better than insurance-based PT.”

1. Don’t Lead with Costs

First, other healthcare providers are not leading with cost. The best surgeons, dermatologists, and acupuncturists don’t take most insurance plans. Their websites aren’t comparing their services to providers that accept insurance. It’s an odd approach in healthcare.

In contrast, I have seen this marketing approach used on Amazon quite often. Physical therapists are trying to break away from the traditional medical model, I understand. But, do we want potential patients to make decisions using the same comparison criteria as they would for an everyday household item (Figure 2)?

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2. Talk About Your Results

Second, if your service really is better, then talk about your results. According to this 2020 survey of close to 1,000 consumers, patients value feedback from other patients the most when deciding which doctor to book an appointment with (Figure 3).1 Potential patients care about their peer’s reviews more than the doctor’s background or credentials — and eight times more than the office environment1 (i.e., stop leading with your certs and your new equipment too)!

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Talking about your results can be done in the form of sharing patient reviews, asking your patients for pictures or videos of them back in action (with a signed release form), and telling a story without patient identifiers.

Use this template to share a successful case study as a story:

I’m so proud of this patient I just finished working with.

They came in with complaints of [use exact words from intake forms].

Over [X amount of time], we worked together to reduce their pain by [choose three interventions; be as specific as possible so that the person reading can picture doing the work with you].

Yesterday at our last session, they told me they were able to [activity, sport, pain point]. Cases like this are the reason I opened [practice name]!”

If this template was helpful, read to the end for my step-by-step process of turning reviews into marketing material that will multiply your best patients and carve out your target demographic.

3. It Alienates In-Network Patients

Third, it makes patients who do choose an in-network practice because of various circumstances feel like they’re not getting sufficient care. In sales, we never want to make the consumer feel that they’ve made a poor decision in the past, because they’ll be even more hesitant to make a similar decision in the future. The feeling of “How can I trust myself now if I’ve made mistakes on this topic before?” Basically, it can deter them from physical therapy altogether.

On the same note, it makes our physical therapist colleagues working at these clinics feel badly about the level of care they’re able to give without offering them a solution. That solution very well could be working at your out-of-network one-on-one practice if you can attract patients, implement systems, and provide jobs.

4. It Focuses on Negatives

Last, it feels all too similar to the bully on the playground. Pointing out the other person’s flaws in order to make themself look better. It screams insecure.

So, what do we do instead?

Instead, let’s drive the attention toward the positive.

Physical therapists who are opening one-to-one practices are evolving our field.

WE are in control of how the public perceives out of network physical therapy.

Here’s how we cultivate the perception we want and attract ideal patients to our practice.


When do I ask?

Ask for a review either when your patient comes to a turning point, “I slept through the night without waking up from the pain” or when they are preparing for discharge (1-2 sessions prior).

What do I say?

Use the phrase, “Would you be willing to share feedback on your experience” rather than “…leave a review of working with me.” This takes the pressure off both of you and ensures that the testimonial will highlight their experience as the patient instead of how nice of a person you are. “Steph is the best!” is my least favorite review.

How do I ask?

Make it easy by texting or emailing the direct link. For example, go to your Google Business Profile, click on “Ask for reviews,” then copy the shortened URL into a text or email.


First, read and respond to all of your reviews.

Next, highlight patterns that come up. What words or feelings are expressed frequently? (e.g., “knowledgeable,” “learned about my body,” or “taught me so much.”)

Then, use the same words that your patients use on your social media, website, and if you choose — paid advertisements (I don’t use ads in my practice).

Here is an example of this step-by-step process in my practice:

Patient review, “Great 1-on-1 experience, very different from ‘big box’ PT services.

Our website, “Our patients say House of PT is not another ‘chain PT clinic in NYC,’ but instead a ‘great 1-on-1 experience, very different from ‘big box’ PT services’” (Figure 4, next page).

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Right below this “Sound Familiar?” question is our highest converting button on the entire website. I’m highlighting how we are different from the traditional physical therapy clinic without saying anything negative and without using any of my own words. The results: we attract patients who have been to multiple providers, who don’t want to be told to stop doing the things they love, and who are willing to wait weeks to see one of our doctors because when they read this they immediately feel “that’s me!

You must use the process with your patient’s words that are unique to you as a therapist and the experience at your unique practice in order for this method to be effective at bringing in new patients.


Once you’ve identified the patterns in your patients, you’ll be able to easily replicate the same message across different platforms. I always recommend starting with free marketing like completing your Google Business Profile, Yelp listing (not for reviews), and testing your message on social media BEFORE paying for ads — even magazine articles. Copywriting is a skill and skills take deliberate practice to fine tune.


In summary, the best way to market your out-of-network physical therapy practice is to make the person reading your website feel like you understand their exact situation. The only way to achieve this is by using your past patient’s words to describe their experience. This allows your future patients to relate to peers that have already taken the leap of going out of network. By the time they reach out to you, they’re confident that you’re the right person to help them solve their problem and willing to pay full price for your services.

Money and conversations about insurance coverage belong last. If at the end of your phone call, the patient cannot afford your services or prefers to go in network with their insurance, then make the referral. Do not be afraid to refer out. At House of PT we refer out frequently and we always have a waitlist for new patients. 

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1Software Advice. “How Patients Use Online Reviews.” Accessed April 25, 2023.

Stephanie (Shane) Telibasa, PT, DPT

Stephanie (Shane) Telibasa, PT, DPT, Owner of House of Physical Therapy in NYC. Business tips for physical therapists @theplanningpt, email

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