Why We Don’t Take Insurance

Before starting Ninja Physio, I worked at physical therapy clinics that accepted insurance. Within just a few months, I became frustrated by how health insurance actually incentivized lower-quality treatment and often led to worse outcomes for patients.

Here are some of the main issues I encountered as an in-network provider:

1. Limited to One Body Part per Referral

Insurance only allowed me to treat the body part listed on the referral. If the doctor made a mistake (e.g., wrote “right knee” instead of “left”), I was still legally bound to treat only what was written. Worse, if the pain was referred from another area—like foot pain stemming from the back—I couldn’t address the root cause. I could only treat the symptom area specified on the prescription.

2. Double or Triple Booking

Insurance models emphasize quantity over quality. This often meant seeing multiple patients at the same time, limiting the individual attention each person received.

3. Lack of Continuity of Care

If a patient canceled or rescheduled, the clinic would fill my open slot with someone new—sometimes just an hour before their appointment. I wouldn’t have time to review their case or consult with their previous provider, leading to confusion for both the patient and me.

4. Excessive Paperwork and Unnecessary Visits

Insurance required an overwhelming amount of paperwork for evaluations, re-evaluations (every 30 days), and discharges. Many appointments were spent doing paperwork and tests instead of actual treatment. The documentation burden was so heavy, I often had to spend hours after work finishing notes—leading to stress, burnout, and less energy for patient care.

5. Longer Plans of Care, Worse Outcomes

Insurance incentivizes more units billed and longer plans of care. Skilled providers who could solve problems efficiently were punished by the system. Instead of innovating and focusing on solutions, we were stuck in a system designed to keep patients coming back unnecessarily.

In conclusion

It’s not that insurance-based physical therapy doesn’t work—I did help some patients under that model. But many didn’t improve because of factors outside my control: inconsistent scheduling, split attention due to overbooking, delays in authorizations, or patients dropping out because they couldn’t attend 2–3 sessions a week during business hours.