Casey Negrete is the owner of IMPACT Health and Performance in Ankeny. We talk about his business and discuss the importance of finding the perfect fit for patients, touch on his experience as a D1 athlete, and learn about practicing as a TPI (golf) certified physical therapist. 🤓 Casey works with active individuals at IMPACT and is specialized to work with golfers. ⛳️ Check out his Instagram for “Trick Shot Tuesday” @impact.ankeny 🏌️♀️ Connect with Casey: www.impactankeny.com YouTube: IMPACT Health & Performance 👨💻 Facebook & Instagram: impact.ankeny 📩 firstname.lastname@example.org 📱 515-446-8389
🎧 This week we wanted to introduce you to Scott! Scott Jensen is a Des Moines native. He is a personal trainer, a certified nutrition specialist, and the owner of Big House Gym in West Des Moines. 🏋🏽 On this episode, we chat about his business and what it takes to run a client focused business model. 🧔🏻 He’s had a personal interest in health and wellness from a young age. 🥦 We talk about the path that led him to Florida then back to Iowa and into managing Big House Gym in West Des Moines and the tight knit community they have built there. 👊🏼 🌟Connect with Scott ⭐️ 💙Facebook: Big House Gym & Nutrition and S.jensen0418 📱Instagram: @bighousegym and @mindset180fitness 📩Email: email@example.com 📞Phone: 515-223-7206 www.bighousegym.com
🎧 This week on the podcast we got to chat with Emily Jenkins. Emily has a passion for yoga and helping people. She is the lead teacher at YogaSix and a group fitness instructor at Genesis Health Club DSM. 🧘🏼♀️ Emily believes that fitness starts with your thoughts and beliefs. Her background is in psychology and she understands the power of the human mind. 💆🏼♀️ We discuss all things from yoga practice to navigating fitness through the pandemic. 👩🏼💻 🌟How to connect with Emily⭐️ 💙Facebook: Emily.jenkins.35 📱Instagram: EmilyJenkins0815 📩Email: firstname.lastname@example.org https://www.corebuiltwellness.com https://www.yogasix.com https://www.genesishealthclubs.com/locations/hickman-road.html
On this week's podcast we talk with registered dietitian Mackenzie "Mack" Woolwich. Mack owns MW Coaching where she works with women who are seeking to find food freedom and end the diet and restriction lifestyle so that they can build a healthy relationship with food. Many of Mack’s clients have had past eating disorders/disordered eating habits and she has worked with them to break that cycle and transform their life by freeing them from the food and diet mentality. To learn more about Mack and MW Coaching you can find her on Instagram. Instagram: @mack_woolwhich_ -Linktree for free Facebook community, weekly newsletter, coaching signup.
This weeks episode of The Fit Moines Podcast is with Andrew Seymour, owner and trainer at Seymour Health and Fitness. We talk about his background and what motivated him to not only become a trainer but then start his own business. Andrew has a wealth of knowledge when it comes to training and was named the 2019 Des Moines' Best Local Personal Trainer. You don't want to miss this episode.
To learn more about Andrew and Seymour Health and Fitness:
Facebook (personal): Andrew Seymour
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Ankle sprains are a common occurrence and something that we see frequently at Kaizen. These injuries can range from a minor, first time roll of the ankle to chronic, recurring ankle sprains that just keep happening - sometimes leaving you hobbling around with an ankle that is swollen and black and blue.
Often times these injuries are minor and don't require any x-rays or surgical intervention and can be treated with some physical therapy aimed at gaining strength/stability and proprioception (perception or awareness of the position and movement of the body).
In some injuries, however, you can also have a fracture in the bones of the ankle or even in the foot. When this happens, we often see avulsion fractures where the force on the ankle from the sprain is so much that it breaks off a portion of the bone with it.
We also sometime see what is called a Jones fracture. This is a fracture in the base of the 5th metatarsal, a bone in your foot. The type and severity of these injuries determines how the are treated. A minor ankle sprain calls for early weightbearing through that foot.
However, if there is a fracture, there needs to be a period of offloading and possibly immobilization depending on the severity and how stable the fracture is. If the injury is very unstable, it may call for surgery which means even more rest and healing time prior to a more conservative rehab program initially.
Because of this uncertainty, people often ask if they should get an x-ray or whether or not they need an x-ray before they come see us. The answer, of course, isn't always clear cut and can varying depending on the context of the injury.
Fortunately there is a screening tool, called the Ottawa Ankle Rules, that we can use to help us make this decision:
5 Component to Test:
A. Bony tenderness along distal 6 cm of posterior edge of fibula or tip of lateral malleolus
B. Bony tenderness along distal 6 cm of posterior edge of tibia/tip of medial malleolus
C. Bony tenderness at the base of 5th metatarsal
D. Bony tenderness at the navicular
E. Inability to bear weight both immediately after injury and for 4 steps during initial evaluation
An Ankle X-ray is only required if:
A foot X-ray series is indicated if:
This screening tool has a very high negative predictive value which means that if you CAN take 4 steps AND you DO NOT have tenderness in those specific areas, it almost certainly means YOU DO NOT HAVE AN ANKLE FRACTURE and thus you do not need to get an x-ray.
Now, if you CAN NOT take 4 steps or DO have tenderness in those areas, that does not necessarily mean that you do have a fracture, it just means you should see your physician and get an x-ray.
The specificity (ability of the test to determine if someone has a fracture) of the Ottawa ankle rules is low. It is simply a SCREENING test to RULE OUT if someone has an ankle fracture, not to RULE IN if you do indeed have an ankle fracture.
ANKLE X-RAY SCREENING QUESTIONS
Bachmann, L. M., Kolb, E., Koller, M. T., Steurer, J., & ter Riet, G. (2003). Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ (Clinical research ed.), 326(7386), 417. https://doi.org/10.1136/bmj.326.7386.417
Physiopedia. (n.d.). Ottawa Ankle Rules. Retrieved August 4, 2020, from https://www.physio-pedia.com/Ottawa_Ankle_Rules
Lau, M. (2020, February 1). Do I Need an X-Ray After an Ankle Sprain? 𝙏𝙝𝙚 𝙋𝙧𝙚𝙝𝙖𝙗 𝙂𝙪𝙮𝙨 | Online Physical Therapy. https://theprehabguys.com/x-ray-after-an-ankle-sprain/
As a patient and valued customer, we feel that you should know exactly what you are paying and what you will get. We want you to know that transparency is important to us and that this experience should be about you achieving your health goals and not having to worry about unexpected costs. This means NO surprise bills in the mail months following your visits.
Unlike many other types of healthcare practices, we list our prices online here (and also here) so you know what to expect before you even walk in the door. No guesswork. No hidden costs. Whether it’s an initial evaluation, follow-up session or anything else we offer, know that you are getting our highest quality care, every hour, no matter what.
As a fee-for-service practice, it is important to understand that we do not take insurance or deal with third party billing. We know this isn’t the “norm.” The learning curve is worth it!
If you’ve never dealt with insurance directly, know that they can take several months to pay, they can choose their own rates, and they quickly deny payment whenever possible (after all, that's how they make money). As you may have guessed, this makes it challenging to run a small, private practice.
Here’s what we have found to work even better. Kaizen Health and Wellness chooses (emphasis on this being an intentional decision) a fee-for-service or cash-based model for our practice. In this treatment model, your Kaizen therapist enters into an agreement with YOU to provide physical therapy services in a manner that both parties have decided upon (AKA: FULL TRANSPARENCY with no surprise bills 3 months in) to help you reach your treatment goals most efficiently.
You will pay at the time of service and we do this for a couple of reasons:
A) It's the model that has proven to work best for our business.
B) When you pay, you pay attention.
What I mean by this is that our outcomes are much better in part because you see the exchange of money and want to get the most bang for your buck. By paying ahead, patients show up to their appointments, and they do their program at home.
It seems simple but I've worked in a model where there was no cost associated with the visits (military healthcare) and our outcomes weren't always the greatest and no-shows were through the roof.
When you truly value your health and want to get better, you will gladly put in the work. I know it can seem hard to spend money on something that can take weeks or even months to see improvement, but we promise it is worth it! Stay the course, put in the work and you will reap the benefits.
This model also allows us to focus on providing direct, one-on-one care, while keeping administrative costs low. You may pay for services using actual cash, a check, a credit/debit card, or with your HSA/FSA. In some instances, you may also personally file for reimbursement from your insurance company to curb your out-of-pocket expense. Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide reimbursement for services received “out of network”. We can help you with this process and call your insurance company directly so you know exactly what your benefits look like and what your costs and reimbursement will be.
Cash-based does not mean our team is short on the education, qualifications or accreditations necessary to provide you with best-in-class medical care. Quite the opposite, actually. Our Doctor of Physical Therapy is both residency trained and board-certified in orthopedics - something you won't find in many physical therapists, regardless of practice setting. We blend our unique background in strength, conditioning, and human performance to go well beyond rehab and help you live your happiest, healthiest life.
Want to learn more about why you should choose cash-based physical therapy?
Check out our other blog post titled "Why cash-based physical therapy?"
Ready to book your appointment or want to learn more? Give us a call at 515-339-2906
Telehealth Physical Therapy
Seeing a physical therapist virtually may seem unusual and possibly intimidating but we want you to know that it can work. We can accommodate your orthopedic needs during these unprecedented times.
After all... we’re all adaptable creatures, so here we go!
What Exactly is Telehealth?
Telehealth is two-way, real-time, interactive communication between a patient and a healthcare provider (in this case a physical therapist) from a remote location. Advances in IT infrastructure, communication, and connected medical devices are enabling clinicians to evaluate, diagnose, and treat patients remotely and safely with end-to-end encryption - this means that your information is safe with us. This is great for busy people who don't always have time to go to an appointment or for people that live in remote areas and do not have access to medical services (or those stuck indoors due to a pandemic, I'm looking at you COVID-19).
Perks of Telehealth
While in-person healthcare is great, Telehealth offers a wide variety of benefits including but not limited to:
Through Telehealth We Can:
Physical therapists are musculoskeletal experts and the go-to for orthopedic issues. There are certainly things we are able to help with through telehealth and other things we may want to see you in person for - or maybe you need to see another specialist. If this is the case you will not be charged for your telehealth visit. We really want to be part of the solution for you, especially during our current healthcare crisis.
Have questions or want to learn more about getting started? Simply call us at 515-339-2906 and we would be happy to help you in any way we can.
Ready to book an appointment? Click the button below to schedule the appointment online for a time that is convenient for you:
Movement is Medicine
Hi guys, just wanted to check in and see how everyone is doing! We all know these are challenging times so we wanted to shed some positive light on the situation.
In case you don’t know us outside the practice, I’m Deana, Bryan’s wife and together we have two boys. Jack is five and Henry is two. We also have another baby boy on the way, he is due in early July.
Just like all of you, this pandemic has affected our family and our business both personally and financially. Bryan is now at home full time with the boys, running his practice via telehealth for the time being, while I work as a nurse in a local hospital Monday through Friday. We are so grateful for technology and the fact that we’re living in this time period that allows so much innovation and opportunity, from our home!
I wanted to share some of the positive things we’ve seen over the last few weeks.
This common enemy throughout the world, this virus, has brought us all closer together. We can now clearly see that we are all more alike than different. No one is immune to this virus nor the circumstances that might come of it. Throughout the ENTIRE world, I realize it’s somber, but this is a pretty amazing revelation.
We have lived in the Midwest most of our lives and in the last few weeks I have seen more neighbors out for walks, bike rides, and playing in their front yard than I ever have!
Challenges make us stronger. They make us more resilient. Challenges enable growth.
Focus on what you CAN control. Chances are you’re stuck at home. Possibly with children. While we know its super challenging especially with little ones, get moving! Those babies are watching you and feeding off your energy. If you’re stressed, move your body. Movement is medicine! If you don’t know where to start or have history of pain or any injury, send us your questions.
Nope, we can’t fix the economy right now. Nope, we can’t cure this virus overnight.
However, we can focus on our health and our family that is sitting right in front of us. We have gotten to spend more consistent, quality time with our boys in the last few weeks than we have since they were newborns (it sounds sad to say, but that’s the reality of full time working parents). They’re loving it and although it’s sometimes stressful and exhausting, it is such a blessing. We have enjoyed going on more walks, practicing yoga as a family (thanks YouTube), playing more games, and doing more puzzles. We can control how much screen time we are all exposed to every day. Set some goals. Read some books. Do what makes you feel good!
Two simple reasons:
1. In order to spend more time one-on-one: provider and patient.
2. Because cutting out the middleman means decreased overhead and the ability to run a practice focused on ONE thing, the patient.
This takes us back to the simple life. Up until the 1950s, this was the traditional model. We want to care for patients the best way we know how. This involves spending time, face to face, listening, assessing, planning, and implementing based on your concerns and your goals. Providing this care as an in-network provider would be tricky. It would require much sacrifice, especially when it comes to time spent documenting, coding, and billing. These things do not impact your care directly and will not help you get better. These are the things that our healthcare system currently has wrong (at no fault of the providers, just a faulty system, unfortunately). In short, billing insurance requires staff to maintain the transactions with the middleman, it means decreased reimbursement (which varies depending on the insurance company), leading to the increased need to get patients in and out of the door, which requires hiring more staff to care for those patients and increased overhead… and, you get the picture.
Seeing a cash-based physical therapist, out-of-network can save you money and more importantly, your time! At Kaizen, that means we dedicate each entire one-hour session just on you to address your concerns and develop a customized treatment plan.
We want you to know that being an out-of-network provider is not a decision we came to quickly or easily. We debated the option to go in-network for the entire first year we were a distinguished company. However, in the end, we conclude it’s just not for us. Here’s another reason why. Insurance companies can be very restrictive. In-network PT is typically limited to “treating one body part,” while Kaizen is able to consider the patient as a whole person. We are not big on limitations – neither are you, which is why you’re here. In our experience, third-party payers pressure for immediate diagnoses, then insist on confining treatments, and simply put, interfere with the therapy we want to provide. This often hurts the patient’s progress and hinders our ability to reach his or her goals.
Out-of-pocket expenses over the course of physical therapy will often be less expensive for patients like you with a cash-based model than through a traditional physical therapy practice. Let’s do some simple math. While it’s hard to use exact figures because everyone’s insurance plans are different, the outcomes are typically the same.
If we take the “standard” protocol in an insurance-based model for a torn rotator cuff in a healthy individual (25-35), the patient will typically need 4-6 months of rehab requiring passive and active PT (~2x per week) according to the US National Library of Medicine. You may also have to worry about meeting your deductible and paying a co-pay at each visit. If you have a $50 copay for specialty care this might end up costing you up to $2,400 in copays or $3,000 if that’s your individual out-of-network deductible.
In our model we typically see the patient 1x a week and give them an extensive home program so he or she can begin working on the treatment plan at home. We also see our patient on average 6-10x during a plan of care and quickly go from rehabilitation to working on performance and prevention. Our ten-visit package is $1,800.
At the end of 6-months cash-based is often more affordable and less of a time investment. This also doesn’t account for the intangibles around enjoying a dynamic, individualized care plan and relationship built with your Kaizen PT.
We totally get it, we want to feel like we utilized the insurance plan we spend thousands of dollars on every year too. The thing is, health insurance was never intended to pay for our every health concern. It’s insurance, there if we need it in case of catastrophic events.
It’s worth mentioning here that the “cash-based model” is able to accept other forms of payment including credit/debit cards, checks, and even flexible spending or health savings account if your plan allows it. Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide reimbursement for specialty services received “out of network” (given your deductible has been met). We can help you with this process. Don’t be restricted by your current health insurance policy. Ask questions. Advocate for your healthcare.
Many people seeking cash-based care have high-deductible insurance plans. It makes sense to seek out cash-based providers when your deductible is $3,000 per person or $12,000 per family. You have more options and are able to choose a practitioner that fits your needs and values. Personalized care!
Have questions or want to learn more? Give us a call at 515-339-2906 or fill out a contact request here https://www.kaizenhealthandwellness.com/contactus.html