As many of you are aware, or may have already received information from your Private Health Insurance (PHI), of the upcoming private health rebate changes effective from April 1st, 2019. Last year the Federal Government made the decision to make certain natural therapies ineligible for PHI rebates. Included in this banner is Pilates – regardless of who delivers it or how it is delivered.
Our Physiotherapy Board has negotiated with the Department of Health and PHIs for a more reasonable and tenable position on Pilates for physiotherapists. Through their advocacy, the department considers that an insurer may lawfully pay benefits if a physiotherapist, providing services to a patient within the accepted scope of clinical practice, uses exercises or techniques drawn from Pilates as part of that patient’s treatment as long as the exercises or techniques are within the accepted scope of clinical practice. However, if a physiotherapist (or any other health professional) conducts a Pilates session or a session where the only service provided is Pilates exercises – then benefits cannot lawfully be paid (PHI Circular 69/18; 18 Dec., 2018)
Due to this, there will be some minor changes we are undertaking to enable you to continue to claim your PHI rebate when attending certain services at Dynamic Stability. In order for you to be able to continue to claim through your PHIs, Dynamic Stability must implement such changes to be compliant. We are also taking this opportunity to trial some structural changes to the way we deliver our services to enable us to continue providing this high standard of treatment and care for you as a client.
As of April 1st 2019, these changes include:
- All Supervised Sessions (such as 1-on-4, 1-on-2, or private 1-on-1), where specific injuries or musculoskeletal medical conditions are needed to be managed by a qualified physiotherapist, will now be referred to as “Physio Guided Rehab” sessions. We will continue to run these as personalised sessions where each client’s program will be individually tailored, and monitored by our highly qualified practitioners. Your Physio Guided Rehab sessions may include, as appropriate, a combination of manual therapy, tailored rehab exercises, biomechanical & management education, and prescribed home exercises along with review and re-assessment.
- Your Physio Guided Rehab Sessions will continue to be 60mins in total. However, 10mins of this (5 minutes at the end and 5 minutes at the start) are allocated to program documentation to allow our practitioners to record the required documentation and notes. During this time you’ll undertake cool down stretches or home exercise revision as appropriate.
- You will be given 2 warm up exercises, that you will be required to remember, to undertake at the start of each session. These will need to be done on your own in the first 5 minutes as the therapist is getting around to all clients commencing their pre-assessments of the session.
- Similarly, you will also be given 2 warm down exercises. These will be done in the last 5 minutes of your session to allow the therapist to complete the necessary notes from the session before the next class starts.
- Due to the above, we ask those clients who arrive early for their sessions to please wait until your allocated time and NOT enter the rehab room prior to your session time. If the Reformer room or Mat-space is clear upon checking with reception, you may warm up early in there. Similarly, please EXIT SWIFTLY at the end of your session to allow the next session to start. You may continue to reflect or catch up in the waiting areas.
- To enable us to stay abreast of the documentation requirement and monitor accurately, we’re planning to conduct quarterly (private 1-on-1 brief consult) review sessions. These are brief 15mins, standard consultations, between yourself and a physiotherapist to discuss any medical or personal concerns; to revise your rehab goals and program; or it may also be a chance for you to receive some further “hands on” treatment for your injury. These brief consult sessions will enable your program to be revised and tailored to any new needs that are identified.
You could either trade in one of your sessions in your Block of 10 for a quarterly review session, or purchase a separate private review session of a similar cost to a single Physio Guided Rehab Session.
- Due to the updated classification, as Physio Guided Rehab Sessions there must be a focus on the treatment of current injuries and/or musculoskeletal conditions requiring specific physiotherapy care. If your assessment concludes that you do not require physiotherapy care, you may be recommended to see a non-physiotherapist practitioner in their Clinical Pilates session. Or otherwise transition to a group fitness Reformer or Mat-work Pilates class.
- All Clinical Pilates classes still have the essence of a tailored program, with specific focus on your individual needs. However as these are post injury/rehab management, they have a stronger fitness focus and are non claimable through PHIs.
- All Group Reformer and Mat-work Pilates Classes are also non claimable.
- All clients attending Physio Guided Rehab or Clinical Pilates sessions must undertake a quarterly review consult, whether with a physiotherapist or non-physiotherapist practitioner. If you are seeing one of our physiotherapist for your quarterly review session, or any hands-on treatment with the physiotherapist, myotherapists or remedial therapists, those sessions continues to be claimable through your PHI.
Again we would like to point out that these changes are unison amongst all private practices and in-order for you to be able to continue to claim through your PHIs Dynamic Stability must enforce such changes to be compliant. We apologise for any inconvenience and hope you continue to value our high standard of services regardless of rebate potentials. As a consumer if you feel unsatisfied, we suggest that you write to your health minister and local electorate to voice your disgust.
Should you need further clarification please feel free to chat to one of our friendly staff, receptionists or even ourselves.
Darren, Loc and Team Dynamic Stability