Got Priority Health? Give Physical Therapy A Try!


Tuesday, February 10, 2015
Has your back been sore for a while now? Are you dealing with a recurring sprain from all that running you've been doing? If you don't really want to deal with seeing your physician, and you're not sure where to turn, consider giving physical therapy a try.

Gina shows a patient how the spine works, explaining why she may be experiencing back pain.

Now that Direct Access is in full effect, you can visit a physical therapist without a referral from your doctor. And, what's even better, is that if you're a customer of Priority Health, they'll cover your treatments!

Priority Health has become the first local insurance provider to reimburse physical therapy services without a prior referral from a physician, as announced here. This news comes just 5 weeks after the Direct Consumer Access Bill went in to effect, which allowed residents of Michigan to seek physical therapy treatment without a referral. Despite the fact that the state law had changed, most insurance companies were not on board, until now.  If you're not a Priority Health customer, call your insurance company directly and tell them you want physical therapy treatments covered directly - the movement can start with you!

Corey treats a patient who has suffered a knee injury.

What does this mean for you? 

There's a shift towards empowering people to take their health into their own hands and to be more involved in the decisions that are being made. People that suffer from constant back or neck pain, have had a recent sports injury, or are looking for an alternative approach to healthcare can now come directly to a physical therapist - we've been advocating for and working towards this for decades - it really is an exciting shift in Michigan healthcare. And, its important to remember, just like you can choose your doctor or your dentist, you can also choose your physical therapy provider, regardless of your insurance provider.

When the Direct Access bill went into effect on January 1, 2015, Priority Health chose to continue to require a prescription before they would pay for physical therapy visits. However, after careful consideration, they have decided to follow state law for their commercial insurance products and physical therapy visits will be covered, with or without a prior referral from a physician.

Terri shows Amanda the proper way to stretch and flex her back and shoulder muscles.

This is a huge leap forward for Michigan consumers and healthcare in general, as the Michigan Physical Therapy Association (MPTA) has been working on the Direct Access plan for 34 years. 

If you have any questions on Direct Access, visit our FAQ page, or check out our segment on eightWest. If you are experiencing pain in your back, neck, shoulders, or elsewhere; have suffered a recent injury; or have questions in general about your health, feel free to stop by and set up an appointment with one of our therapists, or give us a call - we'd be happy to answer any questions you may have.

Talking About Womens Health with eightWest


Tuesday, January 20, 2015
WOOD TV's eightWest welcomed us back once again and this time around we talked about women's health. 

Imagine you’re out with your girlfriends having a great time, enjoying a glass of wine, you get to laughing, when “oops, I think I just peed a little!” Laughter can quickly turn to embarrassment when its accompanied by a little urinary leakage.

It may have started happening after you had your baby, as you got older, or after surgery. But the important thing to remember is that you’re not alone. Urinary incontinence affects millions of women of all ages, not just the elderly. Its an embarrassing topic to talk about, but there is a solution and the sooner you can get it looked at, the better your chances of making a full recovery.

Keeping these issues to yourself because you’re embarrassed or because you think it’s normal is really only doing more harm. Its not uncommon for women to have leakage after childbirth, with sporting activities, or as we age; however this is something that shouldn’t be labelled as normal.

Check out our full interview with WOOD TV, and eightWest and Rachael Ruiz below, and if you have any questions on women's health, bladder issues, or incontinence, give us a call at 616.997.6172.



See our previous eightWest segment with Jordan Carson where we talked about direct access and how it effects healthcare and physical therapy in Michigan.

Our Interview with eightWest and Jordan Carson


Tuesday, December 09, 2014
Being on television in front of thousands of viewers can be very intimidating, but the folks at eightWest and WOOD TV8 made us feel right at home this week when we stopped by to talk with them about Direct Access and all the changes that are happening in physical therapy.

Jordan Carson of eightWest talks with Gina Otterbein about Direct Access and Physical Therapy

Check out our interview below, and if you have any questions on direct access or whether physical therapy is right for you, give us a call at 616.997.6172.

Direct Access to PT is Now Available in Michigan


Monday, July 14, 2014
This article was originally published in the July 14, 2014 edition of the Coopersville Observer

Lower health care costs and a faster road to relief are finally in sight for Michigan residents. In early July the Direct Consumer Access Bill was passed after 34 years in the making. The bill allows consumers the option of seeking treatment directly from a physical therapist without having to gain a referral from their physician first.

“This is a huge day for patients and physical therapists alike,” said Gina Otterbein, a Physical Therapist and co-owner of Northern Physical Therapy, with offices located in Coopersville, Cedar Springs, Wayland, Grant, and Sparta. “Michigan is the last of the 50 states to pass this type of bill, now people in Michigan have the choice to go directly to a physical therapist which provides faster access, results and ultimately lower health care costs.” Otterbein notes that physicians (and physician assistants) will continue to refer to PT especially after surgeries or severe injuries, but now there is the option to see a PT directly for issues such as a sports injury, back flare up, knee pain or shoulder stiffness. The physical therapists will assess the client’s problem and develop a plan of exercise, manual therapy, education and other PT treatment to get the client back to life quickly and safely.

The bill, which was signed by Governor Rick Snyder was previously passed by the House of Representatives in June and by the Senate in May. It will officially go into effect on January 1, 2015 and will grant patients the opportunity to visit a physical therapist up to 10 times. Many Coopersville residents, along with Northern Physical Therapy supported this bill, “We appreciate everyone who supported this bill, both our community members and our legislators” said Otterbein. Northern shared information about the bill's progress through social and electronic media and the community responded. “It was truly amazing!”

Because the Michigan Physical Therapy Association (MPTA) has been working on the Direct Access plan for 34 years, they’ve seen many states ahead of them who have experienced significant advantages from the direct access route. Other states have shown a correlation between direct access and lower health care costs, faster recovery times, and a more positive relationships between the patient and the health care providers.

If you would like additional information on the Direct Consumer Access Bill, contact Gina Otterbein at 616-997-6172.

Michigan Stands Alone : SB690 Say Yes to Direct Access


Tuesday, June 10, 2014
We're asking for a big favor today, and it will greatly benefit both of us. Michigan is the only state that requires you to have a prescription to seek physical therapy, but with your help that could change.

We're generating a grassroots effort to get SB690 Say Yes to Direct Access passed. If you've already submitted your support to your local representative, thank you so much! Direct Consumer Access to Physical Therapy in Michigan means you get the freedom to seek physical therapy evaluation and treatment without a prescription from your doctor.

Please consider contacting your local representative to show your support by sending them an email at http://www.capwiz.com/mpta/home/.

We greatly appreciate your support!
Gina Otterbein, Janis Kemper,
& your friends at Northern PT

West Michigan Woman Welcomes Northern Yet Again


Tuesday, November 12, 2013
Gina and Janis have become regular contributors at West Michigan Woman, both in their print and online publications. They've taken this opportunity to educate readers on various topic of interest and things they commonly see in the clinics.
Most recently, they discussed balance and falls and how those symptoms can affect us as we age.

Seeing our loved ones age can be a difficult process. We want what’s best for our parents and grandparents, and as their health changes it’s not uncommon to worry about their safety. A serious side effect that we, as physical therapists, often see with aging is the increased risk of falling and loss of balance.
Read the article in its entirety here.
In addition to the balance and falls article, you may have also seen their article on back pain. Back pain is one of the most common issues that patients face, but the goods news is, you don't have to live with pain.

We often get patients in the clinic who explain their back pain, along with a lengthy description of the different treatments, surgeries, and medications they’ve encountered along the way. “Nothing worked. I’m hoping you can help me,” they say. Physical therapy is a safe alternative to surgery and medication, and it can help you live pain-free: Our goal is not just to mask the pain, but to find the cause and treat it.
Read the article in its entirety here.

And finally, Gina and Janis spent some time this summer discussing whether to heat or ice an injury. There is often confusion as to which method is better for your injury.

One of the most common questions we get is whether to use heat or ice for an injury. Both are beneficial when used properly, but the best option depends on what type of injury you’ve incurred.
Read the entire article here.
Gina and Janis enjoy the opportunity to educate people on proper body mechanics and practices. They always remind people that you don't have to live with pain.

Health Insurance Changes in Michigan


Tuesday, October 29, 2013
Health Insurance Spotlight
As the Affordable Care Act (also known as Obamacare) and all of its policy changes are implemented on January 1, 2014, many people are left wondering how they and their families will be impacted. Regardless of your current carrier or policy, it is likely that your insurance coverage is going to change. We've summarized four different insurance scenarios and the changes you may see in 2014 under those carriers. Because everyone's situation is unique, the most important thing you can do is talk to your provider, insurance carrier, or your employer to become informed on your individual policy.
Employer Group Plans
Employers with fewer than 50 employees may still offer group insurance health plans, however, they are not obligated to do so. On the other hand, employers with more than 50 employees are required to offer affordable health insurance. Either way, it is possible that your group plan will have changes in 2014. You may find that your insurance carrier could change because employers are also shopping for the best price. Your premium, deductible and copayments may also change. For many employers, health insurance premiums plus new taxes on insurance are raising the costs and in most cases, employers have no choice but to pass some of this expense onto the employees. Another thing to watch for are your "essential benefits," which are items that must be included in all new insurance policies, so you may see changes in what is and what is not covered. If there is a medical treatment that is important to you, check your essential benefits or call your carrier to find out if it is covered. Finally, we are seeing many plans that require your deductible be fully met before the insurance company pays anything, including pharmacy prescriptions and office visits.
Individuals Looking for Insurance: Marketplace or Direct
The federal government's intention with the Affordable Care Act is to get more people insured by allowing those who do not currently qualify for health insurance to be eligible to buy insurance plans either through the Marketplace or directly through an agent or insurance company. Open enrollment for individuals on the Marketplace started October 1, 2013 and ends March 31, 2014. All individual plans are based on medal levels: bronze, silver, gold, and platinum. Each of these levels carry the same benefits but while higher level premiums do cost more per month, they pay a higher percentage of the overall cost of expected healthcare costs. For 2014 there is a fee of $95 or 1% of your taxable income (whichever is greater) if you choose not to carry health insurance.
Medicare Beneficiaries
The good news for Medicare is that there are not significant changes occurring in 2014. However, it is currently open enrollment, so now is the time to review your coverage and decide if you will continue with your current Medicare plan or choose a different Medicare health insurance or prescription drug coverage plan. If you'd like to make any changes you'll want to do so before the open enrollment period ends on December 7, 2013. Remember, if you have a deductible, you will be responsible for this amount on health care services that occur after January 1, 2014.

Medicaid in Michigan
Medicaid in Michigan will increase eligibility levels to 138% of the poverty level ($23,550 for a family of four). This expansion is currently scheduled to occur on April 1, 2014.

Additional Resources
If you have questions regarding your insurance policy or how your physical therapy treatments are covered, contact your insurance provider directly, or call our insurance specialist at 616.259.5674.

Medicare 1-800-MEDICARE, or www.medicare.gov
Individual Marketplace Insurance: www.healthcare.gov/
Marketplace calculator: www7.dleg.state.mi.us/perc/

Know the Truth: Understanding Medicare’s Therapy Caps


Monday, September 09, 2013
If you have Medicare, you may have heard recently more about the limitations or “caps” they place on certain treatments, including physical therapy. Just like other insurances, Medicare (the red, white and blue card) places limits on their coverage and “caps” the amount it will pay for outpatient physical and occupational therapy in a calendar year. The good news is that there are exceptions that allow Medicare patients to continue skilled therapies when they are medically necessary, and we can help easily navigate through the process.
There are two “caps” that require an exception. When services are necessary but reach $1900 there is a process that your therapist will automatically complete, which does not slow down your care as a patient, and allows you to continue treatment. The second cap is $3700. If your therapy is still medically necessary, we will do paper work and ask for pre-approval from your physician and Medicare to continue. It’s important to note that we have found very few patients at Northern ever get to the second cap with therapy services in one year. Our physical therapists and billing team are aware of these financial limitations and can apply for an exception if your continued care is medically necessary. We will explain how Medicare defines “medically necessary” and how it applies to your condition and treatment.

What about Medicare Advantage plans like Priority Health, BCBS Medicare, or others? These Medicare Advantage plans may apply the cap as well, however, some plans have chosen not to follow this Medicare rule. At Northern we always check with your insurance plan and let you, and our therapists, know of the current payment policies for your particular insurance.
If you still have questions about your coverage, simply call our insurance benefits specialist at 616.259.5674 or email us at billing@northernpts.com. We will be more than happy to walk through your personal coverage and answer your billing questions.

Would you like to see this “cap” go away? Make your voice heard. Medicare beneficiaries can ask their members of Congress to repeal the therapy cap by going to the American Physical Therapy Association's Patient Legislative Action Center.

Summer Fun Without the Pain


Tuesday, June 04, 2013
Gina and Janis have once again contributed to West Michigan Woman and this time they're writing about working and relaxing pain free.
After what seemed like a terribly long winter, many of us wasted no time heading outside to fix up the yard and soak up some sun, once warmer weather finally hit. While it certainly feels good to be doing projects outdoors, it’s important to remember how to do these tasks properly, so your body doesn’t pay for it later. How many times have you overexerted yourself doing yard work, only to wake up the next day with back pain and sore muscles?

As a physical therapist and expert in body mechanics, I see many patients come in with sprains and back pain, due to overextending themselves while doing outdoor activities. In an effort to eliminate some of that pain, I put together a list of simple tips to help you avoid injury this season.

While doing active tasks such as gardening and yard work, you’ll want to remember to stretch and maintain a healthy body position.
- Avoid strain on your hands by periodically spreading your fingers wide, then make a fist. Repeat.
- Reduce stress on your wrists by rotating them in one direction, then repeat in the opposite direction.
- Use a stool or knee pads to protect your knees and hips.
- Avoid putting constant stress one part of the body by varying tasks: Rake for a while, then bag for a while.
- When lifting, keep objects close to your body, keep a straight spine, and lift with your legs, not your back.

After the work is done, you’ll want to stop to relax. But keep these tips in mind:
- Lawn chairs can be hard on your back, so get up and walk around every thirty minutes.
- Find a chair that supports your back and fits your size. Avoid staying in one position for more than twenty minutes.

Summer is a great time to be active, but always remember, if you begin to experience discomfort in a muscle or joint, stop and rest. If you are experiencing persistent pain, a physical therapist could often help to relieve pain and educate you on proper body mechanics to avoid injury in the future.

McKenzie Certified: Treating Back Pain


Wednesday, March 27, 2013
Congratulations to our very own Diana Painter who has received her certification in Mechanical Diagnosis and Therapy, which means she is now certified in the McKenzie method of treating for the spine and extremity.
To acquire the certification, Diana had to complete extensive course work involving the mechanical diagnosis and treatment of the cervical, thoracic, and lumbar spine as well as the extremities. In addition, she was required to complete a five part written exam and practical performance simulation.

Diana says she loves working with patients of all ages and diagnoses, but her interests in spine pain led her to obtain this particular certification. She feels the McKenzie method is a great tool for assessing and treating patients with back pain.

Way to go, Diana!