How We Get Paid - Why Clinicians & Clinic Owners are Getting Squeezed by Insurance Companies

In this episode, we break down how money actually moves in the insurance-based PT and OT world, why so many clinicians and clinic owners feel financially stuck, and how the landscape has quietly but dramatically changed over the last 20 year

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Pelvic PT Rising: The pelvic health tools to make you a better clinician and/or a more successful business owner. We want every single pelvic health practitioner to be more confident and successful in your practice and career!

• Clinical Courses: Game-changing online courses to make you more confident, challenge your thinking and improve patient outcomes

• Business Resources: Helping 500+ pelvic health practitioners confidently start, grow and build their dream business!

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In this episode, we break down how money actually moves in the insurance-based PT and OT world, why so many clinicians and clinic owners feel financially stuck, and how the landscape has quietly but dramatically changed over the last 20 years.

We cover:

✅ How insurance companies make money — and why they’re incentivized to pay out as little as possible

✅ The reality of declining reimbursement and rising administrative costs

✅ Why clinic owners feel squeezed from both sides

✅ Why clinicians deserve raises — and why insurance doesn’t support that reality

✅ How this system unintentionally pushes clinics toward lower-quality care models

Most importantly, we talk about why the rise of cash-based care isn’t a trend — it’s a correction.

Cash-based models:

• Allow small, independent clinics to survive and thrive again

• Create real earning upside for skilled clinicians

• Restore transparency and accountability in care

• Exist in every healthcare system — including countries with universal healthcare

This episode isn’t about villainizing anyone. It’s about understanding the system we’re operating in — so we can make better, more informed decisions about our careers, our clinics, and our patients.

🎧 Whether you’re an employee, a practice owner, or somewhere in between, this is required context for the modern pelvic health landscape.

Learn more about pelvic health with our Clinical Courses

All of the Rising clinical courses are designed to:

• Challenge the way you think

• Make you more confident in your clinical practice.  

• Allow you to go-at-your-own pace (all online!)

• Let you go back to your work: you'll have lifetime access to the lectures and handouts.  Check out all the clinical courses we offer (www.pelvicptrising.com/clinical).

Curious about private practice? Check out our Business Resources

• We've now helped more than 200 cash-based pelvic health practices start and grow.  

• We want to make sure you're building a business that works for you (instead of vice-versa) and actually enjoy the process along the way!  

• See all the business resources we offer (www.pelvicptrising.com/business), tailored specifically to pelvic health!

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Nicole Cozean, PT, DPT, WCS

Founder of Pelvic PT Rising and PelvicSanity Physical Therapy in Southern California.

Dedicated to forever changing pelvic health with online clinical courses to help you be more confident in your practice and business resources to help start and grow pelvic health businesses.

Jesse Cozean, MBA

Co-founder of the Pelvic PT Rising and the Rising Podcast.

Jesse uses his business experience to help pelvic health business owners start and grow their practices so they can build a practice that truly works for them. From website design, SEO, conversions, marketing, finance and money mindset, he wants to make the process of owning your own practice easier and fun.