Jerry Durham is Out of Network with Everyone!

I had the opportunity to interview Jerry Durham, PT live from the APTA PPS Annual Conference in Las Vegas, NV. The PPS conference in Vegas was over the top! If you haven’t been please put it on your radar for next year. The relationships alone make it worth the time and investment. The party Friday night at the Wynn hotel was awesome! There was an open bar, gourmet peking duck and fried chicken/slaw sliders, water fountains on fire and a DJ dance party that rocked!


Jerry Durham believes the Magic is in the Relationship you build with your Customer. This relationship is fostered a in your Patient Experience. Jerry has been a Physical Therapist for 24yrs. He opened San francisco sport and spine Physical Therapy with his partner, Sturdy McKee, over 15yrs ago. He has 3 clinics in San Francisco and they are all out of network. Jerry is in charge of Lead Conversion and the Patient Experience.

What is Insurance Fraud anyway?

Recently a question in the CashPT Nation Facebook group came up about out-of-network clinics billing the insurance company more than the cash-pay rate and keeping any “overpayment,” why it cost patients less than the $150 cash pay fee and was this ethical?

Some folks called it “Fraud,” and I agree, it sounds a bit confusing and different. Out of context, with some mis-information about how the whole system works, this process is hard to explain. Understanding the correct terms is vital.

jerry-durham-pt-cash-out-of-network-physical-therapyWhat it boils down to is, there is a way to file a claim on behalf of one’s patients with their insurance company, in an out-of-network setting, earn a fair living and still keep it ethical.

There was not enough space to fully answer this in the post. Jerry offered to discuss the question with me on the phone and after talking, we decided it would be a great opportunity, and better platform to answer, to have him as a guest on The CashPT Lunch Hour to talk about this topic, define the terms needed to understand this question and touch on other “out-of-network” and “cash-based” issues.


I also had the fortune to finally meet Jarod Carter in person. We’ve known each other for about 5 years, thanks to our similar bunion treatment videos on YouTube connected us one day. Jarod is my PT “brother from another mother.” We’ve been on the same trajectory (rocket ship!) for quite some time. It’s always great to have the support of your peers and Jarod is full of abundance and positive energy.

After chatting with Jarod about the conference and the conversation with Jerry, I invited him to participate and be present to ask questions during the interview so that we were sure to get all the answers and clarity this issue required. It was awesome teaming up with Jarod and I’m looking forward to doing it again in the future.


The CashPT Lunch Hour #17: Jerry Durham

In this episode we discuss:

-How to Survive When Insurance Companies Try to Strong Arm Your Practice

-How to Set a Fair Fee Schedule and Balance Bill Your Patient for “Out-Of-Network” Benefits

-Learn The Difference Between In-Network, Out-of-Network & Cash-Based PT

-How Being “Out-of-Network” is Better for Everyone

-The Customer Lifecycle

-The Benefits Call Back

-The Best Way to Respond When Asked “Do You Take My Insurance?”

-What He Is Doing with the Patients Who’s Insurance Don’t Pay…

-Essential Advice to Anyone who Wants to Get Rid of Money Loosing Contracts

-Jerry’s Top Strategies to Develop Customers for Life

-There Will Be Time for Questions From the Audience

-What’s Possible in the Cash-Based, Direct Pay & Out-Of-Network Practice Model.


Jerry’s New Website

Jerry Durham on Twitter

Jerry’s clinic San Francisco Sport and Spine is Growing!



About The Author

Aaron LeBauer

Aaron LeBauer PT, DPT, LMBT started a 100% cash based physical therapy practice right after graduation. He's on a mission to save 100 million people from unnecessary surgery & enjoys helping passionate therapists build successful businesses without relying on insurance.

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  • Jarod Carter

    Reply Reply December 8, 2016

    Tried to leave a comment via facebook above but not sure it posted …

    Just wanted to say this was an absolute blast, and Thank You for including me on this one Aaron!

    • Aaron LeBauer

      Reply Reply December 8, 2016

      Same here Jarod. I’m stoked you were able to participate in the interview and it was great meeting you in person. I’m looking forward to the next time.

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