Do you take my health insurance?

Natalie Gaskin is a licensed Occupational Therapist in PA and NY states specializing in pelvic floor therapy and movement. Please be aware that this practice is a cash-based clinic and is not an in-network provider for any insurance carrier. However, upon request, I can provide an invoice (superbill) at the end of each session that you can submit to your insurance or medical savings plan to seek out-of-network reimbursement. The out-of-network occupational therapy reimbursement rates are dependent on your specific policy, so it is recommended that you check with your health insurance carrier to determine the details of your coverage before starting treatment. I also accept Health Savings Account (HSA) and Flexible Spending Account (FSA) payments, and may clients choose to go this route. Payment is due in full at time of service. Not accepting health insurance allows me to work with you according to your needs instead of according to the dictates of your insurance provider. It also allows me to see you for longer 1:1 individualized and holistic visits, and because of this, many of my clients actually meet their goals sooner than they would at an in-network provider.

Do I need a referral script?

Yes! In Pennsylvania we are required to have a referral script for occupational therapy pelvic floor services following the evaluation. They must be specifically from a licensed physician, podiatrist, certified nurse practitioner (CRNP), or physician’s assistant (PA). Your script also MUST specify pelvic floor occupational therapy in order for me to treat you. If the script says physical therapy, I will not be able to use it. I can provide you with or fax a script for your doctor to fill out that meets those requirements, or your doctor can fax a script to 814-556-2095. In order to prevent delays in your care, I recommend obtaining a script prior to your initial evaluation.

What can I expect from my evaluation session?

You will be welcomed into my therapy space and given the opportunity to share your pelvic floor story, concerns, and goals. You will have already filled out and submitted your intake forms, but the beginning of your evaluation will be your opportunity to share it holistically and paint the picture so that we can begin to connect the pieces of your story, your symptoms, and the physical assessment findings in order to treat the whole picture. I will evaluate your physical posture, breathing, and movement patterns, paying special attention to the movements where your symptoms show up, positioning of your pelvic bones, fascial restrictions in your abdominal and thoracic regions, and external muscle tension/tenderness. You will also have the option of having an internal exam. We will begin to discuss your habits and routines and the health of your pelvic floor, bladder, bowel, and breath. The pelvic floor is connected and integral to all the other parts of your body. It fills many roles, including elimination (bladder and bowel), sexual intercourse, managing pressure from above and below (when walking/moving, coughing/sneezing/talking), birthing a child, etc, and as such we cannot treat the pelvic floor in isolation. We will be addressing your pelvic floor symptoms by looking at your system as a whole and discovering and treating the things that are contributing to your difficulties. Evaluations are typically 90 minutes long.

What can I expect from the internal examination?

Prior to the internal exam I will walk through what she will be doing with a pelvic floor model so that you know exactly what to expect. It is much more gentle than other examinations or tests you may have had in the past, and I will ask you to let her know if you experience pain or tenderness with any of it. I will then leave the room and you will undress the bottom half, and cover yourself with a provided sheet. I will only uncover the areas necessary for the examination in order to maximize your privacy and comfort. First will be an observation portion of the external tissues, then we will check each side of the layers of the pelvic floor musculature and fascia with a single finger. I will let you know what she is going to do and obtain permission each step of the way. If we find any tender areas we may mobilize, massage, or do a trigger point release on those areas. I may also have you stand up and feel your pelvic floor while you are completing movements where your symptoms are exacerbated. Following the exam, I will leave the room and allow you time to get dressed. Afterwards we will discuss findings we have not already discussed.

Do I have to do an internal exam?

No. The internal exam can give us a lot of information about what is happening with your pelvic floor and it can be useful for putting together the puzzle of why you are experience symptoms. It can also provide us with further treatment options that can contribute to decreasing your symptoms. However, it is not the only way for us to gain information and decrease your symptoms. I will always ask for permission prior to and many times during your internal exam and treatment, and you can ask me to stop at any time. You are welcome to have the internal exam at the first visit, delay it to later visits, or not have one at all. If you feel more comfortable having someone there with you, please bring them to your session.

What can I expect from my follow-up sessions?

Your follow-up sessions will consist of a unique combination of tools and strategies including movement and exercise, postural and alignment education, breathwork, education on pelvic floor health, internal and external manual work (including myofacial release, cupping, and other techniques), education on birthing strategies, nervous system re-education, nutrition and hydration, and pain science education.

How soon postpartum can you see me?

The day after you give birth! Seriously! I LOVE working with postpartum women as soon as you are willing to see me! Immediately postpartum I can come to your house (or even the hospital!), I will bring my massage table to set up wherever you would like, and you can take as many breaks as you need to care for your baby. I will utilize external manual techniques to help move your pelvic bones back into position, release your abdominal fascia, rebalance your internal organs, and bring regulation to your nervous system in order to promote the quickest and best recovery possible. I will also teach you to engage your core and use good body mechanics while caring for your baby in order to provide the most support to your pelvic floor, re-awaken your core and pelvic floor, and prevent injury and pelvic floor dysfunction. We can also discuss positioning and tips for supporting breastfeeding, pain management strategies, biomechanics for any activity you’re having difficulty with, and begin treatment for any pelvic floor dysfunction you already have. I do not do any internal pelvic examinations or treatments until 6 weeks postpartum when you are cleared by your provider for internal work.

Do you take Medicare?

No, I am not a medicare approved provider at this time. As such, by law I am not allowed to give necessary pelvic floor therapy services to Medicare eligible people (anyone 65 years old or older). However, I AM allowed to see you for wellness visits (which can include pelvic floor symptoms), preventative sessions, and movement sessions. If you have pelvic floor symptoms and are over 65, please reach out to schedule your complimentary discovery call to find out how I can help your specific symptoms.

Do you treat men?

Yes! I treat anyone with a pelvic floor (which is everyone)!