HealthLinksSC.com | 23 If you come to Apogee Therapy Center in Greenville and Spartanburg to recover from a hurt knee, torn ACL or even lower back pain, you will have the option to pay for your treatment through either insurance or out of your own pocket. While the choice might seem a no-brainer at first glance, the option for self-pay is one that more and more therapists and patients are considering for many reasons. “When exploring out-of-pocket costs for patients with private insurances, the variability of plans and benefits within payers can often be confusing for patients,” said Erik Carvalho, clinical services coordinator with Duke University, in a 2023 article for the National institutes of Health. “In an ever-changing health care atmosphere, patients are often unaware of changes in their benefits from year-to-year, particularly for unexpected new onset conditions.” Self-pay, on the other hand, brings about many more options for individual patients and therapists. For example, Dr. David Carter, owner of Apogee Therapy Center in Greenville and Spartanburg, said that cash-only policies give new physical therapy businesses a better chance to succeed in their critical early years. “It’s really hard to do a start-up practice and accept insurance because the credentialing process is very tedious,” he said. “When we first opened in 2016, it took us up to three years to become fully credentialed with all insurances across the board. In the meantime, you need cash flow up front to really get things moving.” He also pointed out that self-pay allows patients more streamlined treatments and recovery times, because therapists have unrestricted latitude in determining personalized, individual treatment plans. “Big insurance-based practices have a ton of overhead, so they have to see a very high volume of people — maybe 5-6 at a time,” he said. “When people come to physical therapy, they want more of 1-on-1 treatment instead of just being a number. Plus, insurances take a long time to pay. I might treat you today and not get reimbursed for six, seven or eight weeks.” Of course, at places like Apogee, besides getting a choice of self-pay or insurance, you also get the same individual 1-on-1 treatment from Dr. Carter and his entire team. “Physical therapy is more than just doing sit-to-stands, leg extensions, or buying a theraband and doing 4-way shoulder strengthening,” he said. “Our therapists are with you for the entire time because for us, it’s all about getting people in and better as quickly as possible.” PHYSICAL THERAPY GROWING SHIFT FROM INSURANCE TO SELF-PAY? By L. C. Leach III Self-pay allows patients more streamlined treatments and recovery times, because therapists have unrestricted latitude in determining personalized, individual treatment plans.
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