No matter when you feel bad; something unforeseen happens; you wake up with the flu; the prospect of Health Insurance comes to mind. What is my deductible? Does it cover ER visits? Did I make the last payment? Does it cover Urgent Care visits? Health Insurance enters everyone’s life. It is supposed to make our life easier and ease the worries of draining the bank account. But, somehow it manages to do the opposite.
On the other side of the fence, as a health care provider, it is a constant battle with insurance companies. Any excuse to deny a claim costs my staff hours to try to get the claim paid and NOT pass the cost on to the patient. However, the insurance companies do not work for me. You are supposed to be the client with your best interest at heart. Again, it just doesn’t seem to work out that way. Insurance companies work for the investors and the Board of Directors, not the client, you, the patient.
Both you and I seem to get the short end of the stick. I make an agreement with the insurance company; an agreement to treat their client to the best of my ability and spend however much time and my resources to make you feel better. And if I do indeed perform my duties, make the patient not only better for this moment, but look out for their long term health. One would think that I would be compensated from the insurance company at what we agreed was a fair amount (at least for the insurance company). But, somehow it manages to find some loophole or excuse to deny that my efforts were not worthy. I frankly find that insulting. I have over 21 years of higher education and training; yet the insurance company finds my efforts in some way lacking. This results of course in a denied claim or at the very least a greatly reduced compensation. All this despite that we both agreed to act in good faith and I would do whatever necessary for their client (I hate that term; you are my patient).
So what happens? Either the patient does without health insurance due to the exorbitant cost, or they get a bill from me to cover what the insurance company refused to pay. The numbers don’t add up. Patients pay many hundreds up to thousands of dollars a month only to be told it’s not enough. Then I am forced to make due on what they pay and still pay salaries for my staff, rent, malpractice insurance, supplies, etc. All this while the insurance companies stockholders and presidents pocket millions of dollars in bonuses.
Based on all this, I don’t mind in the least bypassing the insurance companies entirely. I believe if I charge a reasonable rate, one that allows me to pay all my bills, give the patient the care they need, including X-rays, injections, and most of all, my time. Time spent listening to your problems, testing what is necessary, explaining why and how we are going to treat this, and have the true concern for my patients that they get better. Do all this for considerably less than what you pay each month, the insurance premium.
Many physicians across the nation are dumping the insurance companies and dealing directly with the patient for their health care. This involves a subscription based system where you pay a monthly subscription (I can’t call it insurance because I am not an insurance agent). This monthly subscription allows you and your family to be seen in either of my clinics for only the cost of the subscription. Everything from injections, X-rays, in-house labs, casting, splints, even IV fluids if needed; everything to do with the visit for only the subscription cost. You can come as many times as needed during the month for no additional charge. Prescriptions sent to pharmacies and outside procedures like MRI’s, Lab testing at independent labs, or referrals would cost whatever those services charge. But by using other private services for MRI’s and referrals the costs are significantly lower than going through the hospitals (which insurance companies require you to do).
My subscription costs are usually less than a fourth of what insurance charge. And unlike insurance companies, If you don’t fully use our services, I will refund a portion of the money you paid (or apply it to the next terms costs).
My subscription charges I think are reasonable, considering what the ER’s charge and monthly insurance premiums:
It is a simple monthly plan with at least a six month commitment.
- Single person $175 / Month
- Spouse or Significant Other $275 / Month
- Each additional child under 18, $50 / Month
Unfortunately there is always a catch. You should obtain some sort of catastrophic policy in case something terrible happens and you are hospitalized. But these policies are much cheaper than routine health insurance.
You essentially get a membership to our clinics and all we offer. I think that is certainly peace of mind.
If you don’t think this is right for you and prefer to just pay as you go, our prices are still cheaper for self paying patients:
- Standard Visit $175
- Extensive visit including IV fluids: $200
- Minor trauma requiring Sutures; $225
These prices are still all inclusive, X-rays, Injections, medications we administer in the clinic, In-house labs, etc.
I know you will go where you feel you get value for your money. For the past 18 years my clinics have proven to be the best and we will continue to provide the best care to everyone who walks in our doors. Of course, if you have insurance, we accept most major insurances and are adding more insurance policies on an ongoing basis.
