Who isn’t concerned with the rising cost of healthcare? With insurance premiums going up and up, affordable care is one of the biggest concerns for American families. We’ve all heard stories of hospitals charging $10 for a band aid or $2,000+ for a few stitches. And how about charges for routine care such as $300+ for an office visit and a simple blood test? The good news is, you can save money on your care by carefully considering all your options in regards to insurance, hospitalization, specialty care and routine care.
Many people are opting for higher deductible/catastrophic insurance to lower their monthly premiums and paying out of pocket for their routine care. This eliminates the third party billing which is a cost savings to the medical office and laboratory who then can pass that cost savings on to you. Think of it like car insurance. You have it just in case of an accident but it doesn’t cover routine maintenance such as windshield wipers or tune-ups. If it did, it would drive the cost of car insurance way up. It’s the same with health insurance.
Many hospitals are willing to negotiate a cash price for a scheduled procedure at 50% or more savings as this eliminates their cost and time to bill insurance. Most insurance companies will then allow you to file for reimbursement yourself for the expenses incurred.
For specialty care, often the doctor is willing to negotiate a cash price with your primary care provider when they set up your referral. As this is not a routine request, you will need to ask your primary care provider if they will negotiate a cash price on your behalf.
When it comes to routine care, direct pay practices are the fastest growing trend around the country to help curb the costs of care. These practices are not credentialed with any insurance companies and services are paid for in full at the time of your visit, including any procedures or labs. This eliminates up to 40% of overhead costs and the office is able to negotiate with their laboratory for the lowest cost possible. The added benefits of direct pay are less patients need to be seen each day to cover costs so the pace is much slower, patients can usually get appointments quicker with much less waiting time in the waiting room, and the care is patient-centered rather than insurance reimbursement driven. The way health care used to be.
Julie Tomsett is a published author and the office manager at GracePointe Healthcare; a direct pay family practice in Cool Springs. For more information visit their website at: www.gracepointehealthcare.com