A couple of weeks ago I went to the doctor for some routine evaluations and my doctor referred me to a specialist to continue the tests I needed to perform. I went to the new doctor’s office and found out I had pay cash because he didn’t accept insurance plans – he said the insurance companies were a racket and he couldn’t deal with them anymore. He said all I had to do was submit the bill and receipt he gave to me to my insurance company and work through their reimbursement services. Before I go any further let me tell you that dealing with that department was an absolute and logistical nightmare! Re-submitting paperwork, on hold forever, calling back, sending faxes and emails, etc… An entire book could be made about handling the giant maze that is the medical insurance industry!
I digress because what I want to talk about is my eventual result, which was that I did not receive any reimbursement after all the herculean efforts I went through because of some technicality about him being out of regional network. Needless to say I was upset and mad at the doctor and the insurance company. In the end I was more upset at my insurance company because as I see it I pay for their services and their job is to reimburse costs. What does it matter if it is to me or to the doctor? I should have received that reimbursement in my viewpoint.
What really astounded me though was when I began to research this idea of doctors not accepting insurance and requiring cash payments. What I found out was amazing! There is a huge and growing new field in medicine for what is called “concierge medicine” or “boutique practices.” It seems that more and more doctors across the United States are leaving insurance groups and joining this new form of direct medical care where the relationship is between the patient and the doctor. In this model the costs to the patient are much lower because the doctors know that they will receive the money now as opposed to maybe possibly at some point in the future. When I say lower costs I mean that in the overall sense. Here are some examples from an article about doctors in New Jersey who left the traditional medical insurance route and now offer Concierge medicine:
|Procedure||Insurance Cost||Concierge Medicine Cost|
|Ruptured Abdominal Aneurysm||8,000||1,800|
|Routine Screening Mammogram||350||100|
|Initial Neurological Consultation||400||100|
Also doctors are providing constant contact through email, text messaging, phone access, and even house calls. It seems that it’s capitalism at its best! Lower costs and better service is available for those willing to buy into these programs. This was the first I had heard of all this and I’m definitely intrigued, even though it did come as a rude awakening in the way I found out about it. I should have been warned and told this ahead of time and then I could have made my own decisions on the matter.
What’s important is that you find out before going to a doctor if they are accepting your insurance or if they are only offering concierge medicine. Knowledge is power and if you know ahead of time then you can plan and prepare what course of action you want to take.
What do you think of concierge medicine? Have you ever had any experience with it?