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(CNN)   Doctor's office receptionist: Will you be paying by cash, cash or cash?   (money.cnn.com) divider line 57
    More: Interesting, American Academy of Family Physicians, primary care doctors, consumer advocacy, family practices, concierges, car insurance, anesthesiologists  
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2827 clicks; posted to Business » on 13 Jun 2013 at 8:02 AM (2 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-06-13 03:20:06 AM  
The central doctor in TFA was on Fark May 28.
 
2013-06-13 07:56:54 AM  

Similar to

this
 
2013-06-13 08:10:03 AM  
While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.
 
2013-06-13 08:16:36 AM  
I'm cool with this.
 
2013-06-13 08:20:18 AM  
I also accept gas, grass, or ass.
 
2013-06-13 08:35:24 AM  

gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.


ftfa: 50 bucks per adult, 10 bucks per kid, so a family of 4 pays 120 bucks per month.  thats less than my cellphone bill for me and my wife.  hard choices though, cellphone or medical.
 
2013-06-13 08:35:59 AM  

blacknite: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

ftfa: 50 bucks per adult, 10 bucks per kid, so a family of 4 pays 120 bucks per month.  thats less than my cellphone bill for me and my wife.  hard choices though, cellphone or medical.


oh, senior citizens pay 100/month, i overlooked that.
 
2013-06-13 08:45:18 AM  
GOOD.  Anything that cuts out the useless, bloated bureaucratic middle-man that is the insurance industry.  They're not the ones that heal you, so why the fark are they making money off of the health-care system?
 
2013-06-13 08:47:35 AM  

blacknite: blacknite: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

ftfa: 50 bucks per adult, 10 bucks per kid, so a family of 4 pays 120 bucks per month.  thats less than my cellphone bill for me and my wife.  hard choices though, cellphone or medical.

oh, senior citizens pay 100/month, i overlooked that.


That's just a bit more than my cable bill.

Sure, a program like this would suck ass for low-income families, but the important thing is it gives people a choice.  Those who can't do this service can still rely on Medicaid*.

*if it doesn't get gutted at some point
 
2013-06-13 08:48:37 AM  

Lexx: GOOD.  Anything that cuts out the useless, bloated bureaucratic middle-man that is the insurance industry.  They're not the ones that heal you, so why the fark are they making money off of the health-care system?


Federal legislation banning this concierge service hits the floor in 5...4...3...
 
2013-06-13 08:49:15 AM  
My allergist does this as well as our son's therapist. They give us a receipt that we send to our insurance company for reimbursement for going out of network. Depending on what we're seeing them for our out of pocket is the same as our deductible or a little more. On the plus side, paperwork for the doctor takes under a minute.
 
2013-06-13 08:49:38 AM  
Who knew the Eagles were so prescient?
 
2013-06-13 08:49:40 AM  

gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.


Generally better in the long run, though it is difficult if you have $0 as you need somewhere to negotiate from.  Even non-subscription visits cost less with cash.  I had a growth removed and checked for cancer.  Would've been a few hundred dollars after insurance and deductible.  Cost me a crisp, clean $100 bill when I offered cash.  The doctors office was ecstatic to hear me offer cash even though they would have banked much much more with insurance whenever they were paid.

Anyways, I completely advocate offering cash if you have it.  You lose money towards your deductible, but if you're on otherwise generally good health what's a few hundred dollars more if you get smashed up in a catastrophic car accident.  All medical services can be negotiated
 
2013-06-13 08:58:19 AM  

Lexx: Anything that cuts out the useless, bloated bureaucratic middle-man that is the insurance industry. They're not the ones that heal you, so why the fark are they making money off of the health-care system?


Because their main sin is not giving a shiat about the prices hospitals charge, given they usually have monopolies in an inelastic demand market.  The reason why you work with a health insurance company is because they occasionally negotiate rates you can't get on your own.

I have no love for health insurance companies -- they operate as if they're paid to fark up and in some cases it's reported they literally fark up on purpose -- but the sky-high costs of healthcare are being driven by hospitals.  Hospital billing is a matter of pure fiction.  It's bizarre how they have a teflon reputation to the point of receiving donations, considering the level of sociopathy and corruption in healthcare would make even a mobster blush.
 
2013-06-13 09:00:18 AM  
Overall, it sounds great-- and it's an encouraging sign that our serious farked up medical system might actually be fixable after all.

They just need to drop (or at very least don't mention to the press) the Ayn Rand reference.

First off, any smart business should strive to be nonpolitical as possible, with precious few exceptions.  I've turned around and walked out of a couple of "folksy" restaurants that took things a step too far by having a conservative "clever" quote-of-the-day on a chalkboard as you go in. The restaurants are still open, but they will never know how much they've hurt their own business by putting up stuff that's bound to be offensive to some of their potential customers.

Secondly,  while I know crazy beliefs can be compartmentalized and it doesn't necessarily reflect the quality of a doctor, I would think twice about going to anybody who took Ayn Rand seriously.

==================

And why in the hell are insurance companies letting themselves be gouged like the article describes?  $90 for a $3 blood test?  WTF?!?  How is something like that even legal?
 
2013-06-13 09:07:48 AM  

bhcompy: gopher321:   All medical services can be negotiated


I see that as hard to do if you're unconscious from being in a car wreck or having a heart attack.
 
2013-06-13 09:09:55 AM  

Riche: And why in the hell are insurance companies letting themselves be gouged like the article describes? $90 for a $3 blood test? WTF?!? How is something like that even legal?


If the hospital charges the insurance company 90$, the insurance company charges the individual 10-20% of that(assuming a decent plan with a general 80-90% coverage) plus deductible and pockets the rest, they make money, the hospital makes money, and you pay more.  Win, win for everyone but you.  It's designed to work that way, and it's only gotten better for insurance companies in recent years(profit margins have increased in the post-reform world)
 
2013-06-13 09:11:44 AM  

Riche: And why in the hell are insurance companies letting themselves be gouged like the article describes?   $90 for a $3 blood test?  WTF?!?  How is something like that even legal?


Billing and actual reimbursement are different things. I'm not sure of the insurance, but if you bill a $90 test, you might get a $20 payment from Medicare. Yes, the test itself cost only ~$3, but the lab company, or another doctor's office has to figure in: cost for MA/RN to draw, lab supplies (tourniquet, butterfly, SST tube, band-aid, gauze, alcohol pad). If they don't have an in-office lab now they need to worry about cost of shipping. There's the printing cost for the lab to be printed on paper. The doctor's time to read the results/make any necessary changes to your health. The staff members time to file the paperwork correctly or communicate with a specialist (or your PCP if the specialist is drawing it). There's the cost of the additive/solution to run the $20,000 machine that had to be purchased to runt hat test (yes, these machines can run a lot of tests, so they're definitely worth it).

So that $20-$25 reimbursement does make a bit more sense if you think about it like that and we didn't even talk about overhead for the buildings/power.
 
2013-06-13 09:12:52 AM  

Riche: bhcompy: gopher321:   All medical services can be negotiated

I see that as hard to do if you're unconscious from being in a car wreck or having a heart attack.


While you're better off negotiating upfront because you can threaten to take your services elsewhere, hospitals and doctors offices will still generally negotiate with you if you offer other means of payment.
 
2013-06-13 09:13:09 AM  

bhcompy: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

Generally better in the long run, though it is difficult if you have $0 as you need somewhere to negotiate from.  Even non-subscription visits cost less with cash.  I had a growth removed and checked for cancer.  Would've been a few hundred dollars after insurance and deductible.  Cost me a crisp, clean $100 bill when I offered cash.  The doctors office was ecstatic to hear me offer cash even though they would have banked much much more with insurance whenever they were paid.

Anyways, I completely advocate offering cash if you have it.  You lose money towards your deductible, but if you're on otherwise generally good health what's a few hundred dollars more if you get smashed up in a catastrophic car accident.  All medical services can be negotiated


You summed it up nicely.
I have been on a high deductible insurance with BCBS in FL for years. 
I had a wicked flu last november and ended up going to a doctor whom I paid $110 to for a checkup, lecture, and antibiotics (had ear, sinus, and lung infection).
Before that, went to ER for lots of stitches (tore up my arm).
Out the door for $400. Winter Park Hospital offered a 50 percent discount for cash.
I pay $125/mo to BCBS for a $7500/yr deductible (2500/incident) that covers me nicely should anything bad happen. 
/Still should get some disability protection though...
 
2013-06-13 09:16:31 AM  

bhcompy: Riche: And why in the hell are insurance companies letting themselves be gouged like the article describes? $90 for a $3 blood test? WTF?!? How is something like that even legal?

If the hospital charges the insurance company 90$, the insurance company charges the individual 10-20% of that(assuming a decent plan with a general 80-90% coverage) plus deductible and pockets the rest, they make money, the hospital makes money, and you pay more.  Win, win for everyone but you.  It's designed to work that way, and it's only gotten better for insurance companies in recent years(profit margins have increased in the post-reform world)


Not really sure what insurance you've been through that doesn't have a prevailing rate. Your hospital can charge anything they want, $500 for that $3 test, but any of the bigger insurances I've dealt with like Humana, United, MCR, etc. all have a rate they'll pay for certain tests, so that $500 becomes $35 which is included in all services, so if you're in an ER or urgent care setting, it's rolled into your deductible cost for that trip. Yeah, if you have JUST labs done somewhere, you'll have to pay your diagnostic charge whatever that is, but don't get fooled into thinking your insurance company is paying $90 for that $3 test.
 
2013-06-13 09:19:07 AM  

bhcompy: hospitals and doctors offices will still generally negotiate with you if you offer other means of payment.


I knew there was a reason those robes open from the back!
 
2013-06-13 09:22:50 AM  
Good luck paying for your brain surgery with cash.
 
2013-06-13 09:35:47 AM  

12349876: Good luck paying for your brain surgery with cash.


Why? Assuming that you have the money I don't think a hospital would have any real objection to it. They might ask for a check just for convenience sake or for you to accompany them to the bank to have it counted but is anyone really going to turn down a briefcase full of money?
 
2013-06-13 09:36:22 AM  

rooftop235: bhcompy: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

Generally better in the long run, though it is difficult if you have $0 as you need somewhere to negotiate from.  Even non-subscription visits cost less with cash.  I had a growth removed and checked for cancer.  Would've been a few hundred dollars after insurance and deductible.  Cost me a crisp, clean $100 bill when I offered cash.  The doctors office was ecstatic to hear me offer cash even though they would have banked much much more with insurance whenever they were paid.

Anyways, I completely advocate offering cash if you have it.  You lose money towards your deductible, but if you're on otherwise generally good health what's a few hundred dollars more if you get smashed up in a catastrophic car accident.  All medical services can be negotiated

You summed it up nicely.
I have been on a high deductible insurance with BCBS in FL for years.
I had a wicked flu last november and ended up going to a doctor whom I paid $110 to for a checkup, lecture, and antibiotics (had ear, sinus, and lung infection).
Before that, went to ER for lots of stitches (tore up my arm).
Out the door for $400. Winter Park Hospital offered a 50 percent discount for cash.
I pay $125/mo to BCBS for a $7500/yr deductible (2500/incident) that covers me nicely should anything bad happen.
/Still should get some disability protection though...


Here's the problem I've found.

You go into the ER and you need to be seen. The first thing they ask you for is your insurance card. Do you just decline to give it at that point? Then, after you receive the bill, say "Oh, I have insurance but forgot my card when I came in."?

Because, once they have it and bill the insurance company, you can't ask them to "un-bill" insurance and have you pay cash. And, it's not really possible to say to the receptionist/nurse at the ER, "So, how much will this run me" before getting treated.

Doctor's office is of course a different animal for routine checkups, etc.
 
2013-06-13 09:50:58 AM  

To The Escape Zeppelin!: 12349876: Good luck paying for your brain surgery with cash.

Why? Assuming that you have the money


thatsthepoint.jpg
 
2013-06-13 10:13:12 AM  
Wish there was a good way to find doctors who are cash only. Last time I wanted to see a doctor about something, I called around and for a new patient they were offering appointments in 3-4 MONTHS... Being able to make an appointment for sometime within a few days, and pay cash for the visit would have been great. Ended dealing with it via google.
 
2013-06-13 10:14:55 AM  
 each patient pays a flat monthly fee to have unlimited access to the doctors and any service they can provide in the office, such as EKGs or stitches.

sooo... its like insurance?
 
2013-06-13 10:21:10 AM  

kidgenius: Here's the problem I've found.

You go into the ER and you need to be seen. The first thing they ask you for is your insurance card. Do you just decline to give it at that point? Then, after you receive the bill, say "Oh, I have insurance but forgot my card when I came in."?

Because, once they have it and bill the insurance company, you can't ask them to "un-bill" insurance and have you pay cash. And, it's not really possible to say to the receptionist/nurse at the ER, "So, how much will this run me" before getting treated.

Doctor's office is of course a different animal for routine checkups, etc.


An emergency room cannot turn you away if you don't have insurance and need emergency care.  Lie to them, if you want, and deal with the insurance forms after the fact if you wish.  If you have a non-emergent need, go to urgent care.
 
2013-06-13 10:35:36 AM  

gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.


This sentence looks like fud to me. Low-income people don't "go to the doctor" now. They go to the emergency room for "free" care. Middle-income families generally have insurance, or can join a cash plan like this guy's. I don't get the hand wringing.
 
2013-06-13 10:40:44 AM  

Lexx: GOOD.  Anything that cuts out the useless, bloated bureaucratic middle-man that is the insurance industry.  They're not the ones that heal you, so why the fark are they making money off of the health-care system?


Because they are the ones that pay for it.
 
2013-06-13 10:42:29 AM  

xanadian: Federal legislation banning this concierge service hits the floor in 5...4...3...


I doubt they'll ban it, but it probably doesn't meet the base requirements of the PPACA either.
 
2013-06-13 10:50:00 AM  
This could be interesting, as long as doctors pass the savings onto consumers. Cut out the middleman. Health insurance doesn't really work like homeowner's. You are pretty much guaranteed to need it, so health insurance companies are really just middlemen raising the cost of health care without providing much of a service.

I get health insurance through work, but if I didn't, I would only buy medical disaster coverage, something with at least a $10k deductible. That should lower my premium to less than $100/month.
 
2013-06-13 10:51:57 AM  

gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.


As a middle income person, I'm extremely pro-this doctor.  I'm sick of (no pun intended) sending the insurance company money every month simply to pay for other people to be sick.  I don't care about them.  They don't care about me.  Cash only doctors is a nice way for neither of us to have to associate with one another.
 
2013-06-13 11:02:49 AM  

bhcompy: gopher321:

Anyways, I completely advocate offering cash if you have it.  You lose money towards your deductible, but if you're on otherwise generally good health what's a few hundred dollars more if you get smashed up in a catastrophic car accident.  All medical services can be negotiated


So who do you make this offer to? The receptionist? It's never occurred to me to try this.
 
2013-06-13 11:28:39 AM  

BrainyBear: bhcompy: gopher321:

Anyways, I completely advocate offering cash if you have it.  You lose money towards your deductible, but if you're on otherwise generally good health what's a few hundred dollars more if you get smashed up in a catastrophic car accident.  All medical services can be negotiated

So who do you make this offer to? The receptionist? It's never occurred to me to try this.


I've discussed it with the doctors and with billing(sometimes the receptionist as well).  In non-group offices where the doctor himself is running the operation, not some hospital group, the doctor is probably the first go-to
 
2013-06-13 12:01:57 PM  
Average life expectancy = 81 for women
12 months a year
The highest rate is $100
81*12*100=$97,200

So for a $100,000, he can set me up for life? Or I can just put it in the bank and set up automatic bill pay?
 
2013-06-13 12:16:49 PM  

gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.


It is dumb for high income people as well.  Why take on that huge amount of financial risk (by not using/having insurance)?
 
2013-06-13 12:17:58 PM  

gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.


They can go on Obamacare and get traditional (i.e., treated like cattle) care. Problem solved. Unless you consider the problem to be that people with the means and willingness to pay can escape the system.
 
2013-06-13 12:21:28 PM  

nocturnal001: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

It is dumb for high income people as well.  Why take on that huge amount of financial risk (by not using/having insurance)?


If you read the article (I know, I know, welcome to fark), you'll see that he recommends obtaining a catastrophic policy for, well, catastrophes. Plus, since Obamacare eliminated the pre-existing condition restriction, patients can always wait until disaster strikes and get an Obamacare plan.
 
2013-06-13 12:23:48 PM  
He has a point about the automobile insurance comparison. My comprehensive package does not cover routine maintenance. I imagine that if it did the average cost of an oil change, only available through licensed and certified practitioners, would go up to $400. And that's what my insurance company would say to me as to why my rates were going up again. I mean, in reality they're only paying $100 for what used to be a $40 service, but it's the same problem.
 
2013-06-13 12:27:55 PM  

jjorsett: nocturnal001: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

It is dumb for high income people as well.  Why take on that huge amount of financial risk (by not using/having insurance)?

If you read the article (I know, I know, welcome to fark), you'll see that he recommends obtaining a catastrophic policy for, well, catastrophes. Plus, since Obamacare eliminated the pre-existing condition restriction, patients can always wait until disaster strikes and get an Obamacare plan.


It still doesn't make a lot of sense financially speaking. There are plenty of non-catastrophes that are still expensive.

/skimmed article
 
2013-06-13 12:41:42 PM  

xanadian: Lexx: GOOD.  Anything that cuts out the useless, bloated bureaucratic middle-man that is the insurance industry.  They're not the ones that heal you, so why the fark are they making money off of the health-care system?

Federal legislation banning this concierge service hits the floor in 5...4...3...


Ban? Why ban when you can get your cut instead?
 
2013-06-13 12:44:21 PM  

nocturnal001: jjorsett: nocturnal001: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

It is dumb for high income people as well.  Why take on that huge amount of financial risk (by not using/having insurance)?

If you read the article (I know, I know, welcome to fark), you'll see that he recommends obtaining a catastrophic policy for, well, catastrophes. Plus, since Obamacare eliminated the pre-existing condition restriction, patients can always wait until disaster strikes and get an Obamacare plan.

It still doesn't make a lot of sense financially speaking. There are plenty of non-catastrophes that are still expensive.

/skimmed article


Pssh, please, people with conditions like MS don't need insurance to cover those drug expenses!
 
2013-06-13 01:11:37 PM  
I switched to a high deductible BC/BS plan with an HSA.  No money at all goes to an insurance company, all goes into an interest bearing rollover account for me to pay the doctors with.  I negotiate prices for routine visits and some procedures are free to me under the plan.  $2100 max per person/$5K family is when they take over at 90% and hit 100% around $10K.

We were paying about $300 a month to Aetna HMO, had tiered co-pays and had to ask for pre-approval or referral for everything.  My wife was the only one going to the doctor for quarterly BP/Hemoglobin check-ups and the annual female stuff.  So that was $3600 in premiums and 5 co-pays @ $20 each for $3700 total spent then.  Now its $75 a visit for the quarterlies and free annual physical for a total of $300 a year spent and the rest of my $3K a year HSA rolls on.  Once I hit the disaster limit, I will probably drop my yearly contributions down to cover average use per year saving me even more money out of each check.
 
2013-06-13 01:29:08 PM  

LL316: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

As a middle income person, I'm extremely pro-this doctor.  I'm sick of (no pun intended) sending the insurance company money every month simply to pay for other people to be sick.  I don't care about them.  They don't care about me.  Cash only doctors is a nice way for neither of us to have to associate with one another.


Can you please tattoo on your forehead DNR?  That way when we find you in the ditch we'll just piss on you instead of helping you.
 
2013-06-13 01:31:11 PM  
What I like about insurance when I was desperately poor was that, once co-pay was taken care of, if there was one, I was not expected to take care of the whole bill right there.  Let's be honest, I knew my insurance wasn't going to cover whatever is about to happen, but a lot of the time I just couldn't afford the treatment.  So, they'd bill my insurance who would laugh and troll the office for a few months asking for various bits of paperwork before they finally admit they just weren't going to pay and the office would finally bill me for which I would either try and make payments on, or, if the office got snippy about that, promptly trash.

/You'll either get small payments or partial or you'll get nothing dammit, work with people.
 
2013-06-13 01:48:33 PM  

gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.


As a low income small biz owner who can't afford insurance for his wife due to her pre-existing condition, this is a shiat-ton cheaper than the $2450/mo they want to insure her.
 
2013-06-13 02:02:14 PM  
The only time I've paid cash to a doctor was for an aviation physical. He did probably the bare minimum of exams, signed the papers, then asked for the money which he promptly put in his pocket. I knew better than to ask for a receipt.
 
2013-06-13 02:13:52 PM  

MadHatter500: LL316: gopher321: While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.

Yeah, no shiat.

As a middle income person, I'm extremely pro-this doctor.  I'm sick of (no pun intended) sending the insurance company money every month simply to pay for other people to be sick.  I don't care about them.  They don't care about me.  Cash only doctors is a nice way for neither of us to have to associate with one another.

Can you please tattoo on your forehead DNR?  That way when we find you in the ditch we'll just piss on you instead of helping you.


You know if more people were DNR that would save the health care system a lot of money!!!

And I agree with gopher. Get a job hippie!
 
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