The Cash-Based Medical Practice Solution

Today’s Medical Practice 

Too many patients. Too little time. Too many limits on care. Too much documentation. Too many prior authorizations, claim denials, and ever decreasing reimbursement rates. All of this with the news of a 7% to 8.5% increase in inflation. Patients are waiting months for basic care, and increasingly having to foot the bill due to insurance denial. Newly enacted law requiring price transparency is creating “sticker shock”  so badly that many patients are delaying or refusing medical care their insurance may not cover. Beside the pain and suffering that’s felt immediately, delayed cancer screening and preventive treatments will lead to illness and death at an even greater cost to the system. What’s the solution? The cash-based medical practice.

The Alternative Approach

Last week we had a patient get a lab panel drawn after her hysterectomy and her ‘estimated’ cost was $1,600 dollars if insurance denied coverage. Instead, she chose to have more thorough testing done through my office for a quarter of the price. We were able to provide her with more complete individualized treatment (including a minimally invasive procedure), supportive medications and supplementation for a lower total “out-of-pocket” expense. We also offered payment options if she needed it. How? We’re a cash-based medical practice providing old-fashioned personal care with cutting edge workflow technology called EVA. 

The Cash-Based Model 

The cash-based medical practice is a model of providing direct care to patients without third-party interference in decision-making. This approach demands the highest quality of care and patient satisfaction with transparent pricing that’s agreeable to all. 

Early in my career I found that drug therapy and surgery were not the only effective ways to help a patient get over illness or become well. Unfortunately, only drug therapy and surgery were considered reasonable expenses for insurance reimbursement. It became increasingly difficult to walk the line between what was best for the patient and what insurance considered worthwhile. To avoid confusion and constant misunderstandings I transitioned my practice to a cash only payment model. Since then I developed protocols and treatments agreeable to patients and my own professional standards based on what works best and not what insurance pays most. Ever since, I’ve been able to develop protocols and treatments that satisfy patients and meet my professional standards based on what works best not what insurance allows. Insurance is critical for major catastrophic illnesses and injuries that cost thousands or tens of thousands of dollars.  Unfortunately, insurance interference crushes high-quality primary care under rules and regulations that guarantee burnout and early retirements. Patients have full control of the money they invest in their care and I never have to suffer moral injury by not providing the care that I believe would be best. When patients and their doctors build a trusted medical and financial relationship at the primary care level, costs are controlled and quality of care becomes the focus of everyone’s attention. It’s a win-win for patient and doctor alike. 

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