If you’re a patient dealing with insurance, Stephen C. Schimpff has something to tell you. You aren’t really your physician’s customer. That’s because the insurer will decide whether and how much to pay the physician after they’ve seen you. You’re largely a bystander in the relationship, he says. The doctor’s customer is actually the insurer.
Tag Archives: Direct Care
We Know Fee-For-Service Healthcare Has Problems. But Would You Guess That It’s Hurting Patient Credit Scores, Too?
Mounting evidence shows that chaos in medical billing isn’t only affecting our nation’s health. It’s marring the financial reputation of many Americans. That’s because the bills themselves can take months to sort out, and medical debts can be reported rapidly to credit agencies, often without notification. Even small unpaid bills can severely damage credit ratings.
Oregon’s ACA Healthcare Website Failed, Too. But The Reason Why Could Spell Direct Primary Care Success.
The state of Oregon has paid software giant Oracle over $100 million to build a healthcare exchange site. Unfortunately, it doesn’t work. And now it appears that Oregon is stuck with Oracle because they can’t hire another firm to finish the job. This is case and point of an old-school IT provider lagging behind the current trends in building massive web operations i.e. the open source approach used on mega-scale websites like Google and Facebook.
Vote For Atlas MD As The Most Influential Cash-Only Clinic
Concierge Medicine Today is asking their readers ‘What are the most influential “brand names” and “people” in the concierge medicine and direct healthcare marketplace? We earned their nod amongst an impressive list of insurance-free clinics/physicians. Results will be revealed mid-March, so if you have time, vote for us! Atlas MD is primary care fit for a CEO — free procedures, unlimited office and tech visits, discounted labs and prescriptions — at a price fit for all of us. Thanks for your support!
Cut The Red Tape: Dr. Ciampi — Portland, Maine
In South Portland, Maine, Dr. Michael Ciampi took a step last spring that Bangor Daily News said some physicians would describe as radical (not us, though). He reclaimed his practice from the Mercy health system because he found that patient care was too impersonal. Then he stopped accepting insurance and Medicaid so that he could work more directly with his patients. Earlier in 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.
Direct Care Is Actually Affordable. Direct Care Is Actually Care. Something The ACA Wishes.
When Blue Shield of California was designing the new health plans it would offer individuals under the Affordable Care Act (ACA), the insurer made a simple request to doctors and hospital in its network — lower your prices or get left behind. The insurer asked providers to accept reimbursement rates as much as 30 percent lower than what Blue Shield previously paid through plans sold on the individual market. Keep in mind that billing through a third-party-payer is about to multiply tenfold in complexity (from ~15,000 to +155,000 billing codes with ICD-10), meaning that getting paid will require more work for fee-for-service docs. In fact, providers are attending training seminars, paid for out of pocket, to learn how to deal with this billing beast.
Some providers got on board with Blue Shield, but not all of them.
Direct Care Is Business. And Its Business Is Serving Patients.
Last year, the New York Times wrote about Orlene Paxson, a 33-year-old, stay-at-home mom. Living on Manhattan’s Upper East Side, she was unable to find an obstetrician that she liked who would accept her insurance. A lot of them weren’t accepting new patients, and one doctor who came highly recommended didn’t return her call for five days and didn’t want to see her until 12 weeks into the pregnancy. This was Mrs. Paxson’s first time being pregnant. She didn’t want to wait. Her policy didn’t cover any out-of-network services, but she and her husband went the cash-only route and paid the entire fee themselves — $13,000.