06/02/2022
If our patients had regular commercial insurance and a commercial insurance primary care "provider", this morning would have been very different for the patient, the radiology clinic and us.
Here's a real time example of responsive, affordable and excellent medical care for a fraction of the cost compared to the industrial health complex accessed through a BUCAH plan - (BUCAH = BCBS, United Healthcare, Cigna, Aetna, Humana)
7:00pm - Dr. Fischer's home - Clinic members calls and explains his symptoms to his own physician who knows him well. Dr. Fischer says, come in first thing tomorrow and call me if it gets worse.
8:30 am - Member comes to Fischer Clinic for free urinalysis and appointment with Dr. Benjamin Fischer. Urinalysis and exam confirms possible kidney stone - ouch!
9:18 am - $325 self pay CT scan ordered with a quick call to Raleigh Radiology with no insurance authorization needed because patient uses health sharing instead of commercial insurance.
Member heads to Raleigh Radiology...
Meanwhile -
9:30 am - Dr. Fischer is able to see next patient on time because he didn't have to fight with insurance to get first patient's CT scan approved. Dr. Fischer is present and relaxed and able to focus on the patient.
10:00am First patient calls to say he has already completed CT
10:43am CT Report received at Fischer Clinic confirming kidney stones. Dr. Fischer calls patient to make a plan for treatment
The fastest, most responsive care comes when you doctor doesn't have to fight with your insurance company for things that aren't expensive.
Patient quote: "Why would l pay $1400 a month for a $325 CT scan?"
WHAT IS EVEN WORSE?
Patient might have paid $2650 if he had "good" insurance
We would have pulled our hair out trying to get it authorized
Our attention on the authorization would have taken our attention away from the other patients that needed us today
The patient probably wouldn't be scheduled today
AND INSTEAD -
With a direct primary care doctor and a direct pay $325 CT scan he has been:
Seen by HIS OWN primary care physician
Completed the CT scan at Raleigh Radiology
Received a follow up phone call from Dr. Fischer who:
explained the findings
called in medications to begin treatment plan
Patient is back at home and beginning treatment before he would have been scheduled if he paid through insurance.
Paying directly is priceless.
Check out this report from Clear Health Costs - - exact same procedure code at UNC Hospital
For the exact same CT scan would you rather pay??
$325 with no delay or
$2650 with a long delay likely
https://clearhealthcosts.com/search/?query=74176&zip_code=27601&radius=100&submit=