Have you ever been surprised by a medical bill? Chose an in-network hospital, only for the doctor to be out of network? What about labs or imaging denied by insurance because they claim it's not medically necessary? How about a physical or preventative visit only to find out the visit was not fully covered? When was the last time the doctor, or anyone, told you what these things cost BEFORE ordering them? Unfortunately, with dozens of insurance plans, multiple tiers, co-pays, deductibles, and premiums, it's nearly impossible to get a straight answer about what things should cost. If neither the doctor nor patient know what things will cost, how can informed decisions be made?
Unfortunately, the system was designed to not only be complicated, but also opaque. The more confusing the system, and the more unexpectedly large bills patients experience, the less often they seek care. Insurance companies will continue to collect premiums whether you seek medical care or not; and both co-pays and deductibles when you do. This lack of transparency around coverage and unexpected costs also weaken the trust between doctors and their patients. However, there is a solution and it's called direct primary care.
"Tell me who pays you, and I'll tell you who your boss is." This was the advice given to me while waiting tables to demonstrate the importance of tips when making less than $3/hr. Obviously, customers were treated to the best service I could provide in hopes of getting paid. Well, in healthcare, insurance is the boss and they tip poorly. Furthermore, their focus is on delivering profit to shareholders; not your health, not supporting clinic staff, and definitely not saving you money. But it wasn't always like this, patients used to pay doctors directly, and doctors set their prices because they knew what things would cost.
With Direct Primary Care, and especially here at Clear Health DPC, we advocate for patients by trying to make healthcare both accessible and affordable. Through direct client billing agreements with imaging & lab facilities, manufacturers, and medical suppliers we not only know how much things will cost, but we have negotiated lower than the cash prices. Whether its labs, X-rays, or even MRIs we can tell you exactly how much it will cost BEFORE we order it, no more surprise bill in the mail hoping it will be covered. No more waiting for insurance approval, we can help get those tests scheduled right away. Price transparency is critical to building trust between our team and patients; we believe cost is an important factor for building an effective long term treatment plan. Long-term health goals are achieved when there is direct, non-judgemental communication and trust between the physician and patient. When our clinic only profits from the membership fee paid directly by the patient, we can help save patients money as we help them navigate the complex healthcare system. As an added bonus, our medical team is rewarded by reaching your health goals and preventative care, rather than reactive sick care and being paid the more often you are seen. You can trust that we will respond with thoughtful and thorough medical advice the same day or next day during business hours because our schedule is no longer full of insurance-driven unnecessary/redundant visits.
If this sounds like the kind of relationship you’d like with your doctor and your medical team, don’t hesitate to sign up for a membership or a free meet and greet. Our panel is initially limited to 500 patients.