Have you ever considered what it’s like for a doctor to operate in our current healthcare system?
Everything is so confusing and convoluted that it can take months for a doctor or hospital to finally get paid…if they get paid at all! This being the case, it shouldn’t surprise you to learn that some providers are willing to offer people discounts if they can get paid up front. You can utilize this trick regardless of the plan you have, although some insurance companies and arrangements work better than others.
High Deductible Health Plans
When you are enrolled in a High Deductible Health Plan or HDHP, your deductible applies to pretty much all care you receive. These plans are often referred to as Health Savings Account or H.S.A. Plans. When you have set aside hard-earned money in your H.S.A., you are more careful about how that money is spent. You have an incentive to be a wiser consumer and enter into whatever negotiations you can to get the costs down. Paying “cash” up front (or really just pulling out your H.S.A. card instead of your credit card) makes things a lot easier for these providers and they’ll likely be willing to give you a discount.
What if you’ve already met your deductible?
While enrolling in an H.S.A. plan has some natural built-in incentives to it, one criticism is that once you’ve met your deductible, there isn’t any reason to pay up front for a discount. The insurance company is the one paying for everything now! For example, let’s say you have a surgery coming up that will cost $20,000. Turns out if you are willing to pay for this surgery up front, the provider will drop the cost down to $15,000. You may reason that whether its $15,000 or $20,000, since you already met your deductible and out of pocket maximum, it makes no difference to you. So why even try to negotiate for a lower price? There is no incentive for you to enter into a pay up front arrangement with the hospital and doctors. The best insurance solutions will therefore offer the member an incentive which can influence their decision. Makes sense, right? If the insurance can save $5,000 on that surgery just for paying up front, then they should kick back say $1,000 to the member too.
When you work with our team, we can guide you to find these types of solutions so that your employees are incentivized to get the lowest possible price. Doing so will benefit your company and your plan by minimizing costs every time.
So how does it work?
While there are a few different pay up front type of solutions out there, this is generally how things work. Whenever one of your doctors or medical providers recommend a major diagnostic exam or surgery that can be planned in advance, you contact us. We will then ask you questions to understand the procedure you need and help you choose a high-value provider. Next, we will attempt to negotiate a cash price for your procedure that is less than your medical plan’s typical cost. Discounts range in size but can be as high as 50%! When you, the provider, and the plan agree to the cash rate, we pay the provider the full cash price when you receive care.
- Doctor recommends surgery or diagnostic exam
- You call us
- We negotiate a cash price
- You save up to 50%!
If you are interested in learning more about this and other creative solutions to health insurance, click here and send us a message.
