Insurance and fees update, Mar 1, 2006

Now that we will no longer be contracturally involved with any insurance company as of March 1st, (Thank God!) we will be able to simplify our fees, and also make them more fair. When insurance companies are involved, they require a certain fee for a certain type of coded visit, no matter how long that visit took. Of course what they paid us had nothing to do with those fees, but they were required anyway. They paid much less than the fee. So non-insured patients were paying more than insurance companies were for the same service, and attempts to fix that inequality would have been illegal, believe it or not. Further, a patients who required less time had to pay as much as patients who required more time, for the same type of visit. The absolute unfairness of this has driven me crazy for many years. Now that I will no longer be involved with those companies, I can fix this. So starting March 1st, my fee for a visit will be $300 per hour, measured in five minute intervals. Thus, a 15 minute visit will cost $75 and a typical 30 minute visit will cost $150. The additional fees for lab tests and pap smears will remain as they are. That averages out to about the same that it was with the previous system, but this is infinitely more fair, so that patients who now require a short amount of time will pay less than those who take a lot of time. Of course, I will continue to code out the superbill receipt in the manner required by your insurance so that they will hopefully reimburse you appropriately.
ALSO, SOME OF MY BLUE CROSS PATIENTS ERRONEOUSLY THINK THAT THEY CAN'T SEE ME BECAUSE I WILL NO LONGER BE TAKING THEIR INSURANCE. THIS IS INCORRECT! Most of my Blue Cross patients have the type of policy that allows you to go out of network and see a non-participating doctor. They will reimburse you for part of what you spend out of their network. So if you choose to continue to see me, we will expect you to pay our fee and in turn we will give you the superbill that you can then turn in to Blue Cross for them to reimburse you. I doubt that they will reimburse you the entire amount, but I suspect they will reimburse at least half. At this point, I have no way of knowing what they will pay. A few of my Blue Cross patients have a plan that does not allow this, but most do. SO PLEASE DON'T THINK THAT I WANT TO GET RID OF MY BLUE CROSS PATIENTS, I JUST WANT TO GET RID OF BLUE CROSS!


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