When our model hits home–the proof is in the pudding.

 

pudding

Pudding Proof

I recently had the opportunity to experience the pitfalls of my own commercial health
insurance.  I tell patients all the time “the proof is in the pudding.”  Well it was my turn to see how this pudding really was in the health insurance world.

 

 

Recurrent Streprapid_strep_pos

This past fall my daughter was hit with yet another bout of strep throat.  She has fought it throughout her young life.  At the age of seven I made the call to consult with one of my favorite ENT docs.  It was an easy decision that she would do better if we proceeded with tonsillectomy and adenoidectomy.

 

High-Deductible-Health-Plan-paired-with-a-Health-Savings-AccountHigh Deductible

I, like so many of my patients, have a high deductible plan that I have married with an HSA(Health Savings Account).  I knew the bulk if not all of the cost of the procedure would be my responsibility.  I did not hesitate to ask for cash pricing.

Insurance Negotiated Pricing vs Cash Pricing

Pricing for any surgical procedure needs to include the following fees:

  1.  Surgeon’s Fee
  2.  Anesthesiologist’s Fee
  3.  Surgical Facility’s Fee

INSURANCE NEGOTIATED PRICING:  

Surgeon $372.51
Anesthesiologist + Facility $2624.00
Total Cost $2996.51

CASH PRICING: 

Surgeon $402.50
Anesthesiologist $578.00
Facility $879.83
Total Cost $1860.33

FINAL PRICING AND SAVINGS:

I was actually able to pay the insurance negotiated pricing for the surgeon and the cash pricing for the anesthesiologist and the facility.  My final pricing was $1830.34 for the entire procedure.  And there lies the proof in the pudding:

Almost $1200 in Savings

Happy Healthy Kid at Great Cost Savings by Paying Cash

alliej.jpg
Bear was Free!

Ann Riggs, DO

DMC Logo
Patient-Driven Affordable Healthcare

 

5 thoughts on “When our model hits home–the proof is in the pudding.

  1. Lynn March 30, 2017 / 10:14 am

    Dr. Riggs,
    Wonderful story with great outcome!!!
    I’m sure Ron will enjoy it !
    Lynn

    Sent from my iPhone

    Like

  2. Mark from Missouri April 1, 2017 / 8:08 pm

    I’ve been wondering around your web page and the forums after being referred by a co-worker. My wife and I are planning to retire in a couple of years and travel around the country in an RV for who knows how long.

    I passed along a link to your office page to several of my friends who are already on the road fulltime via my own blog so I hope you see a few visits to your page.

    What a wonderful concept it is to pay out of pocket at a reasonable fee. This is truly taking charge of ones own medical expenses. My wife and I are considering switching doctors because of this!

    Thank you for providing the service.

    Here is the link to my blog post if your interested: https://ourfutureinanrv.wordpress.com/2017/04/01/health-care-research-direct-medical-care/

    Mark in Clay County.

    Like

    • Ann Riggs, DO April 3, 2017 / 9:22 am

      Great blog post–we do care for a lot of snowbirds, college kids, and some who have just moved out of the area with ties back to here. We can do so much virtually these days that it has made sense. We have at least one in person visit per year. States we have patients living in: FL, NY, WI, KS, OK, TX, AZ, ID, WA, WY. Thanks for sharing!

      Liked by 1 person

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