When our model hits home–the proof is in the 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 Strep

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

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

Bear was Free!

Ann Riggs, DO

Patient-Driven Affordable Healthcare