Cash Discount Plan
As you probably know, traditional medical practice is to set
fees for services, and then offer discounts on those fees to insurance companies
in return for their volume of referrals.
For several years, I have been bothered that a rather perverse result of
this system is that patients who don’t have insurance are ultimately charged
more for their medical care, even
though less administrative work is
involved in their care. After all,
there are no pre-certifications to obtain, no forms to file for reimbursement,
and if the patient pays at the time of service, no need for a billing company to
track the account, mail out bills, process insurance checks, etc.
With that as background, I decided to implement a discount policy in January
2004, and so far, it has worked well for many of our patients.
Traditional Option
(for payment via Insurance)
If you choose to use your insurance to pay for your treatment, we still bill
insurance and do participate on several provider panels.
If you present us an insurance card for a plan with whom we participate,
we will be happy to bill them for you, after first collecting your co-pay or
co-insurance (the part of the charge that is your responsibility) at the time of
service.
Discount Option
(for full payment at time of service)
We are pleased to offer this option for paying for service at our office.
Attached you will find our current fee schedule.
The Discounted Fees are offered to hopefully meet several types of needs
that patients have expressed to me over the years.
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I often treat patients whose benefits change every
calendar year. Many times this means I am no longer a network
provider, and they have to start all over with someone else if they want to
use their new insurance benefits. Many people don’t want to start over
with a new doctor, but have trouble justifying paying full fee when they
have insurance benefits available with a different mental health
professional. This gives them a more affordable option for continuing
their care with a doctor who already knows them. And we will give you
the information needed to file your own claim if you have out-of-network
benefits.
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If you only see me for short visits every few months, it’s
quite possible that you’ll spend less money by using our discount plan than
you will by changing providers, going through the initial intake process all
over again, paying in-network co-pays, and/or having to meet a mental health
deductible before any benefits are paid.
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I respect your right to avoid using your insurance
benefits for mental health care, for whatever reason. If you want to
pay me directly for my work with you, that cuts my administrative costs, and
I’ll pass those savings on to you.
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Sometimes people seek help, especially psychotherapy, for
issues or situations that are not covered by insurance. There may be
times that they are troubled by something, but are not truly ill. For
those times, I feel it is unethical for “force” a mental illness diagnosis
just to gain access to insurance benefits. To make things more
affordable in these non-covered instances, I am willing to discount my fees
in return for reduced administrative costs.
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You pay the day
that you are seen. We can
offer a discount by eliminating the need to track account balances, send
bills, etc. That means you must
maintain a zero balance to make this work.
If you show up for the appointment and find that you haven’t brought
a method of payment (cash, check, or credit card) you may either proceed
with the appointment under the traditional full-fee option, or cancel and
reschedule the appointment. If
you reschedule, however, the $40.00 “Late Cancel” fee will still apply, and
must be paid before we will reschedule.
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If we are “out of network” providers for you and you
choose to file for reimbursement from your insurance company,
you must file your own insurance
forms. We will supply you
with the necessary diagnosis and coding information for you to fill out your
claim form, but will not fill out the form for you.
Again, this system is all about discounting your fees in return for
you discounting our administrative costs.
Processing insurance forms is one of our major expenses.
Eliminating that step is part of what allows us to offer these
discounts.
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What about inpatient services?
Due to the unpredictable nature (and expense) of inpatient
stays, our Discount Option applies only to services rendered in the office.
We can’t expect you to pay your portion of the inpatient fees at the time
of service, so we can’t offer these discounts for inpatient care.
If you are hospitalized, we will continue our usual practice of billing
your insurance company. As always,
you will be responsible for any balances after insurance pays their portion.
If St.
Mary’s is not part of your insurance network, and you wish to use your insurance
benefits for inpatient care (as most people would), we will have you go to
Deaconess (or another network provider) for your inpatient care, and then resume
our outpatient care upon discharge.
If you have any questions about your account or our payment
options, please feel free to ask for clarification.
We are striving to make high-quality care affordable again, and would
appreciate any feedback you may have.
As noted above, this is a work in progress, so we reserve the right to
amend or eliminate this policy as necessary.
Fee Schedule for Gene R. Flick, M.D.
(Fee schedule is available to individual patients upon
request.)