What's a non-insurance doctor?

[hezasan]

Actually I know what this is, but searching for more info -- I read that Dr. Bob (?) Sears is a non-insurance doctor, meaning he doesn't contract with insurance companies and he feels it makes him better able to help his patients (who are free to bill their own insurance companies).
Are there other "non-insurance doctors" out there? Does anyone have experience with them? How does it work? Do you like it this way?
Thanks!

[sbgrace]

We use some non-insurance providers for my son. I don't like it because we have to pay up front and then wait for insurance to process and reimburse us at a "non-network rate" so it's financially harder. We're still waiting on claims processing from early November paid to the provider in Aug and Sept and we now have bills in Dec. and Jan. that we've paid and file and we wait. It's frustrating.

[KatWrangler]

Sounds to me it eliminates a whole lot of less unfortunate people if I am understanding this right. Like people on Medicaid. People that do not have money upfront to cover his charges.

[kjbrown92]

Our osteo doesn't do insurance either. We pay up front using money from our HSA. The first visit with him was about 2 hours, very thorough. And all the ones thereafter have been about an hour. Our regular family doctor - covered by insurance - we're lucky if we get 10 minutes with him.

But since the osteo is the only one who has actually helped us, I'm paying. Insurance covered the 3 MRIs, 4 rounds of physical therapists, 3 different physiatrists, and tons of pain meds. Unfortunately, that didn't DO anything. The osteo is actually doing something.

[BeagleMommy]

If my uncle had known this to be possible, he'd still be practicing medicine! He "retired" because of the amount of BS involved with dealing with insurance companies. He said that 70% of his time was insurance/medicaid/paperwork related and only 30% treating patients / researching patient problems. He's been out of medicine almost 10 years. Sad. He was a good family doctor- rare indeed!

[tanyalynn]

A lot of doctors have a discounted cash rate for people without insurance, I can't tell if that's what you're looking for or not.

As a general rule, the alternative-type HCPs we've gone to have not filed insurance because insurance doesn't cover their services, but we've also gotten more help from those HCPs.

It does help make the discussion of cost easier--they expect their patients to think about cost and effectiveness, and we actually discuss it. I've rarely (never?) had that discussion with a doctor that was covered by insurance up-front, so that openness is helpful. Plus I think they believe I'll leave if I don't get results I'm satisfied with.

[Mirzam]

Originally Posted by KatWrangler

Sounds to me it eliminates a whole lot of less unfortunate people if I am understanding this right. Like people on Medicaid. People that do not have money upfront to cover his charges.

But these doctors are generally are not mainstream, they tend to utilize alternative treatments that don't have insurance billing codes, so they are able to offer treatments outside of AMA/pharma endorsed treatments. It is unfortunate that a certain percentage of the population can't afford to pay up front and take advantage of these physicians. Perhaps the whole AMA/pharma hold on medical insurance needs reforming. Fat chance!

[KatWrangler]

Mirzam,

I agree, it's a mess.

[hezasan]

Originally Posted by TanyaLopez

A lot of doctors have a discounted cash rate for people without insurance, I can't tell if that's what you're looking for or not.

It was more of a general curiosity, but I was kind of curious whether some drs would charge less if they aren't dealing w/ the insurance, and what the difference in cost generally is.
I certainly think if a doctor finds it helps his patients more to not do the insurance filing etc for them, it is a good thing. As has been said, there is way too much insurance presence in the dr-patient relationship in most cases!
I would hope that not seeing madicare/medicaid patients in a non-insurance practice would be an unfortunate side effect, rather than a reason for not taking insurance. There are plenty of insurance-contracted docs that don't take medicare/medicaid patients and make no secret of their reasons.
I heard on NPR a while back that there are many docs leaving their practices because they found they spent all their time dealing with insurance. A non-insurance practice seems like it could be one good way to keep good doctors doing what they're doing. Maybe there are other ways too!

[MyLilPwny]

Originally Posted by hezasan

It was more of a general curiosity, but I was kind of curious whether some drs would charge less if they aren't dealing w/ the insurance, and what the difference in cost generally is.
I certainly think if a doctor finds it helps his patients more to not do the insurance filing etc for them, it is a good thing.

My daughter's pediatrician Dr. Pamela Middleton, M.D. located in Newport Beach, CA doesn't take insurance (she doesn't give any vaccines and would only prescribe drugs as a last resort). We love her. She gives a receipt for what we paid her and then I file a claim with my insurance for reimbursement. The newborn visit was a little over $200 from what I recall, but then every visit after that is $80. I don't know how that price compares to other doctors since we don't have experience with any other pediatricians, but we just got my daughter a naturopathic doctor too and the ND charges more than that ($195 for well child visits).

[kjbrown92]

Well for a regular office visit to my gp, they charge the insurance company $109. That's for 5 minutes with the doctor to say yes I have a UTI (I have test strips at home). Culture was separate, so the $109 was only my time with the doctor. It's 5 doctors, 4-5 nurses. And I'll bet there's at least 30 support staff for scheduling/insurance. So if 5 minutes is $109, then 60 minutes would be $1308. Holy cow!

To go to my osteo, for an HOUR, it's $165. It's him and his wife (also an osteo) and a secretary who does scheduling/billing.

I think a lot of doctors are fed up with the insurance system. It takes time away from them dealing with patients, which is why most doctors got into the business in the first place.

[leafwood]

i can speak from experience on both ends here as i use such drs and practice as a "non-insurance" dr (in the mental health field). i do have to pay upfront for the services i seek for my son (and our out of network as a huge deductalbe and it is not reimbursed), but the services are worth it to me.

personally, there is no way i would be able to provide my clients wiht the support they need by following the guidelines and restrictions of the insurance panels. in order to prevent being in an ethical bind (where i know a certain level of care is needed and they say "NO"), i can not participate or contract with them. that is the biggest reason, and the other contributing factor is the low rate at which they pay paired with the amount of time i would have to spend filing claims, following-up, etc. for my clients that have out of network benefits, many of them are reimbursed 70% of my fee which (in the end) equates to a very reasonalbe co-insurance fee for them once things are settled.

the other issue for me is that i am able to slide my fees as i see fit. if someone is in a bind we can sign a contract such that they pay me my portion and i will wait for the insurance to pay out the rest (to them and then to me). if someone has insurance, i am (ethically) not allowed to waive co-pays in some situations.