Is a Private Physician The Answer?

Is a Private Physician The Answer?

Is a Private Physician The Answer?

0

Is a Private Physician the Answer?

As we all know, health care has made a lot of changes in the last few years. The everyday consumer has been hit with higher rates along with higher deductibles and we all know that salaries and benefits have not increased accordingly. As we see more people covered by medical insurance, we actually see less people in certain groups using it.

Let’s talk….. 

Most working families carry health insurance and always have. Where their annual deductibles or “out of pocket expenses “used to be $2500, they are now often $10,000. These families are probably paying twice what they were paying 5 years ago for what is essentially catastrophic insurance. If they are lucky, they will never have to meet that deductible but in the meantime, similar to house and car insurance, they are paying for insurance they will hopefully never use.

If you are a reasonably healthy individual, you may want to have a catastrophic insurance plan for emergencies but take control of the rest of your health care. You pick your physician, you decide what tests you are willing to pay for and you negotiate how much you are willing to pay.

Another option, if you have a high deductible, is to use your health insurance for your yearly physicals and preventative medicine and pick and choose for your specialists and high cost tests. This will almost always cost less money and you are seeing who you want, and making your own decisions on treatment without insurance involvement.

For example, a consult with a specialist would be billed to your insurance company. If the physician was a provider, the insurance would have a negotiated rate for a consult. Depending on the policy, you would probably owe a co-pay and a percentage of this. If they were not a provider, you could be responsible for the whole amount or a large percentage of the whole amount. No matter what, you will still be paying the bulk of the bill.

Your physician would have to get approval for any tests from your insurance company and you would also pay the negotiated amount for them. Treatment would have to wait while all this is going on.

At ShimSpine, we have cut out the “middleman”. By you paying at the time of service, we are able to keep costs low by not having to spend time billing insurance claims and fighting appeals.  Since no insurance is involved, we do not have to obtain a pre-authorization for any tests such as an MRI, which also saves you time.  You get a price for your whole visit up front and we negotiate your other costs for you.  You still have the flexibility to use your health insurance for testing and treatments, including surgery, if you wish.

In answer to the question “is a private physician the answer?” the answer is, sometimes. If the price is reasonable, if you get the care you need, and if you leave feeling like you did the right thing for both your health and peace of mind, then a private physician is the answer for you.

 

Article by Catherine Nicholson based on over 30 years as a Registered Nurse and 15 years as a practice manager in a spine practice.

No comments

Leave a Reply

Your email address will not be published. Required fields are marked *

*
*

Disclosure Statement

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
Please note all articles, blogs and Q&A’s on this site are general information and are not to be used as medical advice for individuals. No specific diagnosis or treatment should be made based on this information. Only a physician can provide you with advice specific to your situation. Please followup with your physician if you would like to discuss your individual condition.

If you are having a medical emergency,  contact your Doctor immediately,  or go to the Emergency Room.
ShimSpine and ShimSpine.com is committed to honoring and respecting the privacy and anonymity of the individuals using its website(s) and/or services. The purpose of this Privacy Policy is to inform the individuals about the collection, processing and protection of information done by ShimSpine what information we collect, why we collect this information and how we use this information.

This Privacy Policy will be reviewed regularly to reflect the up-to-date practices of ShimSpine.