Why do I pay for telehealth visits if I have health insurance?
Paying for telehealth visits, even with insurance, offers benefits like improved doctor-patient relationships, flexible appointments, and price transparency, allowing you to address your health concerns anytime, from home.
Overwhelming and Time-Consuming
According to a survey by The Harris Poll, managing and coordinating healthcare feels overwhelming and time-consuming for the American people. It's not just that adults in the U.S. are dedicating an average of one working day per month to arrange care for themselves or their loved ones, but a significant 73% of U.S. adults feel that the healthcare system is failing to meet their needs in some capacity. High costs and lengthy wait times for appointments are the key factors driving patient dissatisfaction with the system.
Over half of U.S. adults (56%) are waiting more than a week for an appointment, and they are spending at least 8 hours each month coordinating care for themselves or their family.
Pre-authorization issues
The Kaiser Family Foundation (KFF) recently reported that almost 60 percent of insured US adults have faced health insurance issues, such as delays in pre-authorization approval, lack of specialists within the network, denied claims, and more. Approximately 40 percent of the respondents indicated they had postponed or avoided care in the past year due to costs. Consequently, patients are delaying or foregoing treatment. This situation highlights significant challenges in the U.S. healthcare sector. Yet, an emerging solution, cash-pay care, offers hope.
The Financial Benefits of Paying Your Doctor in Cash, Even With Health Insurance
According to the 2018 Consumer Report, an increasing number of medical services, such as MRIs, blood work, and outpatient surgery, may cost less if you pay directly, bypassing your insurance provider.
This approach contradicts our common understanding of health insurance. We often believe that using insurance will always save us money, as we assume our insurer negotiates the best rates for health services and covers any remaining costs.
However, this is not always the case, particularly for those in high-deductible plans who must pay thousands out of pocket before insurance starts to cover part of the expense.
Opting for cash-pay circumvents delays associated with approvals and claim denials. Under this model, patients transact directly with healthcare professionals, making payments for a variety of medical services. The primary goal for the physician is to ensure high-quality, affordable care, aiming for patient satisfaction. After all, in a cash-pay framework, patients have the flexibility to switch providers if they are not happy with the service. Thus, this model fosters a more affordable, transparent, and personalized healthcare journey.
The Effect of Cash-Pay Care on Physician-Patient Relationships
The cash-pay care model fosters a more robust doctor-patient relationship, paving the way for a personalized care journey that drives better results. How does it do this? The traditional healthcare framework operates on a fee-for-service basis, where doctors and hospitals bill insurance companies for each test or treatment they deliver. This setup encourages volume over value, as healthcare practitioners are pressured to accommodate as many patients as they can to enhance their earnings. Consequently, this usually results in shorter consultations as doctors aim to maintain a smooth flow of schedule.
Better Care
Moreover, some cash-pay healthcare alternatives offer the option of virtual care, leading to reduced expenses for patients. Practitioners might opt to operate from home, thereby avoiding the operational costs associated with running an office, processing insurance, paperwork, and the like. Healthcare professionals can devote more time to their patients by eliminating insurance-related paperwork.
These practices contribute to stress alleviation and improved lifestyle adaptability for providers, which subsequently benefits patients. After all, everyone gains from having a physician or nurse practitioner who is relaxed, content, and entirely focused on the patient's well-being.
More Flexible Appointments
As reported by Elation, L. Rajneesh in July 2022, the optimal average number of patients for a primary care provider is put at 1,000. Yet, numerous physicians suggest the actual figure hovers around 2,500. The American Association for Physician Leadership even places the estimate closer to 3,000. It's hardly surprising that patients often feel disconnected from their doctors!
Physicians operating on a cash-only basis have a smaller patient load, allowing for more in-depth conversations and a better understanding of their patients' concerns. Their schedules are also more flexible, with the possibility of same-day or next-day appointments.
Furthermore, cash pay telehealth offers practitioners the flexibility to choose their method of interaction with patients, be it via video-telehealth visits, phone call follow-ups, text messages, or even emails.
Price Transparency
With a cash-pay telehealth system, it's easy to see the costs of services, as well as the names and backgrounds of the providers. It's important that the website clearly displays the price of each visit and the cost for various services or diagnoses. If you plan to use the service frequently, consider a membership subscription.
References:
Pollitz, K., Pestaina, K., Montero, A., Lopes, L., Valdes, I., Kirzinger, A., & Brodie, M. (2023, June 15). KFF Survey of Consumer Experiences with Health Insurance. Kaiser Family Foundation.
Rajaee, L. (2022, July 25). How many patients does a doctor have a day? Elation. https://www.elationhealth.com/resources/blogs/how-many-patients-does-a-doctor-have-a-day
Rosato, D. (2018, May 4). How Paying Your Doctor in Cash Could Save You Money. Consumer Report. Retrieved from https://www.consumerreports.org/healthcare-costs/how-paying-your-doctor-in-cash-could-save-you-money/
