• Jennifer Goldwasser, MD

Containing dermatology costs--value for your health care dollar.

It may surprise you to know that the cost of your medical care may actually be comparable, or even lower, when you are paying your health care provider directly. This article in Consumer Reports, https://www.consumerreports.org/healthcare-costs/how-paying-your-doctor-in-cash-could-save-you-money/

addresses some of the reasons why this might be the case, but there are even more reasons why this might prove to be true.


Some "participating provider" practices encourage or pressure clinicians to limit the number of services that are provided during your visit, to maximum insurance reimbursement. By the time you return for each service, and pay additional copayments, you have spent more of your valuable time, and money, than you might have otherwise.


Many high-volume practices employ mid-level practitioners, such as physician assistants and/or nurse practitioners. While many of these physician extenders are highly competent, they are not physicians. Complex or unusual problems may be beyond their scope, and you may ultimately require multiple visits before your problem is properly diagnosed and treated.


Participating providers may make up for insurance discounts by overbooking. This means that your allotted visit time is reduced, and that you may waste time in the waiting room. Non-participating providers can devote ample time for each visit, so that all of your issues can be properly addressed, and instructions can be communicated thoroughly, potentially saving you visits, time, money, and confusion.


You may have noticed that your deductible, even to see in-network providers, has risen greatly over the past few years. If that is the case, you may end up paying your physician out-of-pocket, even if s/he is in your network. By the time your pay your copay and deductible, the difference in cost for seeing the non-participating physician of your choice may be negligible, especially if you have a health care savings account or flexible spending account to help defray that cost.


Large insurance practices typically have an off-site call center, which often creates a barrier to communication with your doctor. In small, high-touch practices, accessibility is often much greater. Your doctor may be able to handle minor problems for you by phone, or through a low cost telehealth "virtual visit". You may even be able to speak directly to your doctor when you call, so that s/he can determine in real time whether a visit is even necessary.


High-quality care is within reach--do the math, and don't settle. Trust, peace of mind, and health are priceless.

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