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In network or out of network?

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Pay_My_Claims:
Thats true Linda, and in my business (high end rehab DME), its not always feasible to have a client pay up front. If you are talking general practice or some specialty, most patients will opt to stay in network because of the higher out of pocket expense. There are some patients that will stay with a provider that is out of network simply because they have been long time clients and unfortunately their job may have changed plans, and they just don't want to change physicians. Going to a more cash based business can be just as tedious.

PMRNC:
Right, you definitely have to have the right practice, location and patient base. Lots of doctors are even trying out triage and there are some states/counties doing pilot programs where the patient pays one fee per year. But with each practice there is a LOT that goes into putting these models together, it's got to be the right time and circumstances. I have an old client I worked for a few years back, he went all cash, the process took him about 2 years to get moving because some of the plans he participated with had a wait period for him to get out of, once he got it rolling it was pretty smooth, he notified patients with several notices in advance. He now collects the payment before the visit (psychiatrist), his patients know this upfront and as a courtesy he files claim without AOB and patient gets reimbursed whatever their plan allows. His A/R last time I spoke with him was $490 and that was with a patient he has a hardship arrangement he's working with. I helped him with the leg work to get this rolling and he's never been happier. Now this type of situation is NOT for all providers, again, the time, the practice, ...everything has to be JUST right to do this and with some types of providers this just isn't going to be feasible w/out losing a big patient client base (DME, Surgical, even large family or GP)

Pay_My_Claims:
You hit it on the nail. There are just some practices that doing that is very difficult.

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