I will be happy to see my Medicare patients in my new practice. In fact I’ll be able to provide you better care because I’m adopting a new practice model called direct primary care. This is a type of concierge medicine that does not bill third parties.
The Baylor clinic is incredibly dysfunctional. Calls don’t get answered, referrals don’t get processed or they might be processed incorrectly, billing is complicated and confusing, patients don’t get lab results, and there are long wait times to see your doctor. Unfortunately you will find these same issues at any clinic that bills third party payers. The problem is not with the doctors or clinic staff, we are all working hard; the problem is with the overly complicated health care system that has been created by insurance companies and Medicare. We spend an inordinate amount of time and energy on things like “meaningful use” and audits for insurance companies. All of this takes away from our real job which is taking care of patients.
Medicare is actually the main culprit in creating pointless busy work. A good example is the Medicare physical. The staff at the Baylor clinic have been coached to schedule a Medicare physical for all Medicare patients. If they don’t do that the clinic and their doctor loss money. Did you know that the Medicare physical doesn’t actually include a physical exam? It doesn’t include a physical, bloodwork, prescription refills, disease management or any preventative services. It includes an EKG and vision screen, both of which will be free of additional charge at my new clinic. I’m also supposed to asses you for dementia and fall risk during the “physical”. Those are things that I routinely assess during medication follow ups just by talking to you and watching you get on the exam table. In my opinion the Medicare physical is a huge waste of time and resources but the worse than that, it misleads Medicare patients into thinking they are getting a free physical.
I decided not to bill third party payers such as Medicare and insurance companies because I didn’t want to recreate the dysfunction of the Baylor clinic. In my new clinic I will be able to provide you with the care that you need, nothing more and nothing less. Because I can keep my overhead low, I can pass the savings on to you in the form of low cash pay rates. I will also be able to negotiate for greatly reduced prices on labs and imaging. You could file those services with Medicare but the cash pay rate that I will negotiate may make it not worth the trouble. All in house labs and tests will free of additional charge. Most blood tests that are sent off to an outside lab will be less than $20.
The direct primary care model allows me to offer exceptional care at an affordable rate to all patients regardless of if they are insured, uninsured or on Medicare. In this model the only thing that people really need insurance for is catastrophic events like hospitalizations and surgeries. I encourage patients to save money by going to the lowest monthly premium plan they can find and letting me negotiate for low cash pay rates on everything else. I can also help you find discounts on prescription medicines. You may not realize it but commercial pharmacies like Walmart charge hugely inflated rates, even on generic drugs. Yes, they have a $4 list but it is short, always changing and constantly shrinking. I have been negotiating with a local independent pharmacy to save patients money on all prescriptions.
In summary – YES, I would love to see my Medicare patients. YES, I will offer you exceptional care at an affordable price. NO, I will not bill Medicare because that opens up Pandora ’s Box to regulations and busy work. YES, You can file labs, imaging and prescriptions with Medicare but you may not want to since I’ll be able to get you these things at a low cash pay rate.
Contact me if you have any questions.
