Transparent Pricing
We should be able to work with most insurances. We'll do our best to obtain an accurate cost for our patients ahead of procedure while working with as many third party payers as we can justify. Given the high burden of dealing with pre-authorizations, denials, resubmissions, delayed payments and declining "reimbursements," we will be working to taper our exposure to uncooperative insurers who make doctors' and patients' lives more difficult.
Simultaneously, we will be building out a list of cash-based prices as an alternative option for patients as we accumulate data regarding our own base costs and our affiliates' facility fees. We will bundle those costs into an all-inclusive single fee, to include surgery, anesthesia and facility. We'll model off of the transparent pricing system of Surgery Center of Oklahoma which offers a multitude of surgeries at a fraction of the cost of typical third-party health coverage schemes. Cash pricing could be a better option for those with an HSA, for those covered by businesses that self-insure, for the uninsured, for medical tourists and perhaps others.
Cash price options are under development, which can be signficantly discounted from "list prices" when we can cut out a large part of the non-producing middle layers of bureaucracy. Currently, we are negotiating with facilities and other providers to build out "bundled" pricing, which would allow a single payment from the patient to cover all associated expenses, upfront, transparently, and hopefully at a significant discount. MDSave.com may offer us all a good solution. Stay tuned!
And feel free to inquire about pricing on a case-by-case basis! We'll work with you as best we can.
To offer an example of our cash-based price, the robotic-assisted laparoscopic cholecystectomy (gallbladder removal, CPT code 47562) is $1,150, which includes the pre-operative clinic evaluation and follow-up visit.
We are hoping to be able to negotiate the total price of this procedure, all-inclusive, for under $10,0000 (to include our $1,150 price for the surgery and clinic visits; plus the separate facility's price for the OR, equipment and staff; plus the separate anesthesia costs) . Typically there are three separate bills related to a major surgery (surgeon + facility + anesthesia... and sometimes additional, separate charges, like a pathology lab fee for surgical specimen analysis). When we have our agreements set with facilities and outside anesthesia groups, we will provide an open pricing list for all to see. In the meantime, we'll do what we can to get the best prices possible for self-paying patients.
As an aside, we do have affiliations with private imaging services that can often provide services like CT and MRI scans in the range of $300-$400, rather than list prices that may be in the thousands of dollars.
Accepting all major credit cards, HSA, FSA, cash, check, Bitcoin and Ethereum.
Non-cash and insurance billing will be managed through AdvancedMD billing and electronic medical record services and software.