[VIDEO] Cash Practice?

VIDEO Barbara C Phillips NP Cash PracticeEach day I receive plenty of email from Nurse Practitioners, Physician Assistants/Associates and other clinicians who have questions about starting a practice, practice models, business development or a variety of other topics pertaining to practice operations, management and marketing.

This video (below) answers a question I received from one individual but encompasses a question I hear more and more often about starting or converting to a cash practice, also known as a direct pay practice.

While many have expressed interest in either starting a practice, focusing simply on direct pay models and avoiding insurance (and its inherent cost and headaches) or switching their already established practice to a cash basis, there are some pros and cons to this. In the final analysis it will depend on the provider and ultimately, their patient base.
Take a listen (6 minutes) and see what you think. Please be sure to leave a comment.

Comments 8

  1. Hi Barbara,
    Love the video format. More personalized and friendly!

    Two comments from someone who has had a tradional third party reimbursable practice for over 25 years and a direct pay practice for 4 years (both simulaneously). Your direct pay patients cant apply your charges to their deductibles which is unfortunatley a drawback.
    Another consideration is that in a direct pay practice, if you order lab or xray, say a Pap smear and a mammogram, those services will not be paid to the lab or hospital since you are a non participating/ out of network provider. The patietn will have to pay the full amount and it, too, wont be applied to their deductable. This is probably the hardest thing for patients who would like to use a direct pay practice but the extra burden of lab and xray costs is too much to bear.

  2. I enjoyed the video. Our clinic has been operating for 12 years in a small sub-community hit hard by the recession. In spite of the disappearance of business-sponsored health insurance in our locale, only about 1/3 of our patients are cash payors, and we see about 500 pts/mo. At first, the clinic catered to these cash payors, but lately the low prices we offered those people meant that we were being underpaid by insurance companies (because they pay on a percentage of what you bill them).
    You can’t have two price structures – one for cash payors, one for insurance or you’re running the risk of antitrust. So we offer cash-payment discounts at the time of service to help compensate.
    I’m thinking that there is merit in deciding to go for cash only. But if you’re tempted to do a sliding scale on your fees (for the really poor people), remember that it would require someone to administer that program. So instead of paying a billing person/service, you’re still paying someone to send out the bills, do the collections (sometimes “cash-pay” translates to “no pay”), and verify qualifications for a sliding scale. It might even be MORE overhead!

  3. Do you have a practicing provider who has a cash based practice who can share their experience and gained knowledge?

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  6. I found this to be very informative. I am in the beginning stages of starting a cash only practice and the video explained some of the pros and cons. Thanks!!

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  8. Thank you for the primer in cash-only.

    I have heard about a variety of practices who are cash only, one I recall was actually charging a “dollar a minute”. Thank you Jill Ripley, I didn’t know what the term was or law pertaining to the fees. I wondered how you could do both practice models but it seems increasingly you would have to go all one or the other… with the sliding scale/pay at time of service a good way to meet some of those cash paying clients. Taking it all in. I am just starting my journey after several years of plotting and planning… so glad to have this resource.

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