As anyone who has visited our practice already knows, our practice is not heavily involved with insurance (in case you missed it, here’s my article on why you probably shouldn’t pay for vision insurance). With the exception of Costco employees – and possibly one other insurance that’s in the works – we are what is referred to as a “cash practice,” meaning payment is made at the time of the exam – by cash, check, or any major credit or debit card 🙂
One major reason why I’ve chosen to stay largely free of insurance is that I’ve seen how it can negatively affect both the practice and its patients. Financially, what often happens is insurances will reimburse according to a percentage of a practice’s usual and customary fees (up to a limit). As a result, many insurance-heavy practices will increase their fees to maximize insurance reimbursement. Some practice owners also feel like they need to keep their fees high so cash patients can offset lower reimbursements on insurance patients.
Obviously this has no effect on the insurance patients – they pay their same co-pay and everyone is happy. However, patients without insurance are now paying the inflated fees out of pocket, and these fees can be pretty outlandish. I remember when we had our first child (luckily, covered under our medical insurance), they showed us our bill, which included the total amount billed to insurance – I believe it was over $40,000! For a normal birth with no complications and a one night stay. Ridiculous.
I know – $40,000 is an extreme example. In the world of optometry, more realistic comparisons might be something like $69 vs. $120. Still, that represents a significant difference for what would be considered very similar exams. Something to keep in mind for those of us without vision insurance (which I also don’t really believe in – see the article).