Insurance and me - so far so good...

Two months ago I made the difficult decision to start accepting major medical insurance at Ponce Primary Care. We became convinced that our use of technology and our commitment to keeping our overhead low would allow us to maintain the pillars of our practice (accessible, personalized and comprehensive care) while billing insurance companies for patient visits. This was a major change as in my previous professional life I came to see medical insurance and exceptional primary care as being mutually exclusive. Good news. The two month scorecard = so far so good.

We've found billing insurance companies to be surprisingly easy. A big part of this is that in keeping our promise to limit the size of our practice we generate fewer bills, which of course lowers the absolute number of hassles. Our paperless office is also a big deal as large insurers do much better with electronic claims. We don't have to translate my number scribbles into claim forms - an expensive and error-prone process that handicaps many practices.

We still offer simple visit fee schedules for those without insurance and membership plans for those who want services that medical insurance doesn't cover (direct cell phone access to the doctor, phone visits when appropriate, after-hours appointments, etc), but we've made it easier for many to get exceptional care by broadening the payment options.

I still believe that in an ideal system medical insurance would be limited to covering catastrophic events and we would all pay directly for routine care. The entire system would be much less expensive given the dramatically decreased cost of administering such a system. We could easily finance a safety-net program for those who truly couldn't afford care with a fraction of the savings. However, the recent healthcare law, if implemented as written (a big "if"), will dramatically increase rather than limit the role of insurance in healthcare. I'll continue to advocate for reversing this trend. In the meantime, visit www.ponceprimarycare.com to see how we're balancing an imperfect system in order to provide our patients with the best primary care I can imagine.