by Caroline von Fluegge-Chen
A Currency of Relationship
After the dermatologist checked a few moles, I proceeded to the front desk to settle my account. The staff informed me that I did not have to pay. Not even a co-pay.
That’s weird. My annual individual deductible is $4,500. Certainly I was supposed to pay something?
At the next visit – after the cancerous moles were removed: “Nope. You’re all set.” How can that be? Now don’t get me wrong. The doctor is top notch. Her clinic is one of the best in the city. Yet I wondered. With a $4,500 unmet deductible, I was expecting to swipe my credit card.
Why did her staff not charge me? How much are they billing insurance? And lastly, how much do I then owe the clinic once my carrier rejects their claims or applies them to my deductible?
A few weeks later, another procedure. I headed to the plastic surgeon to close the inch-long incision on my cheek. Immediately upon arrival, the insurance clerk informed me that my co-pay for today’s visit is $1,000 and it was due right now. The co-pay! $1,000! Now!
What exactly is the total cost to sew a few stitches? How much are they billing BCBS? And once again, just like the last time, how ginormous will the invoices from the surgeon be once BCBS rejects their long list of charges?
Many months later, I am still being billed by the doctors for everything BCBS did not cover. Upon review of the weekly invoices, I am astounded by the endless fees. These were very expensive moles indeed.
I am in the trenches, just like most of you. Insurance makes no sense.
So I’ll address the issue as both a consumer and as a doctor.
Everyone should have insurance coverage. Monthly premiums should defray the costs of health-related expenditures. We pay a ton for coverage. There should be some return on the investment. I absolutely agree!
The benefit of health insurance straddles both sides of the moral fence as a being a right and a privilege.
Many years ago I was in-network with a number of insurance companies. I didn’t like adding charges to the patients’ office visit fee, despite performing the multitude of services.
I knew the insurance companies would slash reimbursements to smithereens, not pay at all, delay processing, or demand resubmissions over and over. Back billing loyal clients for unpaid office visits was a good way to irritate trusting relationships.
I once attended an insurance coding and billing seminar. I was horrified by the cat and mouse game played by both doctors and carriers to outsmart one another for the sake of financial gain. No. Those aren’t my people.
Delivering excellent patient care with transparent integrity and compassion was on my compass.
Under these conditions, my future as a hardworking business owner was looking dim. I wanted to serve people and be morally congruent. How could I let fear, doubt and worry replace enthusiasm? No way.
And knowing that everything is energy, how could the vibe of stress help heal and guide my patients?
It couldn’t. I had to get out of network, erase survival-mode, clear my conscience, and LOVE again.
You may be disappointed that I am not in network. That is by moral choice. My employers for the past 20-years have been all of the incredible infants, children, teens, students, moms, dads, husbands, wives, grandparents, and professionals who have been adjusted by my hands at Balance Atlanta, not insurance carriers.
I want to do the BEST job that I can based on YOUR state of health and YOUR objectives only.
I created a Balance Atlanta community that welcomes everyone regardless of age, gender, condition, heritage, or personal beliefs. It is an environment which resonates with peace, laughter, healing, acceptance, commitment, and personal growth. I want all practice members, my staff and my spirit to be happy.
With that said, we’ll do the best we can to help you by calling your carrier, verifying benefits, creating treatment plans to meet your objective, and offering numerous payment options for everyone’s budget.
There’s no up charging, back billing, delayed surprises. We keep it clean and transparent.
The currency at Balance Atlanta is based on personal relationship. You are a member of our family, a part of the community – a place where you feel at home.
Having the goal of wellness in mind, you hold developing balance of mind/body/spirit as a priority for you and your entire family.