Cash Pay Programs and Price Transparency in Urgent Care

Cash pay programs and price transparency in urgent careWith the urgent care industry heavily catered towards customer service, cash pay programs and price transparency are two elements that can work together to improve patient experience and increase patient flow in an urgent care center (UCC).

Cash pay programs let individuals with high deductibles, or without health insurance, choose to self-pay at a set cash price, that is often less expensive than if they went through their insurance. Price transparency reveals these cash prices to patients upfront, so that there are no surprises.

Eric Folkens, MD and Owner/Operator of four Urgent Cares in Sarasota and Bradenton, FL, says that he has all of his cash prices listed on his center’s website, as well as listed on a big poster board at each of his locations.

“The poster boards and website will have the top 100 most common prices listed; everything from the initial visit down to some of our medicines like Tylenol or Lortab,” Folkens says. “There’s never any question about how much a service will be. I would never want to surprise anyone.”

In addition to having all of his cash prices transparent, Folkens says he also makes sure that his patients understand how much a service costs before it’s administered to them.

“Before I do any tests, I’ll tell patients exactly how much it’s going to be,” Folkens says. “If they need a strep test done, I’ll tell them that it’s going to be an extra $15-$20, and ask them if that’s going to be okay.”

Lindsey Graves, office manager at the direct pay only Sora Medical Clinic in Plano, TX, is also a fan of cash pay programs and price transparency in urgent care. She says that all of the clinic’s prices can be found on their website, and that patients love the fact that they can just get online and look at how much a service will cost.

“We’ve had really great reviews about the upfront pricing,” Graves says. “If patients don’t want to pay extra for a strep test, they can easily say no. Patients are able to control their healthcare spending, instead of their insurance saying that it won’t pay for certain tests or services.”

Tom Pascuzzi, MD and former president and CEO of MD Urgent Care in Albuquerque, NM, incorporated a pay-at-time-of-service (PATOS) method into his practice, which included cash pay options and price transparency.

“With PATOS, if a patient was paying with cash or a credit card, we used a receipt that providers could check off the services they provided and see the charge,” Pascuzzi says. “The patient would then self-pay at the end of their appointment.”

Pascuzzi says that PATOS was an effective method for patients to know exactly how much they were being charged, without having to worry about receiving a bill later on.

“Patients knew how much they were spending, instead of insurance coming around later and informing a patient they were, or were not, going to pay for something,” Pascuzzi says.

While his patients were fans of the PATOS methods, Pascuzzi says that his providers also liked it.

“With price transparency, the providers knew what the charge would be,” Pascuzzi says. “When asked, they liked being able to tell patients how much a service was going to cost.”

Owners and operators of urgent care centers can also reap the benefits of price transparency and a cash pay program. When patients pay in cash, there’s no waiting on accounts receivable.

“No time spent in accounts receivable keeps the cash flow going,” Folkens says. “Plus, if you have to go through a billing company, you’re never going to receive the full amount from the insurance company because the billing company is always going to take a percentage of that amount.”

Folkens even encourages his patients to self-pay, instead of going through insurance, especially if they have a high deductible.

“My clinics offer lower prices for cash-pay patients,” Folkens says. “If they have a high deductible, or if they’re not going to meet their deductible that year, they can definitely pay in cash and save some money.”

Folkens says that being honest with patients about how much a service will cost, as well as having reasonable prices, has helped him retain patients.

“Even if a patient went somewhere else first, 99% of the time they end up coming back to one of my clinics because they know I’m not going to rip them off,” Folkens says. “Price transparency helps us get people in the door, but also helps us retain them because they know what they’re going to get from day one.”

Pascuzzi also says that his cash pay program, PATOS, helped him gain, and retain, patients.

“There was a distinct population that knew I had a cash pay program, and it continued to grow over four years,” Pascuzzi says. “The cash pay option was perfect for people in certain industries like construction or waitressing that were not offered insurance by their employers or couldn’t afford it on their own.”

Because cash pay programs and price transparency in urgent care have received such positive feedback from patients, Graves says that she thinks more urgent care centers will adopt these policies in the future.

“Deductibles are being raised, so more people aren’t meeting theirs,” Graves says. “If you rarely go to the doctor, why pay so much per month for a deductible that you’re never going to meet? Instead, you could go to a direct pay urgent care clinic like Sora, and just pay for everything upfront without having to worry about getting hit with a bill later on.”

“With individuals being forced into higher deductibles due to rising premiums, and employers offering higher deductible plans, patients are going to be looking for transparency and trying to find deals,” Pascuzzi says. “As you get more consumers in charge of their own healthcare, they’re not going to pay high the prices.”

As more and more urgent care clinics adopt cash pay programs and price transparency, competition will become fiercer. This can be both good and bad.

“Right now, my clinics are the only ones in the area with cash pay options and price transparency, and if all urgent care centers adopt those, then it could impact my clinics negatively,” Folkens says. “But as long as we continue to give good care to people, and do what we’re supposed to do, patients are going to keep coming back to us.”

“I think all urgent care centers should adopt cash pay and price transparency, because I love competition, and I think that it’s the best way for it to work well,” Pascuzzi says. “True price transparency and competition can drive prices down, and that is good for patients.”

It may seem like a gamble to have lower prices for cash pay patients, but Pascuzzi says that’s not the case.

“Even though you’re not getting the same amount per visit as you might with traditional insurance payments, with PATOS, you’re at least getting paid for each visit,” Pascuzzi points out. “You can make that a very integral part of your practice cash flow because you’re not waiting on money from accounts receivable – you get paid cash at the time of the service.”

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