To Pay Cash or Not to Pay Cash

To pay cash or not to pay cash. That is the question.

Imagine this familiar scenario at your doctor’s office check-in desk:

“Sir, may I have your insurance card so I can make a copy of it?”

“Yes ma’am. Here it is.”

We’ve all had that experience at a doctor’s office. They ask like robots. We respond like robots.

But think about how bizarre that exchange is. This is a scenario that doesn’t happen in any other consumer market.

The good thing is, unless you have a co-pay, they don’t typically ask for any money. But, they also don’t tell you what the visit is going to cost. And if you asked, they’d tell you they don’t know.

Consciously or subconsciously, we hand over our insurance cards and we’re glad they haven’t asked for money.

And even though they have not collected any money, they also never say, “We’ll send you a bill.”

This is not an accident. The system is designed to avoid any talk of money and make is unclear as to who is paying for what, whether it’s you or your insurance company. That way, when you are sent a bill later, they hope you’ll think it’s too late to question the bill.

You Can Pay With Cash, Even If You Have Insurance

Personally, I rarely turn over my insurance card. I just say, “Bill me. I’m paying cash.”  Recently, a receptionist said to me, “Do you no longer have the insurance that I see in my system?” And I said, “I’m just interested in paying cash today. Please give me your best cash price.”

I always ask what the cash price is. Sometimes they know, sometimes they don’t. That’s the thing about our crazy healthcare system -there are no clear rules, there is no clear process, and there is no defined system. It’s different every time because it depends on a variety of factors. Basically, it’s a game. All you can do is try to play the game to win.

When the bill comes, I take a look at it with a business eye. If the cash price seems reasonable, I pay it. If not, I call the office and say, “Why didn’t you bill my insurance?”

When you call to talk about a bill, you are usually connected to the billing office. The people in the billing office are different than those at the doctor’s office who initially ask for your insurance card. So when I say, “Why didn’t you bill my insurance?” they say, “Sir, it says here that you are paying cash.” To which I reply, “No, no, no…that’s incorrect. Let me give you my insurance info. Please rebill me correctly.”

In other words, the game they play is to hide the price from me. They cloak it behind my insurance company, saying they don’t know what I’ll be billed. They defend themselves by saying, “Well, we don’t know what the doctor is going to do or how it’s going to be coded.”

So, I need to play the game too. If they can’t tell me what it’s going to cost and if the cash price or insurance price is better, then I’ll figure it out for myself.

Only about 20% of Americans with high deductible health plans reach their deductible each year, so it’s often better to pay cash. The cash price is almost always lower than the insurance price. But, the doctor’s office or facility won’t offer you that price. So, you must create the choice for yourself.

Healthcare is a game. Americans must play everyday of their lives, without a playbook, coach, or even a fair set of rules. Even so, you have to play to win.

At Amaze, we work with our members to learn how to play the healthcare game. We empower our members to get the best care at the lowest cost and become better healthcare consumers.