According to a recent survey by Statista, using the most recent US census data, approximately 30 million Americans do not have traditional health insurance. Many simply cannot afford the inflated premiums and deductibles, where others chose to bypass the complicated insurance route and pay for healthcare as they need it out of pocket.
Still others who are fully insured find that they may never meet their high insurance deductible for the year, opting out of processing a claim through their insurance by paying a discounted price directly to the provider, when available, for minor healthcare services.
Most people know that insurance companies do not pay the full billed fees charged by providers and hospitals. Rather, they a pay reduced amount determined by what the insurance companies deem reasonable and customary. So why then would it seem fair that a cash paying client/patient, offering to pay their bill in full at the time of service should have to pay the over inflated price attached to a certain code for their healthcare? Because the insurance companies want total control of pricing, and have set complicated rules and regulations, with stiff contractual penalties for providers who do not charge their full billed prices.
Most healthcare entities have instilled cash pay discount systems that fall within the guidelines of the insurance companies they are contracted with. But good luck trying to get a straight answer about how that really works. They may call it a “Prompt Pay Discount”, “Uninsured Discount” or “Self-Pay Discount”. But how does the cash paying client or patient know what the best price is? They have to shop around like any other good or service ahead of time. But how do you shop around in a crisis situation? Plain and simple, it’s a broken system.
Price transparency guidelines have been put in place to offset this kaleidoscope of confusion. However, most large healthcare entities just provide thousands of pages of charge sheets listing their coded insurance prices, which in no way are easy to navigate.
Paying for healthcare services should be just like paying for any other good or service, with a set, transparent fee schedule for uncomplicated visits and procedures. Can you imaging paying for dinner or gas like we do for our healthcare? It seems absurd, doesn’t it?
The American Association of Patients and Providers (The AAPP) program SimpleCare makes the payment process for both the provider and the client or patient “Simple”. The provider sets up a separate fee schedule for their services, procedures and goods available only to SimpleCare members and the SimpleCare member client or patient pays this reasonable fee in full at the time of service. Done! No billing and no surprise charges. It is a win-win situation.
Joining the AAPP nonprofit organization gives you access to the SimpleCare program for only $29/year for an individual and $39 for a family with up to 5 dependents.
If you can’t find a SimpleCare provider in your area, just ask the provider of your choice to join the AAPP, so they can offer you a simple way to see them and pay cash in full at the time of service.
Everybody wins with SimpleCare.