Self-Pay and Take Back your Freedom

At Excel, we are pleased to announce that our patients not only have the freedom to self-pay for an exam, but also have the freedom to self-refer scans. This means, that a self-paying patient does not need to have a prescription in order to request a diagnostic scan*.

Over the last 10 years, patients have been increasingly taking back control of their health treatment plans. With rising deductibles, medical facilities around the country realize that moving through third party insurances often increases costs for a large subset of patients. Some patients and providers are locked into antiquated contracts that limit care, or struggle to find approval for non-standard treatment needed for unique medical conditions.

Here are some of the top takeaways as to why self-paying may be in your best interest:

You want to be able to get in and out more quickly – Your time is valuable.

Self-paying removes the need to wait for insurance approvals, authorizations, or appealing denials. Self- paying also affords you the option to place a rush order or ASAP order on your test. If self-referring, you don’t even need to wait for a provider’s order or prescription.*

You want your privacy.

Self paying means that there is a direct relationship between our facility and you. Because Excel is a “Covered Entity” as defined by the US Health and Human Services, your specific health information is protected and covered under HIPAA compliance laws. When self-paying, we only release the information to other HIPAA compliant institutions for your health care – not for your insurance coverage, nor for advertising or tracking. Other non-medical institutions and insurors may not have the same restrictions in place.

You don’t want your insurance premiums to rise.

Self-paying means that your report data is not submitted to your insurance carrier. Normally, when going through insurance, your diagnosis and procedure codes must be submitted for billing. The insurance has full access to your medical life history. Often, minor health issues found on your scans or reports result in “risk assessment” modifications to your insurance carrier, resulting in your monthly premiums to rise. Over time, these can far exceed the “savings” you had by not self-paying in the beginning.

You want us to fix documentation errors or problems quickly.

Was there a typographical error on your prescription when you submitted it to us? Was the procedure code off by one number? Was your doctor working at one address that’s “in network,” but submitted the prescription from another that wasn’t? Any of these errors could result in delays that span hours to days when going through standard insurance. Even simple requests to correct an order need to go through a chain of phone calls, emails, and texts between your provider’s office, our back office, and the insurance systems. By Self-Paying, these errors can be corrected on site, usually in under 5 minutes. Again, your time is valuable.

You want your doctor to serve you, not your insurance company.

Every in-network doctor is in some way, shape or form bound by contract to follow the rules and regulations of the insurance company. This includes which treatments can be offered to you, how those treatments are performed, and how much can be charged. Unfortunately, this is often not in your best interest. Few insurances company employees are physicians, and even fewer still have ever taken a Hippocratic Oath to “Do no harm.”

Self-paying establishes the direct relationship between you and our staff. You have the option to pay for personalized consultation, or to place a rush on your order. There are no extra third-party contracts that decide what care you can or cannot have. It is simply a discussion of what care you need, and what is the most appropriate.

The Hard Truths:

1.) Health Insurance companies benefit the most financially if you pay your premiums, ignore medical conditions, and die quickly from an advanced illness that is no longer treatable.

2.) Health Insurance companies benefit financially – if they deny you care and make it difficult for you to get the care you need.

3.) Health Insurance companies benefit financially – by being slow and inefficient, by delaying payments out to the providers that give you the care that you need.

4.) Health Insurance companies benefit financially – by raising deductibles and premiums every year, increasing your own financial responsibility, but keeping you within their restrictive networks.

5.) Health Insurance companies benefit financially – by increasing authorization requirements, they further delay care and payments to providers as long as possible.

6.) Health Insurance companies benefit financially – by underpaying your nurses, technologists, physicians and financially restricting the reimbursements on necessary treatments they provide you.

7.) Health Insurance companies … are fundamentally not in the business of making you better.

You want to be informed of and have access to the Latest Treatments, “covered” or not.

Insurance companies are notorious for not approving novel therapies that have good research-proven outcomes to improve health.** As such, many physicians under an insurance plan may not even offer you the options if your insurance plan is not amenable to them (this is especially true for Medicaid and some HMO/Medicare Advantage Plans). This is avoided by self-paying. Since an office can now receive compensation for a new treatment plan, they can offer you this treatment and you can make the free decision whether or not to pursue any of the options available.

You want to take back your freedom to choose who treats you.

Self pay isn’t a network. You are never bound to see one physician or forced to see one “gateway” doctor in order to see another. It gives you back the freedom to see who you want, drop the providers who don’t serve you well, and pursue the quality care you need and deserve.

You want options on how to pay and when to pay.

Excel is currently working with CareCredit, Everyware, and other healthcare financing institutions to help you fund your exams out of pocket. We are continuing to grow our healthcare financing options, with several interest free monthly payment options. Coming soon, we will also be introducing our club membership plans where your monthly payment can be utilized for a variety of our services at no additional charge.

*Note, some limitations apply. Some self-referred orders are reviewed by our radiologist physicians prior to executing the order. Some self-referred exams may require independently acquired labwork prior to completing. Self-referring indicates that the patient is making the order for the test themselves, using their own knowledge, which may or may not be accurate or appropriate to diagnose their current medical condition. All patients must sign legal waivers prior to self-referring. Self-referred patients have full freedom but also assume full medical responsibility for their follow-up imaging and medical care. Excel is not responsible for missed or delayed diagnosis or treatment for self-referred patients not receiving the appropriate care they need in a timely fashion. **A recent example of this are the novel immunotherapies, utilized for a variety of cancer treatments. Despite having shown excellent outcomes in multiple studies over the past decade, most immunotherapies are still not covered by major insurors. Although insurors cite the “cost” of medications in their denials, they rarely appreciate the global cost when they deny care to you, which can include prolonged hospitalizations, treatments for complications, and even death.