PROS & CONS of accepting insurance

[Guest guest]

Feel free to add your two cents:

PROS:

1) In high reimbursement zones can be lucrative

2) reach a greater patient population, wider demographic

3) fascinating to understand how insurance works & doesn't work

4) feel more competent when discussing health care policy

5) can pick & chose best payers. you don't have to accept all insurance.

6) submitting claims is easy & free with online clearinghouses (I use

officeally.com)

7) likely less out-of-pocket cost for patient (depends)

8) very, very poor people can still get care (though you will be paid -

usually - very, very poorly) (a humanitarian gesture?)

CONS:

1) In low-reimbursement regions ( " dead zones " ) may put ya out of business

2) may reach less patients if you don't accept their insurance

3) have to fill out credentialing packets to join ( & renew at intervals)

4) more admin hassles: prior authorizations, formulary issues,

5) have to document more stuff to meet guidelines for coding/billing purposes

6) potentially forced to see patients " assigned " to you

7) you support status quo: for-profit, third-party payer system

8) may have to pay to join an IPA to participate in certain plans

9) may need a billing department or do it on your own

10) can't set your own fees and be paid according to your value or what market

will bear

11) delay in payments, denials and follow-up phone calls required to pursue

payments

12 may lead to high-volume practice & longer wait times (if accept low

reimbursement)

13) higher overhead costs (may need to hire staff or a billing service)

14) may have to charge uninsured more than you would like

15) patients may chose you just cause you take their insurance (may not be a

good match)

16) third-party is in exam room with you & patient

17) life is more complex & more and more complexity coming . . .

8 PROS, 17 CONS & I still accept most insurance. Go figure . . .

Please add to the list. What else ya gonna do on New Years Eve?

~ Pamela