In the face of the Affordable Care Act (ACA), and in recent years, the overly aggressive nature of HMOs, insurance companies, and other third-party providers, the concept of dropping insurances has been revisited and is gaining increased popularity with physicians and physician groups. However, there are numerous issues that need to be analyzed and addressed if a physician is going to drop insurance carriers and opt for private pay directly with patients.
The most obvious benefit is that the insurance carrier no longer has their hand in the physician’s pocket and/or increased scrutiny over the physician’s practice. Also, the physician would avoid any unnecessary audits or attempts by the insurance company to call back money. However, there is a very real balance between not only the patient paying out of pocket for services, but the patient becoming more cautious about making appointments. Even routine appointments might seem more of a hassle to a patient if their carrier is not paying for it.