What are the Direct Care benefits at Cannon Dermatology?

The direct care model gives patients choices - choices on who cares for them and in what way that care is delivered. As consumers, we make decisions daily based on multiple factors like reputation of a product, cost, availability and level of service. As healthcare consumers, this freedom of choice should be no different but unfortunately it is. Care under the insurance-run model of medicine is dictated by government and insurance company rules without taking into account a patient’s needs or wants. The complex and often confusing insurance system clouds the relationship between doctor and patient.

Insurance is still extremely important, specifically in cases of emergencies and catastrophic medical events which are rare enough that insurance coverage in these situations is necessary and appropriate. With the large number of high-deductible insurance plans, the need for cost-effective yet comprehensive options for medical care is critical. Many patients who spend much of the year in good health with high out-of-pocket insurance costs often stand to do better using direct care practices to care for their non-catastrophic medical needs.

The decision is yours to decide what type of care you want. Most would answer expert, quality medical care with transparency and as little out of pocket cost as possible.

Take a look at a few scenarios to highlight how a direct care practice might work for you.

As these are conservative examples, please keep in mind, the charges at participating offices may be much higher, depending on how they code for particular services.


SCENARIO 1

You have a bleeding spot on your chest. You are worried it might be cancer. You schedule a visit with the dermatologist. A biopsy is performed confirming a basal cell carcinoma (cancer) and you are scheduled for treatment.

Many insurance plans have tiers or levels of coverage that vary based on yearly costs including out of pocket deductibles, co-insurance, co-pays and monthly premiums. The plans below mimic this tiered system to illustrate the potential costs a patient may encounter based on the insurance plan they are enrolled in.

 

With Direct Care

With Insurance

The insurance-approved costs are: Copay ($40), new patient visit ($110), biopsy ($120), pathology fee ($150), destruction of the malignant lesion ($200). Total charged fees + copay: $620

Gold plan

(No deductible, $40 copay for office visits): At $40, you will likely choose to use your insurance. Keep in mind, you are still responsible for a percentage of the total medical charges (depending on your insurance policy) and your monthly premiums are likely very high.

Silver plan

($500 deductible, $40 copay): If you have had no medical expenses, you will pay a $40 copay, the entire $500 plus your percentage of fees after your deductible. If you have already spent $500 on medical care, you will pay your $40 copay and then your portion of the charged fees.

Bronze plan

($3000 deductible, $40 co-pay): If you have not met your deductible you will pay the entire $620. If you have already spent $3000 and met your deductible, you will pay your $40 copay and then your portion of the charged fees.

With Direct Care the costs are: No copay, 15-minute visit ($95) - biopsy included, pathology processing and reading ($70), and destruction of the cancer ($195). Total cost - $360

Direct Care Benefits: You saved up to $260 out of pocket, got a same day or same week appointment and did not wait in the waiting room. During your visit, the doctor spent extra time going over other issues you brought up and you were happy to not receive a bill after your appointment.



SCENARIO 2

You wait 3 months for a full body skin examination appointment. You take a half day of work, wait an hour in the waiting room and then have a quick skin exam with the doctor who dictates during your visit to the medical assistant who is scribing on her computer. You have some questions about issues with your skin tone as well as some mild acne on your back but your doctor is already in the next room. The medical assistant tells you that you must schedule a separate appointment to discuss these other issues.

 

The benefits of direct care are obvious. The main question is what is your time worth? In a direct care practice, the inefficiencies due to insurance requirements are gone and the cost savings are passed to YOU. Your visit may cost less than a night out at dinner and you will never be limited in the number of questions or issues you would like to discuss within the time slot you choose. We respect our patient’s time and focus on quality patient care. This is why we give you the control - control to CHOOSE your doctor and how extensive or minimal your appointment will be. As this is the type of care we want for our own families, we offer same day to same week appointments and little to no waiting room times. You will never feel rushed during your appointment and the processes of this practice will always be clearly laid out for you beforehand. We will always treat you like family and appreciate your trust.