Introducing BuildMyBod 2.0. The revolutionary way to check pricing from healthcare providers near you. Price transparency in healthcare used to be the stuff of dreams. But thanks to changing policy and political winds, the day of true price transparency has arrived!

Price Transparency and BuildMyBod 2.0: Hospitals

Traditionally, healthcare was the only area of commerce where you would find out the cost after utilizing their goods and services. Not anymore. With the BuildMyBod Health Price Estimator, you can research costs ahead of time.

Since January 1st, CMS, the Centers for Medicare and Medicaid Services, began requiring hospitals to post their prices online in a spreadsheet format. Additionally, the government is requiring that hospitals showcase their pricing within a user-friendly pricing tool. Granted, the tools developed by the hospitals themselves are more user-friendly than no tool at all, but still not as easy as the newly revamped BuildMyBod Price Estimator. For example, see how easy it is to research prices posted by MedStar-Georgetown University Hospital right here!

The user can choose their insurance plan or check the cash pay rate. And as per CMS guidelines, the user can see their potential out-of-pocket cost compared to other insurers. The video below explains how BuildMyBod Health is making it easier for hospitals to comply with these new CMS rules:

See how BuildMyBod can help hospitals with the new CMS price transparency rules

And whether it’s a hospital, surgery center or physician practice, the facility can choose how they want to show their pricing. The cash rate, bundled rate or allowable rate based on the consumer’s insurance.

Price Transparency and BuildMyBod 2.0: Physicians and Practices

As consumers explore pricing prior to a hospital visit, they will come to expect price transparency in all aspects of their healthcare. Eventually, physicians and physician practices will have to provide pricing info on their own sites.

However, in contrast to hospitals that are not allowed to require the user create an account to determine their out-of-pocket costs, physician practices can require the consumer enter their contact info prior to getting a quote. Therefore, physicians have the extra benefit of generating leads through their price transparency efforts.

To make it easier for the consumer, they will be able to create an account with their email address, Facebook or Google (gmail) account! Single sign-on technology is making account creation and lead generation easier than ever.

As consumer attitudes change, BuildMyBod will help private practices and physicians connect with consumers checking their pricing too!

Introducing the BuildMyBod PriceChecker Chatbot

For consumers more comfortable with texting and automated interactions, there’s an even easier method to check pricing. The PriceChecker Chatbot provides a “quick and dirty” method to check pricing.

Sure, it doesn’t provide the patient with video education or the ability to purchase online like the Price Estimator. But it does make the option of checking pricing easy, and front and center on the doctor’s homepage.

The PriceChecker Chatbot may become the practice’s newest employee of the month!

Demo of the Price Estimator and PriceChecker Chatbot

If you’re a consumer and want to check pricing near you, click here. If you’re a provider that wants to generate leads or a hospital that wants to comply with the latest CMS price transparency rules, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Welcome to the future of price transparency! BuildMyBod 2.0 first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Virtual visits aren’t just safe, they’re convenient

Forcing patients into non-urgent virtual visits has made them realize, “why weren’t we always doing this?!” Patient behaviors will change as they recognize the convenience of online doctor visits. First, they will be much more discerning about which visits actually require in-person visits. This will evolve even further once a vaccine is available and we’re truly past the pandemic.

Consider that in-person visits require many patients to leave work early. That consequently requires them to ask their employer to leave early for a doctor’s appointment. Which may or may not lead to a discussion of their particular malady.

Leaving early may also require them to desert some of their duties or hand off those duties to a fellow employee. Which may also lead to a discussion of their medical issues with a colleague.

And this is all before the patient has to contend with a commute to the doctor’s office and the cost of parking. It’s no wonder more consumers will prefer a non-emergent virtual visit if their doctor offers it or if their condition allows for it. If they haven’t already, patients will realize that not only are virtual visits safe, they often suffice for a real in-person visit and are more convenient.

The one issue that may curtail a full blown embrace of virtual visits is the cost. During the pandemic, online visits for COVID 19 related and unrelated issues were covered by insurance companies. Now, as insurance companies curtail coverage for virtual visits, or shift some of the copay to consumers, virtual visits will continue to rise, but possibly not at as steep an incline as seen during the peak of the pandemic. But make no mistake, virtual visits are here to stay.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Virtual visits are convenient, not just for COVID avoidance first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

One of the reasons I’ve built a worldview that includes price transparency is because I recognized early on that everyone wants to know cost ahead of time.  So why make it difficult for them. No one likes sticker shock. But there’s another benefit of price transparency.

By knowing the cost ahead of time, the hope is the patient will feel less of an urge to ask for a discount or a special. In other words, “this is the price, be prepared when you come in.” However, as we all know, it doesn’t always work out that way. In this Amazon world, discounts and specials are just a way of life. If left unchecked, discounting and specials can lead to a race to the bottom where everyone is undercutting their competitors. This potentially leads to the cheapening of a brand.

Which is why bargaining, an even more insidious cousin of discounting and promotions, takes things a bit too far. If you have to choose between the two, discounts vs bargaining, discounting is the lesser evil. If we embrace discounts and promotions in certain circumstances using certain techniques, we can “build a fence” around the potential for bargaining so that it never gets to that point.

Bargaining in a bazaar may be in the natural order of things in that setting, but it has no role in healthcare. Even for medically unnecessary aesthetic procedures.

How to use discounts and specials the “right” way

Having a set program or programs to allow for discounting can be an effective way to draw patients in. And at the same time, avoid cheapening the brand.

In our practice, we offer discounts and specials in three different formats. While they all provide a discount to the patient, there’s an equally important benefit to the practice, in addition to greater patient volume. In each format description below, take special note of the additional benefits that show how discounting and specials can serve a greater purpose.

Online purchases

On our website, we allow patients to purchase non-surgical services (neuromodulators like BOTOX®/Xeomin and fillers) and skin care products online.  And when these purchases are made online, a nominal discount is included.

Even before we realized the benefits of contactless payments during the pandemic, online purchasing is just plain more convenient. Convenient for the patient and the practice. Consider a patient that purchases skin care online. Tax, shipping and a discount are already  included. This saves the patient from having to come in unnecessarily but it also encourages the patient to continue taking the path of least resistance. Why seek out another practice when the patient can get the products (or prescription creams) they want delivered to their door with just a few clicks!

For injectables like Botox or fillers, the patient of course still needs to come in for treatment. But similar to buying a movie ticket online, there’s no need to stop at the front desk/ticket booth to make a payment. The transaction already occured online. More importantly, there’s the added benefit of privacy for the patients by not having to check out on the way out the door.

On an equally practical note, how do practices that run specials keep up with all of the deals swirling around all the time? Have you ever sent out or received an email from an aesthetic physician’s office? There’s a ton of specials listed! How does the front office staff track the current specials and not accidentally discount the wrong item for the wrong amount? With online-only discounts, they’ll always pay the correct amount. In our practice, whenever a patient purchases online, a voucher is automatically generated that clarifies the amount paid and the amount of product or Injectible they’re eligible to redeem.

We’re fans of online purchasing. Here are some of the benefits:

1. contactless payments
2. enhance privacy by avoiding front desk checkout
3. reduce lost revenue from inaccurate discounting

Subscriptions and Memberships

This specials format includes recurring payments that either cover the entire cost of the service in question (subscriptions) or give the consumer access to additional discounts in the future (memberships).

For subscriptions, payments are structured so that a monthly payment covers the entire cost of a discounted quarterly treatment, such as Botox. Therefore, when the patient comes in for their treatment every three months, they pay nothing out of pocket during that visit. Psychologically, if the patient feels like the treatment cost nothing at the time of their office visit, they’re open to purchasing another service. Thus leading to greater, unexpected revenue.

Memberships involve lower monthly payments that don’t cover the cost of any service. But they do offer the availability of VIP (discounted) services. Similar to subscriptions, patients may rationalize additional purchases because of the savings.

While a one-time online purchase described above has the benefit of capturing the patient, it doesn’t incur loyalty the way subscriptions and memberships do. With recurring payments and repeat traffic, this is the easiest way to build a long-term patient-doctor relationship.

Consider subscriptions and memberships to realize these benefits:

1. loyalty
2. recurring revenue
3. increased revenue from the purchase of non-subscription items while in the office

Day of consult discounts

Consider this scenario that takes place in most offices: A patient puts down a deposit to hold their place for a larger procedure. Then, 2-3 weeks prior to the procedure, the balance is due. Capturing the balance is never as easy as one would hope.

Often times, the office staff must go to great lengths to track down the patient to collect those remaining funds. Multiple phone calls, patients not calling back, endless games. And even if it doesn’t require multiple phone calls, it still requires at least one, potentially avoidable phone call.

Why do physicians’ practices put themselves in this time-consuming position? Wasting so many hours following up with the patient, trying to collect prior to the procedure? Not to mention the angst of wondering if the patient can pay the balance in advance of the operation. Or the frustration of postponing the procedure because they can’t. Which in turn leads to awkward conversations, hurt feelings, miscommunication and potentially a bad online review.

Wouldn’t it be great if the patient would book and pay in full at the time of the consultation? That would have the benefit of less wasted time trying to track down the patient and your office staff wouldn’t feel like a bounty hunter! With the right incentive, it’s possible.

At the time the patient schedules the consultation over the phone, we let them know the probable cost of their procedure. This is based on the information they provide regarding their concerns. We let them know that if they come in prepared to pay that amount in full at the time of consultation, they’ll receive a discount ($1000 for a procedure greater than $10,000 or $500 for a procedure less than $10,000).

This discount is a great benefit for the patient but clearly, there’s also a huge benefit to the practice. We gain increased productivity not chasing patients for the balance of their procedure. With a combination of price transparency prior to the consultation and incentivizing the patient with a discount, 72% of patients that booked surgery at the time of their consult paid in full, including procedures costing $22,000!

Benefit to the practice:

1. improved cash flow with full payment up front
2. incentivize only the most serious patients to come in for consultation
3. avoid wasted time on tracking down patients for the remainder of their balance

Summary

Bottom line, don’t discount without a purpose! By linking discounts and specials to  specific goals, other benefits will reveal themselves. These include 1) improving cash flow, 2) incurring loyalty, 3) increasing productivity (reducing time wasted), 4) avoiding confusion in regards to which specials are being offered and 5) having enough hard-wired options for discounting that a reasonable patient knows the practice’s disposition on price, and never has the opportunity or urge to resort to bargaining.

Let your competitors race to the bottom while you stay above the fray!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Discounts and specials? Sure. Bargaining? Absolutely not. first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Virtual consults are nothing new

The first thing that should be made very clear is that virtual consults are nothing new for us. We’ve always offered them as an option for out-of-town patients but also in-town patients that couldn’t get off of work early enough. The only thing that’s changed now is that virtual consults are the only option during the shelter-in-place.

After the shelter-in-place designation is lifted, we will continue to “push” virtual consults as our preferred method of seeing patients who want to discuss surgery. Yes, that means that the first time we see the patient in person could be the morning of surgery! While that may seem odd to see your surgeon only for the first time the morning of surgery, in the age of social media, there’s more to the story.

The patients that we see in our office virtually or in-person, are rarely seeing us for the first time. Most of our patients have been following us on social media, watching us operate, for months, before their consultation. So it’s not accurate to say they’re seeing us for the first time on the day of surgery. Because even before the virtual consult, they were seeing us operate and interact in our office on social media day in and day out!

Why we charge for virtual consults, just like regular consults

Whether it’s virtual or in-person, the doctor still avails the patient of their time and expertise. Whether it’s in person or not, that fact doesn’t change. So the fee shouldn’t change either. In fact, one could argue that, in the case of virtual consults, the consultation fee is a convenience charge! Because of the virtual consult option, the patient avoids the imposition of asking to leave work early, then driving to the office and searching for parking.

That being said, we did toy with the idea of not charging for virtual consults when this crisis began. We thought it might give people stuck at home something to do. But guess what we found? Just as we made it so easy to book a virtual consult online and not charge for it, it was just as easy for patients not to show up! With a greater than 80% no show rate, we reinstituted consult fees. In other words, those no shows ruined it for everyone!

So we’re back to charging for virtual consults and we’ve had a no show rate of 0%. We also have much more serious patients booking consultations. If you’re considering a cosmetic procedure, click here to check pricing online and then schedule your FaceTime or Skype consult online here!
 

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Yes, we charge for virtual consults first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Postop recovery on the cheap!

As the video below suggests, there are two options to accomplish each postop goal. When it comes to where you recover, sure, you can go to a postop recovery “house.” These can be expensive and the level of care is not always assured. You may be best simply going home and getting in your own bed initially. But don’t stay in bed too long. You should also get up and move around to avoid getting blood clots in the legs.

The other potential problem with a recovery house is they may do something different than what your doctor recommends. Whereas if you go home and do what your doctor tells you to do, there’s no one suggesting otherwise.

To buy a booty pillow or not to buy a booty pillow

There are many websites that sell booty pillows for your post-BBL recovery. The idea is that when sitting on a booty pillow, it keeps the pressure off the buttocks while recovering from a Brazilian Butt Lift. The reason sitting directly on the buttock is supposedly bad is it hinders blood supply to the newly transplanted fat cells.

Rather than sitting on a booty pillow to reduce pressure, you can sit on anything that accomplishes this same goal. For example, you can take the decorative round pillow from your couch and place it under your thighs. This will provide the same result.

Check out the video below to see our perspective on a host of other recovery options.

Video: Keeping it real during your postop recovery

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Postop recovery on a budget [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Whenever I discuss the concept of price transparency with other healthcare providers, the first thing they say is, “I don’t want to compete on price!” I simply don’t understand why the premise of price transparency automatically leads to the assumption that you have to compete on price.

Healthcare doesn’t follow the rules of a free market system

The idea of price transparency in healthcare is quite foreign. Historically, the healthcare industry has never been fond of showing their costs.

It’s partly due to the unusual arrangement between health insurance payors, the consumers (payers) and providers. In the past, insurance companies paid the charges submitted by providers after seeing a patient. This ultimately led to two epiphanies by the insurance industry.

First, at some point, insurance companies felt doctors were charging too much. And two, insurance executives realized that with so many beneficiaries (consumers) under their umbrella, they had the leverage to negotiate better terms for themselves (and poorer terms for providers). Meanwhile, the consumer’s premiums kept rising! Think about that: insurance providers pay out less per service/treatment provided by the doctor but somehow the consumer’s cost continues to rise.

The subsequent negotiations led to various contracts with each provider or healthcare entity (hospital, multi-specialty clinic or health system). And as with many contracts dealing with compensation, they’re considered a secret. Moreover, insurance companies consider these secrets protected by the Uniform Trade Secrets Act.

“…insurance providers pay out less per service/treatment provided by the doctor but somehow the consumer’s cost continues to rise.”

This is what the Trump Administration’s recent Executive Order and rules are trying to uncover – these negotiated rates. By pulling the curtain back and showing everyone what the rates are, consumers can make better financial decisions about their healthcare before, rather than after treatment.

Price transparency, not price wars

Since most providers (doctors, hospitals, multi-specialty clinics or health systems) don’t reveal their pricing, that means those of us who do can separate ourselves from the competition. Consumers want pricing information prior to purchasing any service. That’s how it is in every other sector of the economy. Buying a house or car? You want to know how much it costs ahead of time. That’s reasonable. That doesn’t make you a price shopper!

Just because you show your pricing doesn’t mean you have to compete on price. If others show their prices, could they be lower than yours? Certainly, that’s always a possibility. But that does not mean you are required to lower your price. There’s not an automatic “trigger” in place that requires you to begin a race to the bottom.

However, there’s a caveat to that resistance to lower your price: be prepared to substantiate your higher prices. If your prices are higher because of better customer service or more qualified professionals in your organization, great. That’s certainly worth the higher price if the consumer also places a premium on that experience.

Don’t compete on price, compete on quality

I recently served on a price transparency panel at this past Becker’s ASC meeting and one of my co-panelists, Andy Poole, CEO of Monticello Community Surgery Center, explicitly stated that you should commit to price transparency but compete on quality, not price. So he gets it!

In the end, offering price transparency online will allow you to stand out from your competition. It will give you a competitive edge. And it’s possible without lowering your prices.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Compete on price transparency, not price! [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

It’s official! Price transparency in healthcare is closer to reality. President Trump released new rules requiring hospitals to publish their charges and negotiated rates. You may be thinking, “oh this doesn’t affect me! It only affects hospitals and their employed physicians.” But make no mistake, this affects all physicians!

Why price transparency in healthcare will affect everyone

You see, as hospitals begin to show their prices, the consumers’ mindset will change. Once they realize hospitals are displaying pricing, consumers will expect pricing information for ALL healthcare services. That means from ALL doctors, whether you’re employed by a hospital or not. So while the law may not affect you directly, it definitely affects you indirectly.

Another way to look at it is from the perspective of a Millennial. They have easy access to the cost, ingredients and details of most everything via their smartphone. But if they’ve ever sought out healthcare services, confusion ensued. They thought to themselves, “how can I not know the cost of something that’s potentially very expensive, before I purchase it?” As they have grown up with an Amazon world, and continue to grow older, they will expect and demand price transparency in healthcare, just like there is price transparency in other aspects of their lives.

The new rules

So what exactly is contained in these new rules. Most would argue that the rules went further than expected. Based on the initial proposal announced in June, many thought the Trump Administration would only require hospitals to post their negotiated rates. If that was all they demanded it would still be a big improvement over the previous rule requiring only chargemaster rates – rates that no one actually pays.

In addition to the negotiated rates for facility fees and their employed physician fees, the new rule states that hospitals must also disclose the negotiated rates for medications and supplies. Specifically, the rule requires hospitals to list negotiated rates for 300 “shoppable services,” listing 70 in the rule and allowing the hospitals to come up with the other 230.

Aside from the payer-specific negotiated rates, the hospital must also list the gross charges, discounted cash prices, de-identified minimum negotiated charges and de-identified maximum negotiated charges according to Becker’s Healthcare Review.

The Biggest Surprise

There was one big surprise in addition to the official rules regarding negotiated rates at the hospital. The Trump Administration also proposed requiring insurers to list their negotiated rates with various facilities and doctors. Basically the Administration is working this from two angles. Hospitals would list negotiated rates with various insurers and insurers would list their negotiated rates with hospitals! Somewhere in there, the consumer would find the truth and be able to compare pricing.

Despite their best efforts, and there’s no reason to think hospitals and insurers will try their best when being forced to doing something they are reluctant to do, the posted rates will be difficult to navigate. This presents an opportunity for the rest of us in the healthcare industry.

Physicians shouldn’t wait!

Physicians and independent practitioners need to get ahead of the curve. Don’t wait for hospitals and insurers to list your rates. Price transparency, when done correctly, can be a customer service satisfier. Whether it’s providing the consumer the bundled rate, the negotiated rate or the cash rate for their healthcare services, the consumer will find it much easier to determine their costs through the physician’s site rather than a clunky hospital or insurer’s site. None of this will be easy but doing the right thing rarely is.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post One step closer: Price transparency in healthcare [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Options for Financing cosmetic surgery or other healthcare services

If you don’t have the cash flow to pay for a procedure in full at the time of service, you’re not alone. There are several financing companies out there that are happy to help. In exchange for a little interest!

CareCredit and Alphaeon Credit

These two companies operate similarly. After applying for credit and getting approved, they’ll pay your doctor or facility in full, up front, for your procedure. You then pay them back based on the terms of agreement. There are several options, including 6 or 12 months no interest. Be careful with this option. That’s great if you can pay it back within 6 months at no interest. But if you don’t pay it back within 6 months, the interest skyrockets to around 26%.

There are other loan options wherein the company is paid off over 2-3 years with interest. The longer the time to pay it back results in more money paid back to the company but it also means a lower monthly payment, which could be easier on your checking account.

Prosper Healthcare Lending

In this scenario, Prosper pays the patient directly. If the patient still wants the procedure, they would then pay the doctor or facility, and the patient would pay Prosper back over time with interest. If you have any questions, check out the video below.

Video: 3 options for financing cosmetic surgery

Don’t forget, before you request funding for your procedure, you need to know how much it costs first! Check pricing on services from Dr. Kaplan by clicking here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post 3 options for financing cosmetic surgery and other healthcare services [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Everyone should get a quote!

In this study, we found that patients were 41% more likely to book a procedure at the time of consultation if they were aware of price ahead of time. Patients who were price unaware were less likely to book due to sticker shock. That typically leads to a poor customer service experience.

Therefore, it’s incumbent upon the front office staff to provide the patient with a quote no matter what. Sure many patients may stumble upon the price estimator on a physician’s website. But what about the potential patient who calls, unaware of the existence of a price estimator on the doctor’s website?

To minimize sticker shock, the office needs a process. A process for all patients to know the cost prior to the consultation. Just like the office staff collects the patient’s demographic info when booking their consultation, they should also provide the caller/patient with an estimate over the phone or via email or text.

Providing a quote through all channels – online or off

Just because the patient didn’t find the price estimator on their own doesn’t mean they have no interest in the cost. Everyone wants to know the cost of their procedure! In our office, when someone calls to book a consult, we ask if they checked pricing online. If not, we send them an estimate via our iPhone pricing app. Even the random caller asking about price receives an estimate via the pricing app.

In this way, everyone, whether it’s the price shopper, the serious patient, the person booking a consult, the social media follower, the visitor to our website – everyone – receives an estimate prior to consultation!

If you’re a consumer interested in pricing for a procedure from a doctor near you, click here. If you’re a healthcare provider who wants to showcase your pricing on your website in exchange for the consumer’s contact info – a lead for follow up – click here.

Special thanks to Jessica of Setty Plastic Surgery for the inspiration behind this blog post!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Prior to the consultation, everyone should get a quote first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

It’s hard to believe that even if you have health insurance, you may be better off if you pay cash for outpatient healthcare services. If that’s the case, why do we have health insurance at all?! We have health insurance to cover very prolonged illnesses or major trauma. Basically, catastrophic issues. But when it comes to screening tests or basic health maintenance, patients could save a lot of money if they pay cash!

My wife’s procedure

Recently, my wife had a strange sensation of food getting stuck at the bottom part of her esophagus, before going into the stomach. This is a different concern than symptoms of reflux which can be easily treated with over-the-counter Pepcid or Zantac.

When someone complains of a feeling of blockage when swallowing, you don’t take a “wait and see” approach. You take a “don’t wait, and see now” approach. The appropriate test to check out the esophagus and stomach is a gastroscope. Also called an esophagogastroduodenscopy, or EGD for short. This is the lighted tube a gastroenterologist puts into the patients mouth under sedation, down the throat, into the esophagus, then finally into the stomach and first part of the intestines. It allows the doctor to get a clear view of what’s going on, if anything. Luckily in my wife’s case everything was fine. She may have reflux that causes that sensation but there’s no tumor or abnormal tissue blocking that area.

Why pay cash for outpatient healthcare services

Aside from the medical decisions, this scenario also requires a financial decision. If the facility, anesthesiologist and gastroenterologist submits their bills through insurance, this is what would happen. They would submit a very large bill. Because the provider (doctor/hospital) knows the insurance company will pay them less than what they bill, they aim high! In other words, if the doctor charges $100 and they only get paid $80, then what if the provider charges $150…maybe they’d get $120 in return. That’s more than the $80 you were going to get paid. And that’s the game providers play with the insurance companies.

If you let the provider submit those higher bills to the insurance company and you have not met your deductible, the insurance company will turn around and say, “hey, you owe this amount!” And then you’re stuck paying this higher bill out of pocket.

The game

But if you go into this situation knowing the game, don’t let them submit the bill to insurance. Since the facility doesn’t have to go through the process of submitting paperwork to the insurance company, getting denied, filing an appeal and back and forth, they’ll gladly charge you less to avoid that whole process. And in that case, the anesthesiologist may only charge $200. The doctor may only charge $600. And the facility may only charge $1200. A total of $2000 out of pocket.

In contrast, if your bills were sent to the insurance company, the charge could be closer to $5000. And if you have a high deductible of $5000, you’ll have to pay $5000 out of pocket instead of $2000 for the same procedure!

So if you haven’t met your deductible, call the facility or doctor’s office performing the test first. Ask them what the cash pay rate is. Yes, it’s a shame that you have to pay anything before your health insurance steps in to help. But better to pay less than more if you’re having to pay out of pocket regardless.

If you’re tired of calling around asking about healthcare prices – for cosmetic or medically necessary services – check BuildMyBod.com/pricing to make your life easier!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Why you should pay cash for outpatient healthcare services first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

This recent Wall Street Journal article highlights the increasing competition in the neuromodulator market. A neuromodulator is the fancy term for a chemical used to relax facial muscles, thereby reducing wrinkles, ie Botox! In most industries, when you have more competition, that benefits the consumer by forcing lower prices. Will these competitive forces cause Botox to lower its price? Don’t bet on it!

Why more competitors won’t force Botox to lower it’s price

It is a natural assumption that with more options for a particular product, prices will go down. That’s why competition is good. But Botox is different. We’re most familiar with Botox for relaxing the wrinkles in between the eyebrows. Or treating a gummy smile. Or narrowing the jawline. But it has other uses that are less cosmetic.

Botox (and it’s competitors Dysport and Xeomin) are also great for medically necessary problems. Babies that have problems with bowel movements can get Botox to relax the anal sphincter. It can help with hoarseness. It’s an appropriate treatment for torticollis – a severe spasm of the neck muscles that causes the head to tilt. Medicare and other insurance companies will cover the cost of Botox for these medically necessary issues.

But because Botox has an agreed upon cost with the Federal government (Medicare) and other insurers, they have to be consistent with their financial practices. For example, if Medicare or an insurance company agrees to a certain cost for Botox, the makers of Botox can’t charge doctors a different rate. Said another way, if they charge the doctors less that are using Botox for cosmetic purposes, then the government or insurers won’t agree to pay a higher amount. Or at least it will bring up the uncomfortable conversation of why they’re charging one group one amount and more (or less) to a different group.

So they can either charge everyone (doctors, Medicare and private insurers) less, or charge everyone a higher rate to obtain a higher profit margin. Because the makers of Botox generate a lot of revenue from the medically necessary side of business, they don’t want to take a hit by lowering the cost to be more competitive with the cosmetic side of their business. Make sense? If not, comment below.

While we’re on the subject, check pricing on Botox and Xeomin from Dr. Kaplan by clicking here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Will more competitors force Botox to lower it’s price? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Listen to the episode now on 99.7

You can check out a soundbite from the episode by clicking here. Listen in as Dr. Kaplan answers callers’ questions. One of his patient’s is also present discussing her experience in his office.

If you’re looking for pricing from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Dr. Kaplan talking price transparency on 99.7 in San Francisco first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.