This story is closed for comments.
chasey Dec 22, 6:16 p.m.
I have read the comments posted here, and while i agree this is a good idea in theory there are a LOT of holes in it. For example the article says:
Forrest also has built a network of specialists with which he has negotiated discounted rates for his patients who will pay cash up front
This business is this mans personal business, so of course he is free to run it any way he chooses. But to charge your patients differently based on cash payments seems very shady.
doctors/providers/facilities all know what the insurance companies will pay for a given procedure, usually it is based on the UCR (usual and customary rate). so the biller purposefully OVERbills the ins co, who then forces participating doctors to do their write offs.
I work with medical claims all day everday, and will see, very often, where providers will submit the SAME service, same day, to different insurance companies with DIFFERENT fees
so you go to the grocery store and buy bread, for the person in front of you, a
fmaon06 Dec 22, 11:54 a.m.
"If the pharmacies didn't file, just like this doctor, people would see how much their meds cost and it would raise a huge outcry against the drug companies. People would demand more generics driving the price of name-brand drugs down."
Drug companies have a monopoly on the drug as soon as they file a patent on it, which lasts for 20 years. This is before clinical trials though, so a patent roughly lasts for about 7-12 years while the drug is on market. The manufacturer can set whatever prices they need to offset the BILLIONS of dollars it took to develop the drug. After the patent is up, the generic companies swoop in and use the same active ingredient, but change the fillers and excipients. They still have to run clinical trials, but they're not as intensive because the drug has already been proven to be effective.
And that is why brand drugs are so expensive and it takes a while for generics to come into play.
Source: pharmacy technician and pharmaceutical sciences student
superman Dec 21, 3:42 p.m.
If it sounds too good to be true-- move on. I go to a doctor in Apex, they accept insurance. He always takes his time and never rushes me out and answers questions. Furthermore if you do go to a doctor and you are not satisfied with his services, rates etc. you are always free to change doctors. Thats your choice. Insurance companies are so slow to pay so I cant blame doctors if they dont want to accept that. If you go to see Dr. Forrest and the service you require is going to be expensive-- you might just wish you were going to a doctor that accepts insurance. Do his patients have medical insurance and do they feel so comfortable with his practice that they dont have any?
genralwayne Dec 21, 1:21 p.m.
"... then I file to my insurance company and get the money BACK over and above my 20.00 co pay. Sounds like a win win situation. I pay what the Doctor orders and then get a refund."
You've obviously never filed a medical insurance claim before. Good Luck!
stupiditydeservesnosympathy Dec 21, 1:21 p.m.
Direct patient pay, catastrophic insurance coverage, significantly expanded HSA's (instead of contracted in the health care bill) and significant tort reform to reign in malpractice claims is all we really need. The poor will be covered by charity care and low cost clinics.
What lala land do you live in? The working poor are always the ones who lose out. Real health reform is include services for those who work but can't afford to shell out hundreds up front for services. FYI it can take months to be seen at a charity care clinic-- if there is one in your area. Kinda sucks when a person has a real medical issue and can't get an appointment till 3 months later. Lack of health care reform is why sick people have to come to work instead of taking the day off.
davidgnews Dec 21, 12:42 p.m.
Gary, they do lab panels too (info on their website).
davidgnews Dec 21, 12:35 p.m.
This is awesome. We need much more of this, and more physicians to lead the way. They'll better-control their own destiny and take it out of the hands of insurance and government. It's a total win-win for patients and caregivers.
Dr. Forrest should get more recognition for his efforts -kudos!!
Lerxst Dec 21, 11:53 a.m.
"get the money BACK over and above my 20.00 co pay"
Um...there would be no co-pay. You pay him directly the full amount and submit to your ins. for reimbursement if you so desire.
Mr William Dec 21, 11:46 a.m.
Is there an equivalent for getting lab work done, special tests?
teklc Dec 21, 11:44 a.m.
So if I go to this Doctor and pay 49.00 for a physcial and whatever for cholesterol check, then I file to my insurance company and get the money BACK over and above my 20.00 co pay. Sounds like a win win situation. I pay what the Doctor orders and then get a refund.
teklc Dec 21, 11:36 a.m.
now that is a GREAT idea. We need more Doctors to do this. I know that CVS has minute Clinic and they don't file a lot of insurances but they don't offer across the board fees for everyone. Can you PLEASE open a satelite please in North Raleigh
BubbaDukeforPresident Dec 21, 11:19 a.m.
I hope more clinics adopt this method. This will hold down the cost of medical care and it will keep people out of the emergency rooms for routine illness.
rebecca7 Dec 21, 10:59 a.m.
rebecca7 Dec 21, 10:57 a.m.
I personally have been seeing Dr. Forrest since he opened the doors at this practice several years back. He is the BEST doctor I've ever had, hands down. The most thorough, most educated, most concerned about my health and well being - both mentally and physically. His staff is impeccable.
For the record: He is not the only person working in the office seeing patients. He both interns upcoming physicians (under close eye), and has Stephanie Brinson(unsure of her official title) who is also a wonderful health care provider. They only schedule 1 person per PRACTICING physician per hour, so you're tallies mentioned above are inaccurate as far as making a living. His prices are low because his costs are far below average for a doctor's office. As far as the RX's, if he has (and he most often does) samples of the medication in his office, he will give you your meds free of charge. I have not paid for my Rx in over a year because of him! I LOVE DR. FORREST!
we_all_have_it_coming Dec 21, 10:57 a.m.
Scheduling one patient per hour also means he can take walkins as well. Of course you don't need an hour for every patient... so this is another smart move.
wondermom24kids Dec 21, 10:54 a.m.
ncguy "wow saving 250K a year! His example was 3 people working on billing etc....
I never knew medical billers made over $83K a year."
I'm a medical biller. I have worked at the largest private hospital in the triangle for 11 years. I don't make more than $83K a year. Heck, I don't make more than $50K a year.
pinus5 Dec 21, 10:51 a.m.
This is the first Dr. who really listened to me, and made me feel cared for. They don't hurry you out the door, ever.
Plus, it's actually cheaper for people who are fairly healthy and who take care of themselves.
I'm grateful they are here to give a positive health care choice to those of us who think insurance companies are leeches on society.
andreanicole686 Dec 21, 10:41 a.m.
I think this is a great idea. Good for him.
boatrokr Dec 21, 10:40 a.m.
I like that. I bet his costs are actually lower because he isn't "required" to do tons of unnecessary testing by the industry.
fl2nc2ca2md2nc Dec 21, 10:24 a.m.
I love all the deniers commenting on this article. The man has something that works, keeps costs lower, and his customers like it. We should be looking at things like this with an open mind if we really want to solve the health care problems.
Lerxst Dec 21, 10:20 a.m.
"considering that the Drug co. (not my Dr.) gets to set that price however they see fit, insurance makes a lot of sense for me, and anyone else who takes expensive medication (which is all of them)"
If the pharmacies didn't file, just like this doctor, people would see how much their meds cost and it would raise a huge outcry against the drug companies. People would demand more generics driving the price of name-brand drugs down.
Get the third-party out from between the patient and the provider and the costs will come down.
ifgraceisanocean Dec 21, 10:14 a.m.
I applaud this practice and doctor for what he's doing. People like myself who make too much for medicaid and can't live off the system, but not enough for health insurance, can actually afford to go to the doctor and not have to suffer through being sick due to the insane prices that we're not allowed to know about until we get the bill.
TomLynda Dec 21, 10:13 a.m.
"Not dealing with insurance allows more time with patients, Forrest said, noting that he schedules just one patient per hour."
Third paragraph from the bottom.
mpheels Dec 21, 9:58 a.m.
"Consider his 1 patient per hour"
Where does that figure some from? I re-read the article, and don't see any mention of 1 patient per hour. That is incredibly low volume for any general practitioner. My physician takes longer than average for a comprehensive annual physical, and even then it's only 30-45 minutes. I would estimate that this practice can handle 9-12 patients/hour, with some need 30 minutes or so, but most only needing a few minutes. Someone coming in for a simple blood test probably doesn't have to see the doctor at all, just the medical tech for a blood draw, then the doc reviews the results when they come in. I know several physicians who run similar fee for service practices, they have all accepted that they'll make less than their colleagues who take insurance, but they also have more freedom to practice medicine as they see fit.
BigfootBeliever Dec 21, 9:55 a.m.
Good Job Dr. Forest! For the record the insurance companies have been and always will be the problem with our healthcare system in US. If Obama would focus his energy in the right place, improvements could be made.
genralwayne Dec 21, 9:43 a.m.
Hurrah for Dr. Forest and all those like him around this country. I wish him and his staff every success in this endeavor.
handbasket Dec 21, 9:43 a.m.
FABULOUS BUSINESS CONCEPT!
RaleighRob Dec 21, 9:41 a.m.
@ncguy- you also have to factor in cost like billing software, bank transactions, insurance fees etc. Also do note that insurance companies dictate costs and procedures to the doctors that also drives up that figure. So suffice to say, no....medical billers do not make $83k a year. Barely half that if they're lucky!
Lerxst Dec 21, 9:38 a.m.
"Find another doctor. There is more to this story."
wildcat Dec 21, 9:33 a.m.
Find another doctor. There is more to this story.
JDNCSU Dec 21, 9:11 a.m.
Interesting but the numbers don't make sense to me, there must be more than the story reports...Consider his 1 patient per hour at, say 2 procedures per patient, assume $100 per patient based on his typical (assumed) prodedure costs. For 2 docs that's just $1600 per day or $400k revenue per year ($1600 per day x 5 days x 50 weeks). After salaries, taxes, overhead, operating costs, etc., etc. I don't see how he can keep the doors open, let alone make a small profit. Has to be more to the story.
Lerxst Dec 21, 8:59 a.m.
Now *this* is how you bring healthcare costs down. Get the third party payer out of the picture except for a catastrophic accident/illness.
Z Man Dec 21, 8:57 a.m.
I pay over $800 a month for just health insurance for my family of 4. What if I only used it for catastrophic events? Should that not cost maybe $200 a month? Then I'd have $600 a month to pay Dr. Forrest, which should be plenty.
I think the good Dr. is on to something here. We gotta change something. It costs more for the paperwork than for the service!
ncguy Dec 21, 8:55 a.m.
wow saving 250K a year! His example was 3 people working on billing etc....
I never knew medical billers made over $83K a year.
luvbailey Dec 21, 8:53 a.m.
He'd got it figured out: insurance should pay for the big stuff - we should personally pay for the little stuff. The problem with our whole system is the belief that the patient should only have to pay a small co-pay, small deductible. People have been trained to think that way (including my own wife & adult children) That belief is a distortion of reality and now has led to that monstrosity of a health care bill. Direct patient pay, catastrophic insurance coverage, significantly expanded HSA's (instead of contracted in the health care bill) and significant tort reform to reign in malpractice claims is all we really need. The poor will be covered by charity care and low cost clinics.
btneast Dec 21, 8:48 a.m.
We would get our check from BCBS within about 20 days of filing - the doctor said it would take him 90 - 120 days to get paid.
Can you imagine how long reimbursements will take if the federal government takes it over? Ask anyone who has dealt with the VA or any other federal agency in similar situations.
FairPlay Dec 21, 8:44 a.m.
Tax Man... by law insurance companies have 30 days to pay or deny. If your doc was waiting that long he was billing wrong or something else was wrong. It is legal but not looked upon favorably to the doctor.
readme Dec 21, 8:43 a.m.
This was a great read. It's good to see someone who actually has common sense and sufficient brain cells trying to improve our health care industry.
FairPlay Dec 21, 8:42 a.m.
By law Dr's can do this. No hold on their license or anything. It is their choice how they do business. Obamacare will not change this thank God. Good luck to them!
sap0953 Dec 21, 8:39 a.m.
Tax Man - I guess I not getting what you are saying. You pay the dr a discounted amount but the non discounted amount is filed with insurance? How would that be legal?
Lily Dec 21, 8:38 a.m.
God bless you, Dr. Brian Forrest. Maybe MANY more will follow your example.
fl2nc2ca2md2nc Dec 21, 8:37 a.m.
"You wouldn't buy clothes and not ask how much it costs before you go to the counter or look to see. Why should medicine be any different?"
Best sentence in the whole article. We really are just like the government we complain about when we go to the doctor, because we're spending other people's money... I knew it was a problem, but I'm blown away by how much money it actually costs a practice to deal with insurance! This is the model we've had for the past few decades and it is broken, it doesn't work anymore. The model this doctor uses, combined with HSA accounts and catastrophic policies would solve way more problems that the health care law we got ever will.
jprime Dec 21, 8:26 a.m.
"The government will never allow it."
They do allow it. Right now. It's legal.
heelbilly Dec 20, 7:49 p.m.
The government will never allow it.
Tax Man Dec 20, 7:45 p.m.
In CA we had BCBS insurance but our family physician would give us a substantial discount to pay at the time of the service, then we would file the claim and BCBS paid us 100% of the bill before the discount. Many times that meant we paid nothing for the healthcare! We called BCBS to make sure this was legal and they said it was. We would get our check from BCBS within about 20 days of filing - the doctor said it would take him 90 - 120 days to get paid. Take the insurance out of healthcare except for catastrophic items and we will all save money. Doctors should have to post all prices and indicate what the "cash" price is and what the insurance company pays them! Free competition should be the way of medicine. Also prescriptions should follow the same model - whatever the lowest price is available should be what you pay, even if reimbursed by the insurance co.
james27613 Dec 20, 7:39 p.m.
Dentist offices have been doing this for years.
My dentist office gives me a copy of my bill so I can file
the dental insurance myself. They do not fill out any forms.
westernwake1 Dec 20, 7:37 p.m.
This is a great concept. I hope to see more of it.
murdock Dec 20, 7:29 p.m.
Dr. Forrest is a wonderful Family Physician who is innovative and makes sure his patients' health is first!
Published: 2007-10-05 09:38:00
Updated: 2014-06-24 16:03:36