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

"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

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?

"... 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!

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. luvbailey

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.

Gary, they do lab panels too (info on their website).

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!!

"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.

Is there an equivalent for getting lab work done, special tests?

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.

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