April 17, 2024

With today’s medical environment so reliant on complicated insurance company regulations and intricate billing procedures, many physicians are looking for niche medical practices that will allow them to maintain their income standards while decreasing their paperwork at the same time. One such niche is a cash only medical practice, which is basically a medical office that does not maintain contracts with insurance companies and instead requires patients to pay cash for medical services rendered. Ending your contracts with insurance companies and building a successful cash only medical practice will likely take some time, and many physicians decide that they need to have a gradual changeover rather than an overnight exchange from an insurance pay to cash pay medical practice. If a cash pay medical practice sounds like it may be the type of office you would like to run, it may be time for you to begin doing some market research to find out if your practice has the potential to be successful:

* What is the condition of your local market? Does your local community have a large number of uninsured or affluent patients? If you do run a medical practice in an affluent community, you may be able to establish a large panel of patients-even patients with insurance-that is willing to pay cash for high quality, efficient medical care. On the other hand, if your local community has a lot of middle or lower-income residents with HMO plans, which do not give any out-of-network benefits, you may find that you have difficulty building a cash-only practice.

* Would your current patients be willing to transition to a cash pay medical practice? It is a good idea to survey your current panel of patients to find out if they would be willing to continue using your medical services if you were to change to a cash only medical practice.

* Should you continue your contracts with the more lucrative insurance companies? Not all insurance companies negotiate unappealing prices with their contracting physicians, and not every insurance firm has unreasonable paperwork requirements. You may choose to work with two or three specific insurers, while asking that patients who do not use these companies pay cash for medical services. It is your medical practice, which means you can choose whom you contract with.

* Which medical services will you provide, and how much will you charge for them? Some physicians find that they are able to see fewer patients with a cash pay medical practice, and they also discover that they are able to focus on the particular medical services that they enjoy. Perhaps you decide to focus on acute medical care rather than chronic ailments, or maybe you will choose to perform fewer diagnostic tests. Whichever services you decide to offer your cash only patients, deciding how much to charge for them will take some research. Ask other physicians, particularly other cash only physicians, in your area how much they charge; there is nothing unethical about doing this as long as there is no discussion about setting collective rates. You may also want to take into account how much your cash pay medical practice will need to net in order for you to cover your overhead expenses.