What is a Direct Pay Clinic?

Advantages of an Insurance-free Clinic
Home / What is a Direct Pay Clinic?

What is Direct Pay?

No insurances are accepted; all services must be paid in full before or immediately after they are provided.

Prices for all services are 100% transparent. No insurance is accepted, and certain patients who have government insurance policies (Medicare, Medicare Advantage or Medicaid) are not permitted to be seen for non-cosmetic services due to government regulations.

Certain complex surgical procedures, like Mohs surgery and reconstruction, may be performed at a different clinic site. This will be reviewed with you by your care team prior to proceeding. The majority of services are provided at our Arden Hills location.

Advantages of Direct Pay

Higher Quality Care, No Insurance-imposed Limitations

What is the care like in a direct-pay practice? In a word: better. Physicians who opt-out of the insurance-based reimbursement system can spend more time with their patients and prescribe the medications and treatments that their patients need – not just what the insurer wants. Gone are cumbersome, government-mandated, electronic medical record systems that force your doctor to look at a computer screen instead of you. Gone are rushed visits mandated by a bureaucrat who only views patients as “widgets to be made” by a physician. Your physician can get back to doing what he or she was trained to do: care for you, the patient.

Significant potential cost savings for Patients

Direct-pay, also known as cash-pay, practices do not contract with insurance companies. Direct-pay practices only accept payments from patients. This prevents limitations on care that may be found with insurance-accepting practices. It also means that direct-pay practices can run with much lower overhead. As a result, direct-pay practices are often significantly more affordable than insurance-accepting practices.

No surprise bills

When you book your visit with Premier SkinMD you prepay for the visit itself. Additional expenses are clearly listed in our fee schedule, but most patients do not pay any additional fees after their visit. Before you are treated by your physician any additional costs will be clearly explained. You will never get a surprise bill after your visit like you might encounter when using insurance. You will never be charged hidden fees like a ‘facility fee’ or ‘hospital outpatient department’ fee.

Common Questions

If I have insurance shouldn’t I use it?

We all own various types of insurance – car, home, health. Let’s look at car insurance. It would be financially devastating for most folks if their car was stolen or totaled. Due to that large financial risk, you purchase a comprehensive or collision car insurance policy for a reasonable fee. Now the insurance company is on the hook if your car is destroyed. This is how insurance is supposed to work: insure you against things that would be financially ruinous.

Does your car insurance cover oil changes or new tire for your car? Of course not. Those costs are maintenance. If your insurance covered those costs it would quickly become very expensive. What if your neighbor drives 35,000 miles a year while you drive 5,000? Should you really pay the same for maintenance? Unfortunately, in this country we have started wrapping “oil changes and new tires” into the cost of medical insurance. As a result, the costs of medical “insurance” have spiraled out of control.

Direct-pay practices seek to separate “maintenance” – like a yearly checkup, visit for warts on your foot, or sinus infection – from catastrophic medical events like a heart attack, cancer or trauma. The latter are rare events so they’re perfect for insurance to cover.

Many Americans stand to do better by separating “maintenance” from catastrophic coverage. By combining a high-deductible health plan with smart expenditures of your health care dollars for “maintenance” most folks can get better care for less money.

Are all patients accepted?

All patients are accepted with one exception. Government restrictions bar us from seeing patients with any type of government insurance including Tricare, Medicare (including Medicare Advantage plans) and Medicaid (including PMAP) insurance unless the visit is for cosmetic purposes only. We realize that this is frustrating, but we have to follow the rules. All patients will be required to sign an affidavit in-person, before their visit, attesting to the fact that they do not have any type of government supported insurance or are being seen for a statutorily non-covered service (i.e. cosmetic surgery).

If you have any type of private insurance, or no insurance, you may be seen for any concern (medical/surgical/cosmetic) at any time and without restriction. We will provide a medically-coded “superbill” that you may turn into your insurance company. They may, at their discretion, credit the amount that you paid towards your deductible or reimburse you for your expenses. However, this is completely at their discretion. We do not communicate at all with any insurance company including prior authorizations for medications. Exceptions may be made, at the discretion of the practice, on a case-by-case basis.

What’s a deductible?

A deductible is the amount of money that you must pay out-of-pocket before your insurance is required to “kick-in” and pay. For example, if you have a $1,000 deductible you are a “cash payer” until you reach $1,000 in medical expenses within a year. If you break your arm and need $2,000 in care, then you would pay the first $1,000 and your insurance would pay the second $1,000.

As healthcare has gotten more expensive, more Americans are seeing increases in their deductibles. In some cases, deductibles can be $6,500 per individual and $13,000 per family.