Comments on: TV Show Prompts Question: Why Can’t All Docs be Concierge Docs?

By: Devon Herrick

Devon Herrick — Wed, 26 Aug 2009 19:52:05 +0000

Some concierge docs bill insurance for when a visit occurs (besides charging an annual retainer fee), while others do not. Some concierge docs charge a high retainer for unlimited visits while others charge modest retainers good for only a limited number of visits. I think the main problem is getting insurers to count retainer fees against the deductible. I suspect that if demand for concierge physicians grows, at some point insurers will integrate retainers into the deductible. This could theoretically include billing the insurer and crediting the patient’s account against next year’s retainer as a way to show funds spent towards the deductible.

By: Bart Ingles

Bart Ingles — Wed, 26 Aug 2009 17:27:18 +0000

I think Ken misunderstand my question. The whole point of the concierge concept is that doctors don’t bill insurance companies for any service, actually don’t bill for a particular service period, and therefore CPT codes would be irrelevant.

What I was getting at is that insurance should offer e.g. a fixed per annum adjustment to the policy deductible, worth some portion of a typical concierge fee, to policy holders who sign up for a concierge service.

By: Ken

Ken — Wed, 26 Aug 2009 16:10:34 +0000

I agree with Stephen. The problem with Bart’s question is that these doctors aren’t just repricing, they are also repackaging their services. So they don’t have CPT codes for much of what they do.

In other words, these doctors function like normal service providers in a real market.

By: Bart Ingles

Bart Ingles — Wed, 26 Aug 2009 15:26:49 +0000

Do any mainstream insurance plans try to accommodate the concept? If there were some sort of adjustment, either to the premium or to the deductible, to compensate for the absence of claims for primary care, the idea might gain wider acceptance. Basically an HMO using an out-of-network primary physician.

By: Stephen C.

Stephen C. — Wed, 26 Aug 2009 14:19:28 +0000

I agree with the idea that all primary care doctors should be concierge doctors. And they probably would be if it were not for the third party payers.