Doctors Charging "Membership" Fees

[Ava]

I'd pay about anything I could afford to keep good doctors. The doctor who treats my cancer has an 8 month waiting list to begin with.

In this situation I would definitely pay to keep good care.

But I wouldn't pay a fee to see someone I only go to for routine check-ups or the occasional sick visit. I like my doctor, but I don't like her enough to pay an extra $650/year just for the privilege of having her do my yearly exam. I'd find someone else in a heartbeat.

 

[Cruise]

This is becoming more common in LA. I'd never do it, but my previous employer does it. He wanted to keep his doctor, so he paid up.

The only extra benefit he's received as far as I can tell is that, while out of town, his doctor took his personal calls regarding some pain he was having and gave him some advice over the phone. It turned out to be appendicitis which this doctor recognized and told him to get to an ER right away. But I'm guessing he would have taken himself to the ER eventually even without this phone call.

Of course, in the 5 years I've been in LA, I've yet to meet a doctor worth keeping, so I guess it would depend on how strongly I felt about one that I finally actually liked. I don't think asking for a bit of bedside care and that a doctor wash his hands before touching me is too much to ask. *sigh*

 

[momto2girls]

I've heard of this and I expect that we'll see more and more of it. None of my doctors do it yet, but I would definitely sign up if my doctor (an internist) or my kids' doctor (a ped) went this route.

 

[Shelly F - Ohio]

This does not sound right!!!!

I would call the medical society or your insurance company and ask about the Dr charging for membership. I would think a doctor would only be able to bill for actual medical services provided and that all charges need to be submitted for payment to an insurance company. At least that is what they taught us in medical coding class.

If a doctor submits a bill to the insurance company for say $100 then the insurance pays $70 because that is the negotiated rate between the dr and ins. co. You get a statement from the insurance company shows nothing is due from the pt. The doctor can not ask you to pay the other $30

 

[funnygarcia]

No buy

As a spouse to someone who does have complex medical needs, we still would not pay extra for services that are already offered in my area.
And I don't see how we could afford to pay the fees.

 

[ssawka]

This does not sound right!!!!

I would call the medical society or your insurance company and ask about the Dr charging for membership. I would think a doctor would only be able to bill for actual medical services provided and that all charges need to be submitted for payment to an insurance company. At least that is what they taught us in medical coding class.

If a doctor submits a bill to the insurance company for say $100 then the insurance pays $70 because that is the negotiated rate between the dr and ins. co. You get a statement from the insurance company shows nothing is due from the pt. The doctor can not ask you to pay the other $30

Yes, but that's the thing. The doctor will only bill to the insurance company the normal fee, but in order to see the doctor in the first place, you must be a "member".

 

[NJGirl]

My PCP's office is doing this too...called "MD VIP". Thankfully only 1 of the 3 doctors in the practice is doing it and the one I prefer to see is still seeing us peons. I refused to join the VIP program as did my mom and other family members. Our fee was almost twice as much as the OP's. They claim it comes with a dedicated phone number, priority to make appts, longer time with the doc, etc. YES, all the membership fees are ON TOP of all your normal copays, office visits, labs, etc. You're just paying to be a patient.
No way Id pay..there are other good doctors out there and I'd switch if I was going to have to pay to be a patient.

 

[Mommee]

I would a small fee if my orthopedic surgeon were to go this route. I'm in there at least monthly, and really it's a pain to get appointments or prescriptions at times. I would love to be able to call with my questions and get quick answers, especially in those first post-op days. And keeping this doc would be important to me.

I could never see paying this for my family doctor, though, who sees me only occasionally.

 

[TheRatPack]

Wow....that kind of makes you think less of the doctor. Sort of like a bribe to treat me better as a patient....doesn't seem right at all.

With that being said though....I'd just about pay more for an appointment where I didn't have to wait for 2 hours in the waiting area before even getting taken back to a room....then you have to wait there as well for a 2-3 minute doctor visit. It's ridiculous what some offices book in a day for one doctor.....a patient every 10 minutes...etc.

Still, seems really close to a bribe LOL

 

[vicki_c]

This does not sound right!!!!

I would call the medical society or your insurance company and ask about the Dr charging for membership. I would think a doctor would only be able to bill for actual medical services provided and that all charges need to be submitted for payment to an insurance company. At least that is what they taught us in medical coding class.

If a doctor submits a bill to the insurance company for say $100 then the insurance pays $70 because that is the negotiated rate between the dr and ins. co. You get a statement from the insurance company shows nothing is due from the pt. The doctor can not ask you to pay the other $30

This has nothing to do with your insurance and negotiated rates or co-pays. The insurance company would never see the membership fee. And it's not illegal. I also don't think it's unethical as another poster stated. I may not like it or decide to pay it but that doesn't make it unethical.

 

[melancholywings]

I think it can be unethical. If you're in an area that has a lot of doctors - then you can switch but what if that doctor is the only doctor that town has? Or it's the only specialist with in 300 miles - not unheard of. Only treating the wealthy is wrong in those situations.

I adore my daughters specialist and he works incredibly hard. I have never seen a doctor who is more there for us. But all our copays are already overwhelming. I don't know what I would do if he did this - maybe cry.

 

[si-am]

I used to go to an OB/GYN who charged a $5 "comfort fee" (on top of your usual co-pay) if you wanted a paper sheet to cover yourself during the exam. Now, who is NOT going to pay that?

 

[chicagodisneyfan]

I do this and love it.

For my yearly fee I get:
24 access to the doc
if you go to ER he will meet you there
real cotton gowns and slippers
same day appointments
and if needed housecalls!

 

[Tink-aholic]

This has nothing to do with your insurance and negotiated rates or co-pays. The insurance company would never see the membership fee. And it's not illegal. I also don't think it's unethical as another poster stated. I may not like it or decide to pay it but that doesn't make it unethical.

I do not agree with this. Insurance contracts with doctors are very specific about what cannot be charged to a patient. Particularly Medicaid patients; a doctor cannot charge anything additional to the patient beyond what is specified in the contract.

I think charging additional fees to park at the site would make more sense than this "service" and it wouldn't surprise me if the insurance companies shut this down.

 

[babynurse31]

Like it or not, this is definitely a legal practice and will likely continue to become more and more popular. Just like a physician can choose to not see medicare/medicaid patients. They can choose to only see patients who are part have a membership.

Physicians spend a ton of time and money to get there education and the reimbursement keeps going down. Many times general/family practitioners have a difficult time even repaying the student loans it takes to get through 10+ years of schooling. It's becoming harder and harder to get good people to go into medicine due to these conditions.

I don't know if I'd choose to join or not--depends on the doc

 

[ulcards99]

Co-pays are determined by your insurance company -- not your doctor's office. Co-pays and concierge medicine are two different things. Insurance is pooling risk so you don't have to pay "full price" for something unexpected. Concierge medicine is basically when a patient pays a fee to be able to see the doctor. It allows the physician to have a certain number of patients and to increase their income to an extent. Primary care physicians are the lowest paid physicians in healthcare.

It also allows the physician to provide more "focused" care to each patient. I'm not necessarily a fan of this type of medicine, however, it does have its advantages. Some physicians will make house calls under this arrangement and they will also have hours on the weekends (or later at night). In many cases, physicians will also give out their cell phone numbers and you can call them late at night or whenever you need a consultation.

 

[vicki_c]

Like it or not, this is definitely a legal practice and will likely continue to become more and more popular. Just like a physician can choose to not see medicare/medicaid patients. They can choose to only see patients who are part have a membership.

Physicians spend a ton of time and money to get there education and the reimbursement keeps going down. Many times general/family practitioners have a difficult time even repaying the student loans it takes to get through 10+ years of schooling. It's becoming harder and harder to get good people to go into medicine due to these conditions.

I don't know if I'd choose to join or not--depends on the doc

I agree - it has nothing to do with insurance and what the doctor might be allowed to charge for their medical services. A membership would not fall under those type of guidelines - physicians do not have to treat everyone who walks in their door like a government-funded ER would and they are free to set up almost any kind of business model they want. Like it or not, medical practices are businesses. And no one is forced to go to a particular doctor, even if it is geographically undesirable or close to impossible to go to another one.

As to the unethical part, I see the PP's point about a doctor in a rural area but the thing is - they don't have to practice there at all - it was their choice to locate their practice there, so if they want to charge some extra fee, they can. And that wouldn't apply to the OP I'm guessing in No.Va.

I'm just playing devil's advocate here - I don't have a stake in the discussion since it hasn't come up in my own life.

But it's definitely not illegal and it has been going on for quite a while. Here are just a few snips from the Wikipedia article I linked earlier:
The origins of concierge medicine are often traced to MD2 International ("MD Squared"), which was launched in 1996....

Since 2003 there has existed a professional society of concierge and other direct practice doctors known as the Society for Innovative Medical Practice Design or SIMPD....
In late 2009, early 2010, SIMPD changed their name to the American Academy of Private Physicians or AAPP.

In early 2008 it was reported that one health insurer was dropping from their provider networks, some physicians who charge an annual fee. Another insurer also expressed opposition to annual fees. Other insurers do not oppose concierge medicine as long as patients are clearly informed that the fees will not be reimbursed by their health plan.

 

[eeyorethegreat]

I used to go to an OB/GYN who charged a $5 "comfort fee" (on top of your usual co-pay) if you wanted a paper sheet to cover yourself during the exam. Now, who is NOT going to pay that?

Me I would bring my own sheet and night gown.

 

[mickeymaker2003]

Me I would bring my own sheet and night gown.

I was just thinking I'd bring my own sheet too....

 

[Swimalie]

Me I would bring my own sheet and night gown.

I would too.

I wouldn't pay for a general practitioner or even my orthopedic surgeon. But for something really specialized that I know I'm going to see all the time like oncologist or neurologist, I would pay for extra care.