Nowadays it is common to have a very high deductible. This is a big problem as patients are bearing a significant cost. In this case, it is very important to choose your doctor wisely!!!  Let me give you a few examples and some critical information.

  1. Contracted Rates–some plans pay doctors very differently. In fact, one may get paid almost twice as much as another.  One way to check this is ask, “What is your reimbursement for a 99202 New patient visit”.  This will compare apples to apples.
  2. Get some good opinions on the doctor–when he/she takes biopsies are they almost always cancer? Are they often negative (non-cancerous). Does he/she prescribe inexpensive medications?

It is important to look at BOTH of these. I’ll give a couple of examples.

Doctor 1 gets paid $100 for a 99202. He is very conservative and only does biopsies that are necessary. He is uses inexpensive prescriptions when possible.

Doctor 2 gets paid $75 for a 99202. He is fairly conservative, but tends to take a biopsy at most visits. He uses some inexpensive medications and some that are expensive.

Who would cost less? How much?

In this case, Doctor 2 may cost a patient more than double of what Doctor 1 gets, even though Doctor 1 gets paid at a higher rate. With a biopsy you have the fee for the procedure and the pathology as well. The cost difference between a generic inexpensive prescription and a brand-name can be $50 or more to the patient if it is covered. If the medications are not covered, the cost difference can be over $300 difference for products that do the same thing.

In short, look at the reimbursement rate and get good recommendations. Even if you have to pay a little more for the doctor in terms of reimbursement, it will likely save you money in the long run if he/she is a good physician who practices ethical medicine.

Free skin cancer screenings are offered all of the country. These are usually offered around May and is a no-cost opportunity to get screened. Nothing else will be evaluated during these visits–no treatments, no prescriptions, no biopsies. This is a great option for those unable to afford their deductible.

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Robert S. Bader, M.D., Dermatologist

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