Why Doesn’t Thrive Medical LLC Take Health Insurance?

Many medical doctors and practitioners are opting out of the traditional health insurance model and Thrive Medical LLC has joined the rebellion against sub-optimal healthcare. While many patients wonder why a provider might choose to avoid using insurance, we hope this article will clarify our rationale.

The primary reason Thrive Medical LLC doesn’t accept insurance for office visits is so that we can provide the highest level of health care directly to the patient. The many reasons why health care isn’t working under the typical insurance model include low to non-existent reimbursement rates for preventative care, extremely high administrative time and cost required to try to get reimbursement, high rates of reimbursement denial, the delayed reimbursement time (sometimes 2-3 years), limitations on “approved” treatments or medications as dictated by the insurance (not the provider), and many others. Not to mention the “gotcha bills” that patients often receive months or years after a service was received due to insurance coverage denials. For more on this see our article titled “Health Insurance is a Scam.”

What is Preventative Healthcare?

Most insurance companies will provide little to no reimbursement for preventative medicine appointments. They will, however, pay very well if a provider writes a prescription, regardless of how much time that provider spent with a patient. How many people change the engine oil in their vehicle before the engine blows up? Hopefully most if not all people perform this preventative maintenance on their vehicle.

Just like your vehicle, your body needs preventative maintenance to reduce the risk of, or to treat many diseases like high blood pressure, diabetes, chronic heart problems and many types of cancer. Your health insurance company makes more money the sicker you are. So, their very lucrative model is to wait until you are quite sick and then try to keep you alive with their medications and hospital services without dying. This makes boatloads of money for big pharma, big hospital organizations and the politicians who accept money from these organizations, but it is not a sustainable model for patients. This is in no way, shape, or form placing the health of the individual (you the patient and customer) as a priority!

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As a medically trained professional, you expect your doctor to take more time to get to know you, to consider the whole picture in diagnosing health problems, and to do their best to recommend the most beneficial treatment plan even if they don’t fit within what the insurance model dictates. Example: The American Diabetes Association, who advises insurance companies on the management of diabetes, doesn’t consider someone “diagnosed” with diabetes until 50% of their pancreas is dead and high blood sugars have been ravaging the body for years causing permanent damage. Think about the diabetic that has a foot amputated, loses their vision or goes on dialysis due to diabetes. Sadly, if addressed at a much earlier stage all of these complications are completely preventable but are common in the insurance-based health care model.

How Does This Change the Level of Care?

Here at Thrive Medical LLC we prefer our patients receive as much face time with the doctor as needed to provide the highest quality care, incredible customer service, fast response times (typically the same business day), rapid appointment scheduling rather than having to wait 2-6 months (usually less than a week), and zero waiting room time. There isn’t a health insurance plan on the planet that will approve or reimburse for this type of service. We provide a higher level of care offering more than other doctors that will bill insurance.

While we do not accept insurance for the cost of an office visit, we will run everything else through your health insurance like lab work, imaging studies, and prescriptions. Speaking of prescriptions, we had one insurance company dictate that we prescribe and have the patient try nine different medications before the one the doctor knew would help, NINE!!! Any idea how many office visits, how much time and money that would take?

What Does This Mean for Our Patients?

• A dedicated doctor: our medical practice model allows us to operate with less patients on the roster which means you get more time and attention to your healthcare needs.
• Simple billing: we know how frustrating it can be waiting on hold, waiting for an appointment, waiting on the insurance company, waiting in the waiting room, and waiting more in the exam room. We offer a solution to all these issues and more by billing patients directly and transparently eliminating complicated insurance problems.
• Cost savings: few patients are aware just how much insurance companies over charge them and reduce reimbursements for doctors. Thrive Medical LLC charges less for services because we don’t share profits with a third-party middleman.

Contact Dr. Melissa Gomez for more information.

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