What if it is a major surgery or major medical event that I need to schedule?

We will help walk you through the process.  After you’ve done it once or twice, you’ll find it’s really pretty simple. We treat healthcare just like any other business transaction.  We, you along with us, will ask the doctor’s, hospitals, “What their cost is for “xyz” procedure and what do we need to do or how do we need to pay to receive the lowest, best price?”  Sometimes that is payment in full or 50% down and 50% upon the procedure date or within 30 days of the procedure.  Either way, we will help walk you through doing this and making sure you are well taken care of and that the process goes smoothly.

How Do I schedule a doctor visit or any other medical appointment?

The same way you would normally schedule a regular medical appointment with the only difference being that when they ask you upon arriving, “what has changed with your address or health insurance?”  You will tell them, “I don’t have health insurance.  On the paperwork as you are completing it, where it ask for your health insurance, you simply write “none- I am cash pay patient.”

How do you submit a claim? What if I receive a bill?

It’s really very simple. You can “snail mail” in bills or you can scan and email the bill to us or many of our members simply take a picture and text the bill into us.  We will respond to you either way you send in a bill and let you know what our portion is and what your portion is and if we owe you any money, when to expect that reimbursement check.

Are Annual Wellness visits and Annual Preventative Care visits covered?


What does this cover? What does it not cover?

We cover virtually everything a regular health
insurance company covers with a few exceptions. We don’t cover some major, pre-existing
medical illnesses or issues, if you already have that diagnosis. It’s just a few things, so it’s
best to complete the next steps document and start the process. There’s no obligation. Then
we also don’t cover ongoing mental health counseling or serious mental health issues like
severe depression that requires hospitalization, alcohol or drug rehabilitation and regular
elective procedures not covered by any health insurance plan or carrier. Other than that, we
cover everything a regular health insurance plan covers from sprained ankles, stitches, broken
bones, cancer, stroke, heart attacks and anything else physical that may come up out of the
blue with you.

What’s the network?

None. You can go anywhwere that takes uninsured, cash pay patients,
which is just about every doctor, lab or diagnostic center.

How does this work?

It’s really very simple and straightforward. We manage healthcare the same way any other
business is ran. Your medical treatment, services and or diagnostics is a product. We handle
it just like any other business sells their goods or services. When possible, we pay for the
medical “product” at the time of service. That gets us the lowest pricing on medical treatment.
The doctor or lab generally has two different pricing structures. They have what they charge
health insurance and they have the individual, uninsured, cash patient price. The uninsured,
cash patient pricing is usually 25-50% lower than what they charge a health insurance
company. You go in for a doctor’s appointment and when leaving, either you pay for the
appointment in full or you call us and we’ll pay them right over the phone in full for the
appointment. Either way, they are getting paid today, at the time of service. That’s about 4 to
5 month’s sooner than if they were to use a billing company and send the bill off to a health
insurance company and wait 4 or 5 months to get paid. That’s why the substantial discount.
It’s very important to update the office where you are attending for your appointment that you
do NOT have health insurance. You simply inform them, you are a cash pay, self-pay patient.
You do not even need to give them or show them your membership card. In fact, we

recommend that you do not show them your membership card, because this will only confuse
them and reduce your discounted percentage. If they think there is another entity that they will
have to negotiate with or send bills to, they will treat you and us just like health insurance. It is
best to leave us out of the pricing process. It is between you and the provider. Again, they are
getting paid right then and there either by you or us, if needed, you can call us and we’ll pay
them on your behalf, right over the phone. Our agreement is with you, our member, not the
medical provider. You simply handle your own medical affairs just like it is any other business
transaction and yours alone. You ask, “What are your terms for getting the lowest and best
pricing?” Then once you’ve obtained the price and the terms on how to pay, if you need help
paying, then you simply call us.

If I am a “Cash Pay or Self Pay Patient” will I get the same care and treatment as if I had Health Insurance?

Yes, and in some situations, possibly better, because you can go
anywhere you want for services. If it is a simple routine medical procedure, like an X-ray,
colonoscopy, Mammogram, Blood or lab work, CT scan etc you can shop the provider and get
the best service at the best price by simply calling 2 or 3 places and asking them, “What do
you charge for xyz service?” They’ll tell you and then you can determine where to go based on
your findings.