Contacting the Surgeon about our First Need

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Posted by admin | Posted in Our Need Experience, Samaritan Perks | Posted on 06-12-2016

Well it looks like it’s finally going to happen, we are about to have our first need as Samaritan members. My husband’s having pain, numbness and tingling in his hands, which seems like possible carpal tunnel, but since we weren’t sure about that we met with a surgeon for testing.

I did a bit of quick research on the procedure options and figured out which surgeon we want to use from those available in the area. A friend recommended his surgeon from last year as he’s one of the top guys in the area for this procedure and he can do the endoscopic method instead of the open procedure (the cut you open method is much more painful and takes longer to recover from). So I called the surgeon’s office to find out what they have for self pay policies, whether we needed a referral, etc. When I first called I wasn’t sure how my questions would be received, but it really was a great conversation. Their website said they want a $250 deposit from self pay patients, so I knew they had some policy for self pay patients, but I didn’t know much beyond that.

When I asked what their policies are for self pay customers, the receptionist asked if we had any insurance at all. I told her no, we are self pay, and we are members of a health care sharing ministry and would be reimbursed in a couple months after the bills were submitted. She said we didn’t need a referral from another doc, and for self pay customers they offer a 50% discount. I thought that was pretty awesome! They want $250 up front during the consultation visit, the testing would be billed to us later (also discounted 50%), we can do a payment plan if we want but the nurse would want everything paid in full before any surgery was performed (if it’s needed). She gave me an all inclusive rate for the surgery for both hands, and it was reasonable since we get 50% off. I asked if paying 1/2 up front and 1/2 afterwards was an option, considering that we’d be reimbursed in a couple of months and she said that was something we’d need to speak with the nurse about (interesting that it’s determined by the nurse and not a standard billing person), but “since you have the support of the ministry that may be possible”.  It’s logical, and it’s further confirmation of what I’ve heard from others for a while now. The all inclusive surgery rate I was quoted was very close to the rate advertised by the Surgery Center of Oklahoma. I use them as a comparison because they are a cash only facility, no insurance taken, payment is due at time of service, and they quote all their rates (which are quite reasonable) directly on their website. Knowing that our local cash rate was close to the one 8 hrs away was a relief because I want to keep the costs as low as possible for the good of the members.

The gal I spoke with was so helpful. She not only gave me the inclusive rate for doing the procedure in the surgeon’s office, she also quoted a different flat rate if we wanted it done at another facility (he travels), but she cautioned us that the other facilities would also have fees for using their place; anesthesia, supplies, etc. Based on the numbers she gave it was clear that the package deal in his office was going to be the least expensive. Sh also had said that it’s pretty busy because of end of year deductibles that people want to meet. Since we don’t have an annual deductible to meet we can easily get this done in January since they’re getting full and avoid the rush and headache of end of year holiday scheduling. So far this is a win-win-win.

Being members of Samaritan gives us:

  • a healthy discount for being self pay along with financial assistance from ministry members
  • the flexibility to choose our favorite surgeon who can do our preferred procedure
  • we choose our timing with no deductible pressure or permission requirements

We don’t have to care about getting it crammed in before the end of the calendar year. With our work and holiday schedules that is so freeing and a significant stress reliever. We were quoted an amount that will fit on our credit card or that we can pull from the small medical savings account we built by saving so much compared to insurance premiums. This feels like the way health care is supposed to be. So far it’s just as easy as having insurance. Of course I know what insurance would stick us with so that makes Samaritan MUCH easier. It really comes down to having a plan and knowing the policies. With insurance we’d be charged twice as much, insurance would then knock it down a little to make us feel better, we’d have a giant deductible to meet and since the surgery is close to the deductible level of the insurance options we rejected (especially at double the price) we’d probably end up paying everything out of pocket and it would cost more than what we’re sharing with the members now. If we had started meeting our deductible already this year then we’d be scrambling to get everything done before Jan 1 to try to keep costs lower and the stress of cramming all of this during the holiday season would be wretched (not to mention crushingly expensive!) assuming they could even get it done by then. No thanks. I’d rather do this on our timetable and I’m SO THANKFUL that Samaritan’s guidelines let us do this.

This is step one, my next post will describe how the meeting with the surgeon went. So far I’m quite pleased with this process as self pay patients and ministry members.

I have been a big fan of Samaritan membership for years now. Going through the process now of having our first need has only solidified exactly what I knew and trusted based on the experience of others. This is an amazing way to do health care and to get our needs met while helping meet the needs of others.