<p>I understand that large insurance companies demand to pay a fixed percentage of the walk-in rate. So for clinics to be in-network, they need to set their walk-in rate stupidly high.</p>
<p>Ignoring for a moment how incredibly broken this is, there seems to be a fairly obvious workaround. Set up an &quot;insurance company&quot; which doesn't actually provide insurance, it just bargains clinics down to the same rate that eg. BlueShield demands, but then there's no (or a trivially small) monthly payment and also an effectively infinite deductable. Clients pay per-visit, but they pay the same rate that BlueShield pays, not the walk-in rate.</p>
<p>Are there any insurance companies which actually do this? If not, why not?</p>
<hr />
<p>Edit:
This question was closed for not providing details, but the closer didn't mention which details weren't provided so I'd like to re-open it. Please tell me what's missing.</p>

CC BY-SA 4.0
2021-09-14T20:54:58.490Z
One of the promises from the insurance company is that (providing the details of the agreement have been complied with) payment is guaranteed.  Can your scheme make the same promise?
Henry
CC BY-SA 4.0
2021-09-14T21:03:48.433Z
I've been to a doctor's office before and been told they have to look up my individual account or something, that just knowing _which_ insurance provider isn't good enough. So why not just have customers set up a pre-paid account and only grant access if there's sufficient funds?
dspyz
<health-economics>
Is it possible to pay the same amount health insurance companies pay for a doctor's visit in the US
dspyz
# Is it possible to pay the same amount health insurance companies pay for a doctor's visit in the US

(Asked by: username_0 on 2021-09-14)

I understand that large insurance companies demand to pay a fixed percentage of the walk-in rate. So for clinics to be in-network, they need to set their walk-in rate stupidly high.

Ignoring for a moment how incredibly broken this is, there seems to be a fairly obvious workaround. Set up an "insurance company" which doesn't actually provide insurance, it just bargains clinics down to the same rate that eg. BlueShield demands, but then there's no (or a trivially small) monthly payment and also an effectively infinite deductable. Clients pay per-visit, but they pay the same rate that BlueShield pays, not the walk-in rate.

Are there any insurance companies which actually do this? If not, why not?

---

Edit:
This question was closed for not providing details, but the closer didn't mention which details weren't provided so I'd like to re-open it. Please tell me what's missing.

**Tags:** health-economics

> **Comments:**
> **username_1**: One of the promises from the insurance company is that (providing the details of the agreement have been complied with) payment is guaranteed.  Can your scheme make the same promise?  
> **username_0**: I've been to a doctor's office before and been told they have to look up my individual account or something, that just knowing _which_ insurance provider isn't good enough. So why not just have customers set up a pre-paid account and only grant access if there's sufficient funds?  

---

## 0 answers

