All of the doctors at Chelsea Foot and Ankle are out-of-network and third-party free.
What does “out-of-network” mean?
It means that we are not bound by any contract with any commercial insurance company, Medicare or Medicaid. The overwhelming majority of health insurance plans in the New York City area have out-of-network benefits coverage. As long as your health insurance plan has out of network benefits, you can use your insurance to see Dr. Ciment. If you are not sure if your plan has out-of-network benefits, we invite you to contact us and we would be happy to contact your insurance company and determine your level of coverage.
What is “Third-Party-Free”?
Third-Party-Free is the rationale behind the decision we made back in 2008 to go out-of-network and drop our contracts with the insurance companies. Third-Party-Free means that we don’t work for any insurance company. We work only for you, the patient.
Third-Party-Free means that we do not participate as an in-network provider with ANY third party (Medicare, Medicaid, HMOs, Workers Comp, Motor Vehicle No Fault, insurers etc). However, most major commercial/private insurance plans will offer out-of-network benefits. Patients with these kinds of commercial plans may see Dr. Ciment at The Chelsea Foot and Ankle Center utilizing the out-of-network portion of their plan. As is the case with most out-of-network plans, deductible and coinsurance may apply. (To find out if your plan includes coverage for out-of-network providers, please contact our office)
Because we have no contract with any third party payer, we have no conflict of interest with our patients. We are not subject to the coercion, restrictions, rationing and meddling in your medical care by bureaucrats – for the purpose of improving their profits or limiting care to meet cost-containment objectives (often at the expense of the individual patient). We are able to practice ethical medicine, based on our best medical judgment (in accordance with the Oath of Hippocrates) as opposed to practicing medicine according to the “substituted judgment” of a third party.
What are some of the benefits of seeing a Third-Party-Free physician?
- First and foremost is accountability. Since a Third-Party-Free physician is not dependent on any third party for payment, Third-Party-Free physicians are accountable solely to their patients. The doctor works directly for you and for no one else – i.e. the doctor’s medical decisions are not influenced by Medicare or HMOs. This maintain a doctor’s objectivity and promotes a sense of trust in the patient-doctor relationship. Third parties often require that a doctor adopt a conflict of interest with his patients. Certain third party insurance plans have even provided perverse financial incentives that work against the best interests of patients. For example, they offer doctors more profit for providing less care or ordering less testing. Third-Party-Free doctors have no such conflict of interest. Our only priority is the health and welfare of YOU—OUR PATIENT.
- Freedom to choose physicians and treatments which youbelieve are right for you. We believe that patients are smart enough to make their own choices about their medical care, with the advice of their doctor. When you choose a Third-Party-Free physician, you and your doctor make all of the decisions, as opposed to a medically untrained and unqualified Medicare or HMO bureaucrat making a decision about what tests and procedures you can and cannot have.
- No referrals are necessary to see a Third-Party-Free physician. Many third parties require complex referral forms and “permission” to see specialists. Patients are often subjected to unnecessary hassles and delays in getting to see the doctors and specialists they want due to the unnecessarily complex “Gatekeeper” system imposed by many third party plans. Often this requires you to go back and have unnecessary appointments with your family medical doctor just to get a referral to see the specialist you need. While a referral from your primary care physician is always welcome, we believe patients are smart enough to choose the specialists and other physicians they want to treat them.
- Improved access to medical care. As the government ratchets down physician fees in the Medicare program to levels that will no longer sustain medical practices in higher cost-of-living markets, like New York City, Medicare patients will have increasing problems getting timely access to care. At first, this will translate to longer waiting times to see your primary care doctor or specialist. In some cases, it will mean that some doctors may no longer accept any new Medicare patients. A Third-Party-Free practice offers no barriers to timely access to medical care – we are happy to see you in our office on a timely basis. Likewise, because of financial disincentives provided by HMOs, many patients are forced to incur long waiting times to get in to see a specialist. A Third-Party-Free practice offers timely access to care for HMO patients that is often not possible “in network.”
- Complete Privacy. Because we are a non-covered entity under the new HIPAA law, all medical records in our office are kept private and confidential. Unlike other practices that are covered by HIPAA, our patient records are not subject to increased risk of disclosure to a multitude of snooping government bureaucrats, law enforcement, “approved researchers,” and others as allowed under the HIPAA law. We do not share your private, confidential medical information with ANYONE without your written permission, and we do not enter your private information into any electronic government or insurance database (where it may not be secure). We believe that patients value their medical privacy, and in the Hippocratic tradition, we intend to make sure that your records are kept completely secure and totally private.
- Non-Interference in the Patient-Doctor Relationship. The patient-doctor relationship is the single most important aspect of the practice of medicine. We believe that the highest quality of medical care is achieved when patients and doctors interact with one another directly, without Third-Party-Payors in between. In our office, we do not allow ANY bureaucrat to come between patient and doctor. We firmly believe that all medical decisions should be made by physicians and their patients, not by bureaucrats. We also believe that patients are smart enough and should be empowered to make their own medical decisions with the advice of their physician.