At Chelsea Foot and Ankle, we understand that the evolving landscape of healthcare coverage in the United States is ever-changing and increasingly more confusing to most of us.
Because we value transparency, we endeavor to make things as simple as possible for our patients. We take the time before your appointment to investigate the particular details of your insurance plan, the coverage and benefits, and we advise you of all of this before your appointment as well as in writing at the time of your appointment, just to ensure that there are no surprise costs or unexpected expenses.
All of the doctors at Chelsea Foot and Ankle are third-party free.
What is “Third-Party-Free”?
Third-Party-Free means that we don’t work for any insurance company. We don’t abide by their rules, their decisions on what diagnostic testing you should be allowed, nor do we take any incentives, accept any contracted fees or other forms of loyalty rewards from them. That is because we believe that as your healthcare providers, we should only be loyal to our patients, and as such, we only work for our patients.
We accept all major insurance plans on an out-of-network basis.
Many of the health insurance plans offered 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 our doctors. If you are not sure if your plan has out-of-network benefits, please call us and we check your benefits immediately with you on the phone and let you know if your plan allows you to use your health insurance to see our doctors.
Being out-of-network means that we are not bound by a contract with any insurance place. Another way of thinking about this is that we do not participate as an in-network provider with any third party (Medicare, Medicaid, HMOs, Workers Comp, Motor Vehicle, No-Fault, etc…) However, most major commercial/private insurance plans will offer out-of-network benefits. Patients with these kinds of commercial plans may see any of our doctors at Chelsea Foot and Ankle utilizing the out-of-network portion of their plan. As is the case with most out-of-network plans, a deductible and coinsurance may apply. To find out if your plan includes coverage for out-of-network providers, please contact our office.
Why are you a third-party-free practice?
Because we have no contract with any third-party payer, we have no conflict of interest with our patients. This independence from insurance companies means that we are not subject to coercion, restrictions, rationing, or meddling in your medical care by administrators at health insurance companies. Increasingly insurance companies have used their network contracts with various healthcare providers as a tool to increase their profitability by limiting care to meet their cost-containment objectives. This always comes at the expense of the individual patient. Because our doctors have not signed away their rights to make the best decisions for our patients, we are able to practice medicine ethically, basing our treatment decisions solely 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 who has never met or examined our patients.
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. Our doctors work directly for you and for no one else – i.e. the doctor’s medical decisions are not influenced by Medicare or HMOs. This maintains a doctor’s objectivity and promotes a sense of trust in the patient-doctor relationship. Third parties often require doctors to adopt a conflict of interest with their 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 your health and welfare. We care only about you, not the considerations of an insurance company.
- Freedom to choose physicians and treatments which you believe are right for you. We believe that patients are smart enough to make their own choices about their medical care, after consulting and seeking advice from their doctors. When you choose a third-party-free physician, you and your doctor make all of the decisions about your care as opposed to a medically untrained and unqualified Medicare bureaucrat or HMO administrator 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 healthcare providers 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. We practice relationship-based medicine and we believe that 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-parties who force their way into that relationship. In our office, we do not allow anyone from an outside insurance company 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 our patients are smart and should be empowered to make their own medical decisions with the advice of their physician.