Benefits of Private Pay

When it comes to seeking out healthcare for yourself or your child many people assume that using your health insurance is the best option, however, paying privately has numerous benefits that many individuals may not realize. 

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We are not in any way advocating to get rid of your health insurance altogether. Having health insurance is extremely important especially when you're hit with a large expense. But there are circumstances when it may be beneficial to pay out-of-pocket for the services that you need, rather than the services your health insurance says you qualify for. 

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Let’s take some time to discuss some of the benefits of private pay:

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FASTER ACCESS TO HEALTHCARE

Private healthcare providers typically offer shorter wait times for consultations and appointments. This can be particularly beneficial for families who have an immediate need or who prefer timely access to therapy services. 

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FREEDOM TO CHOOSE YOUR OWN PROVIDER

Without the constraints of a healthcare company, families are able to choose their preferred provider, allowing families the ability to retain more control over their healthcare decisions. This is especially advantageous for those who have a specific medical preference or are seeking a second opinion. 

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GET THE CARE YOU NEED

With private pay, you won’t be limited in your care (such as pre-authorization or visit caps). Choose any therapist you want and get the care you need regardless of whether or not you “qualify” for service.

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GET AS MANY SESSIONS AS YOU WANT

Insurance often limits the number of appointments you’re able to have in a year. With a private pay option, you have the flexibility to schedule as many or as few sessions depending on your needs. 

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GET FOCUSED CARE

Private pay clinicians almost always have fewer patients than those who take insurance—which means they can provide fully focused, thoughtfully individualized care (without having to constantly jump through hoops for the insurance company). Don’t get us wrong: we believe all therapists are doing the best they can. That said, therapists who take insurance see 2.5x more patients than private pay therapists. Anyone in the healthcare field can tell you that working with insurance companies is extremely time-consuming and tedious. This tends to lead to burnout in clinics that accept insurance.

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FLEXIBLE SCHEDULING

Private pay providers may provide greater flexibility in appointment scheduling, allowing patients to arrange consultations and treatments at times that are more convenient for them. This is particularly beneficial for individuals with demanding work schedules or other time constraints. 

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Here at Benchmark Pediatrics, we are private pay—so we don’t have any of the limitations associated with health insurance. That gives us the ability to be 100% focused on what’s best for your family, without having to cater to insurance regulations. However, “private pay” doesn't necessarily mean more expensive. We don’t include any of the “up-charging” that often occurs for insurance patients. 

Plus, you can still take advantage of your HSA account and/or out-of-network benefits to help cover our costs.

HSAs (Health Savings Accounts or Flexible Spending Accounts) provide a convenient way to pay for health care with pre-tax dollars, which means you save on your tax bill.

Out-of-network benefits allow you to see any healthcare provider regardless of whether they’re in-network. In this case, you’ll still need to pay for the appointment up-front and provide a medical reason for seeing a therapist, but the insurance company will then reimburse you for some of your out-of-pocket expenses. Usually, this comes to 60-90% of the total costs, after meeting your deductible. Benchmark Pediatrics is committed to providing you with all the necessary information, including a superbill, in order to maximize your out-of-pocket benefits. 

It is our belief that by not taking insurance, we gain additional freedom that allows us to provide better care.  If you are interested in gaining information about the services we offer, get in touch with us. 

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