Blog

Costs and Why We Don’t Take Insurance (Yet) 

SenseMed was always intended to be a clinic serving people who have trouble breathing and fatigue regardless of socioeconomic background. Therefore, we started off with the intention of accepting insurance, including Medicaid and Medicare. Unfortunately, after hours of reviewing reimbursement options we discovered that there would be too many roadblocks to delivering the kind of care that we want to provide to our patients. For full transparency we list these roadblocks below: 

1. Medicare and Medicaid will not pay for review of the scientific material or consultation with other members of the patients’ family if it occurs on a different calendar day from when the doctor sees the patient. 
2. Medicare and Medicaid will not pay for the doctor to review and prepare for the clinic visit if it does not happen on the same day as the clinic visit. 
3. Medicare and Medicaid will not pay for doctor to doctor ‘curbside’ consultation about aspects of the patient’s care if it does not occur on the same day as the clinic visit. 
4. Medicare and Medicaid will not pay for a consultant review of the patient’s chart if the consultant does not have a separate clinic visit with the patient, or if the curb-side (doctor to doctor) consultation does not occur on the same day as the clinic visit. At SenseMed, one of the key solutions for patient care that we will offer is a streamlined review of a patients’ data, what the data is that they have from past clinic visits and also preventing the patient from having to re-tell their same story to several different doctors. We are adamant about preventing double testing of the patient just because its convenient for the provider (like repeating bloodwork or other recent tests in order to have these readily available in the health record); and adamant about saving our patients time and expense so that we want to prevent the patient from having to see multiple specialists when all that is needed is a focused review about a certain aspect of the symptom or a certain result from a lab test.