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No Insurance for Primary Care: Washington physician sidesteps traditional insurance to focus on patients

“”  I will be offering Primary Care services for a small fee of $45 per month. For those of you who chose to join, this will be an automatic monthly deduction from your checking account and will cover up to 15 visits per year.  ​The $45 fee will cover all of my office costs. There will be no co-pay at the time of the visits and no other costs for my care which is available 24 hours a day, 7 days a week. You may still use your insurance for your prescriptions, labs, x-rays or other covered services.” ~ Dr. Nila Jones, Woodland, WA.

By Lyxan Toledanes

Dr. Nila Jones of Woodland, WA.

Dr. Nila Jones of Woodland, WA.

JULY 19, 2014 –Dr. Nila Jones said she loves spending time with her patients, but she hates dealing with their insurance companies.

That’s why the Woodland physician eliminated the middle man and transformed her clinic into a “concierge practice,” forgoing traditional health insurance for a $45 per person monthly fee. It’s a relatively new model in health care, which Jones said will open her services at Woodland Ideal Medicine to more uninsured and Medicare patients.

Jones was featured in The Daily News last summer when her practice first opened, promising patients more access to her under a unique “micropractice” model that resembled old-fashioned country doctors. Jones managed all paperwork and examinations as the clinic’s only employee.

The structure worked until she started dealing with insurance companies. When she filled forms incorrectly, the insurance companies would not respond immediately, delaying her reimbursements.

“I’m not trained in insurance billing, and I don’t have any particular interest in the business side,” Jones said Thursday. “I would get reimbursed four weeks later — months later, in some cases.”

Monthly Fees at Woodland Ideal Medicine

Monthly Fees at Woodland Ideal Medicine

  • $45 a person
  • $80 for a two-person family
  • $115 for a three-person family
  • $25 per person for a family with four or more members

Under the concierge model, she’ll still have time for hour-long appointments with patients, but she won’t have to work with health insurance companies anymore.

“I really hate working with insurance companies. They’re a pain to work with. Medicare is particularly difficult to work with,” Jones said Thursday. “My goal is to provide ideal medicine for my patients. I have not worked with Medicare (patients) yet, but I would really love to be able to help them.”

Dr. Howard Maron, a former physician of the Seattle SuperSonics, started concierge medicine in 1996 at his practice, MD Squared. Fewer than 5,000 U.S. doctors have concierge practices, which often target wealthier patients and charge an annual fee between $200 and $700, The Wall Street Journal’s Market Watch reported in 2013.

Jones intends her concierge practice to be more inclusive. Her monthly fee is equal to a high co-pay, but she does give deals to families. She also offers sliding-scale payments under special circumstances.

Patients — insured and uninsured — will pay the monthly fee, which covers up to 15 visits a year to her office. More complicated patients will be referred to specialists, who could then accept insurance for X-rays, labs and prescriptions.

Jones said she’d won’t see even a penny of reimbursement from patients’ insurance with the concierge model — which she prefers.

“I’m side-stepping (traditional insurance),” she said. “I’m hoping that the $45 a month is going to be reasonable on incomes so they can pay that and have a primary care doctor. There will be no other costs to patients.”

Jones said she hopes more Medicare patients will take up her offer and add to the 100 patients under her care.

“I’ve had to turn down so many people on Medicare, and older people are the people that tend to need the doctor more,” she said. “It would be financially reasonable for them.”

Woodland Ideal Medicine

339 Bozarth Ave
PO Box 1646
Woodland WA 98674 us

TEL: 1-360-773-8834



Categorised in: Business, DPC News, Inside A Practice, Insurance, Micro, National Acceptance, National News, Trends

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