House calls, longer office visits mark Dr. Brenda Arnett’s cash-only practice.
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When it comes to dealing with insurance companies and Medicare, Dr. Brenda Arnett has been there, done that. The 39-year-old Winchester internist, who completed her residency at Georgetown University Hospital, once worked in a busy, multi-specialty practice where she saw about 40 patients a day. She didn’t like rushing through office visits and worried about her patients. “I would lose sleep at night,” she says.
Today, she is one of very few cash-only doctors. She has a manageable 400-500 patients, and “gained many new patients in December after ACA [Affordable Care Act] initiation,” she says. She does accept credit cards, but unlike many concierge and hybrid practices, does not accept insurance or Medicare–or even file the forms. (She will provide forms with proper coding for her patients to submit on their own if they wish.) Interestingly, she regularly must go through a formal process to opt-out of Medicare. “I have to send in an affidavit–and have it notarized–every two years,” she says.
Such drastic measures allow her to focus on her patients and have more control over the time she can spend with them. It’s not unusual for her to spend up to an hour and a half with a patient at an initial visit. She charges $99-$150 depending upon the length of time she spends with them. Some other examples of her charges include EKGs ($50), CBCs ($12) and cholesterol testing ($20). She says she can keep her costs reasonable because she has opted out of the various systems. “I don’t have a coder. I don’t have an insurance company person,” she says.
Dr. Arnett has traveled to Africa, Central America and China on humanitarian medical messions. A third generation physician, she grew up in Elkins, West Virginia. She went on house calls with her father, a pulmonologist. “I remember one patient that we used to visit in rural West Virginia [a retired coal miner with black lung who] was 102 and he only drank black coffee and ate toast. I swore that I would only drink black coffee and eat toast the rest of my life so I could live to be his age,” she says. Today, she makes house calls to her own patients, carrying her grandfather’s medical bag on the visits.
Longtime patient Sharon Fisher of Front Royal, 60, decided to follow Dr. Arnett when she started her new practice in 2007—even though Fisher has insurance (with a high deductible). She appreciates the level of care that Dr. Arnett provides. “It’s worth every penny,” she says. “To have somebody really managing your health care, what could be more important?” ArnettMD.com
Helpful tip: Patients can cut costs at most physician practices by offering to pay cash for their care, even if they have insurance. If you can pay cash, ask your practice for a discount the next time you are seen, you could save a bundle.