About Us

 

Patient Options was founded in 2015 by a group of doctors fed up with the status quo of discounting self-paying (cash-paying) patients.   They said: “there has to be a better way!” This was the impetus to that led to Patient Options DMCO.

Healthcare, Managed Care and the Insurance Industry is highly regulated Federally as well as in each state, necessitating  attorneys, doctors and insurance compliance specialists to collaborate and address the increasing  regulatory and compliance issues facing health care providers who help the uninsured or under-insured- specifically doctors avoiding  dual fee schedules. It’s no secret that today, patients have to absorb more out-of-pocket expenses related to their health care. Certain state laws, federal laws and provider contracts prohibit many common practices among providers, specifically these laws and contracts prohibit offering excessive discounted (different) prices for “cash paying” patients (dual fee schedule) or other inducements to patients seeking care. This has been called a dual fee schedule and insurance companies construe this as a type of false claims act  both of which can get you into trouble.    Patient Options is here to help. In this highly regulated health care marketplace, our mission is to help patients and doctors alike.  We offer solutions for patients in need, and also help providers keep compliant and out of trouble. Patient Options gives providers an opportunity to  offer contractually based  discounts to patients.

But equally important, let me tell you what Patient Options is not.   We are not  a traditional “Discount Medical Plan Organization”  (DMPO) that charges “fees” for Patients to be become “members” and become enrolled in the “plan” and be entitled to discounts.  These are regulated in many states because of the history of patient members purchasing “memberships” and thinking they are purchasing health insurance.  This history is unfortunate and gave some players in the industry a black eye for not being ethical in their sales tactics.

Likewise, we are not an Indemnity Plan, HMO,  or Insurer for Providers or Patients, either.  We do not sell insurance to patients and Providers.

We are not a “traditional” Managed Care Organization, because we have no financial relationship with Patients.   Because of this,  many states require traditional Managed Care Organizations (MCOs) to be registered with that state, and subsequently be involved in claims processing, credentialing, etc. to protect those insured from financial harm.

What we are is a newer model of a managed care organization that is modifying the direct patient care model.  We are making the doctor-patient relationship streamlined  with the patient paying no additional fees or membership fees to participate in a discount. Simply put- the doctor gives the patient a true discount!

Our goal is quite simple.  We want to make practice easier.  There’s an old saying K.I.S.S.- keep it simple stupid.  The more simple it is the more likely you are to use it.  Why complicate practice more than you need to?

What makes us different is that we have FREE enrollment for patients, with no limits on the number of patients per provider.  Simply put, patients can participate and have access to affordable health care all  at no charge to them.  Put yourself in your patient’s shoes- What makes more sense to them- “pay more to pay less” or would they rather “just pay less“