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I switched to an HSA in 2005 and it's been the best thing ever.

Most doctors offices have given me anywhere from an immediate 20-50% discount for immediate payment. I even got a 66% discount last year for paying before the procedure.

The reasoning behind it is simple..

If you did $100 of work and weren't going to get paid for 3-6 months, you would charge more than $100. There's the time value of money. If you have to spend a lot of time and effort to get that money, you would charge significantly more. If you knew that you would have to give up some of what you asked for, you would charge more. (When I worked in a hospital, we had one person that her only job was to call and argue with insurance companies.)

Now.. on the flip side. If you did $100 of work and were used to Net-90 or even Net-30, what discount would you accept to get the money now? And not just now but with zero arguing, effort, etc?

Oh.. and with an HSA, I have consistently gotten same day appointments when there's a "two week wait" for people paying with insurance.

In that case, it's simple cash flow management.. if you have one slot open and you can take a customer that will pay 3-6 months later but only with lots of effort OR a guy who will pay less but before they leave the office, which would you take?




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