The Emergency Room & Qliance

When I met with Dr. Bliss and Chapin over the Holidays, I explained a recent situation with our daughter that occurred on a Sunday evening where we had no choice but to take her to the emergency room. Our health insurance through my wife's former employer had been costing us over $800 per month plus the customary co-pays for every visit.

Early last year, I converted our health insurance to an Anthem Blue Cross/Blue Shield Lumenos high deductible policy ($10K individual, $20K family). The premium was only $265/month (though it increased to $304/mo. several months later). The plan encourages a healthier lifestyle by offering preventive care routine exams and programs to kick bad habits such as smoking and overeating free of charge. The invoices from the emergency room visit have arrived. The initial charges were $1,281 for the hospital and the physician charged $528 for a total of $1,809. That's what I would have been asked to pay if I did not have insurance. Though I still pay the providers directly myself for anything under my deductible, I get the benefit of their "contracted" prices which reduced the expenses to $704 and $160, respectively or $864 total (a 52% discount). Not bad. However, I am fairly confident from my recent visit to the clinic that Qliance could have handled the situation without a trip to the emergency room. Assuming $60/month, that single visit would have paid for over 14 months of primary care at Qliance at the discounted "insured" prices and 2 1/2 years at the "uninsured" prices. That does not even factor in the prescriptions which may have been available from Qliance at a lower price. So far, the high deducible insurance plan has worked well for us but we would be prime candidates for Qliance if it were available here to mitigate some our exposure to the high deductible.

Keep up the good work.

Respectfully,
Kevin