BUSINESS

Money woes solved with cash-only practice

A Mississippi internist explains how his situation changed for the better once he stopped accepting insurance.

By Mike Norbut, AMNews staff. Feb. 10, 2003.

The days of waiting for insurance reimbursements and adding up accounts receivable are over for Todd Coulter, MD, an internist from Ocean Springs, Miss. About seven months ago, Dr. Coulter's practice, Midway Family Care, stopped accepting insurance, and he started seeing patients on a cash-only basis.

Dr. Coulter, who is the vice speaker of the Mississippi State Medical Assn. House of Delegates and the immediate past chair of the AMA Young Physicians Section, operates his clinic from 8 a.m. to 7 p.m. Monday through Friday. Office visits are $40, paid in cash, and patients can receive other tests, such as $40 x-rays and $20 ECGs, without going elsewhere. Patients who have insurance are instructed how to file their claims with their respective insurance company.

Dr. Coulter is happy with his practice and says he is often complimented by other doctors "for doing what others are afraid to do." In a Q&A with American Medical News, he talks about how he managed the transition and how his practice has changed.

Question Why did you decide to switch to an all-cash practice?

Answer Basically, to maintain the solvency of the clinic. Patients would come in for an appointment and pay their $15 co-pay, and we'd file the claim, and then we'd wait three and a half, four, sometimes even five weeks to get the balance of our payment. It just took us too long. It was a cash-flow problem.

Along with that, we were seeing patients without insurance, who would just pay in cash. They were paying $68. I looked up one day and said, "We could do this all the time."

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