Fredrick Insurance Brokers: Take Back Control Of Your Health Costs

Why Is Giving Your Insurance Card A License To Steal?

What if the fastest way to lower your medical bills is to keep your insurance card in your pocket? We walk through a practical, step-by-step playbook for taking control at check-in, starting with a simple rule most people never hear: you have the right to a diagnosis and treatment plan before you agree to pay. From there, we show exactly how to ask for self-pay pricing, use CPT codes to comparison shop, and negotiate using transparent benchmarks that providers respect.

You’ll hear real stories that make the strategy concrete: a surgery quote cut from $23,000 to $11,000 on the spot, and a five-figure ER bill reduced to under $2,000 by refusing vague financial consent and insisting on itemized charges. We explain why many clinics push for your card “as policy,” how that shifts leverage, and what to say when a front desk insists on billing insurance anyway. You’ll learn the difference between self-pay and cash pay, how to request a superbill, and how to file your own claim to capture reimbursements that often exceed your negotiated costs.

We also dig into plan design for people who want control. Defined benefit plans, paired with smart shopping and tools like MDSave, can create predictable payouts and real savings for families, the self-employed, and small businesses. By calling ahead to compare self-pay and network prices, using transparency rules to your advantage, and avoiding blanket consents, you can cut through confusion and protect your wallet without sacrificing care. If you’ve ever felt trapped by copays, deductibles, and surprise bills, this conversation hands you the scripts, the codes, and the confidence to change the outcome.

If this helped you reclaim control over your health costs, subscribe, share with a friend who needs it, and leave a quick review. Your support helps more people get clear, affordable care without the runaround.

To learn more about Fredrick Insurance Brokers visit:
https://www.FredrickInsuranceBrokers.com
Fredrick Insurance Brokers
Dallas-Fort Worth, Texas
972-375-0507 

Transcript

SPEAKER_00 0:03

Welcome to the Frederick Insurance Brokers Podcast, where health insurance finally makes sense. Your hosts, Katherine Clark and John Frederick, are independent health insurance specialists and co-owners of Frederick Insurance Brokers. Family-owned, faith-grounded, and serving individuals, families, the self-employed, and small businesses across the country with options instead of headaches. Around here, they're known as Health Insurance Brokers with a Heart, guiding you toward quality care that's simple, affordable, and aligned with real life. So if you've ever thought health insurance is confusing, expensive, and definitely not fun, you're in the right place. Let's dive in and take the fear out of coverage one conversation at a time.

SPEAKER_01 1:15

Catherine, it's great to be back with you. Thank you for being with us.

SPEAKER_02 1:18

Hi, Julie. How are you today?

SPEAKER_01 1:20

I'm doing okay. I'm excited to learn from you. So, Catherine, you mentioned to us before we even hit the record button that handing over your insurance card to a provider is a license to seal. Can you please explain that?

Say No To Automatic Insurance Billing

Your Right To A Diagnosis First

Self-Pay, Filing Your Own Claims

Price Shopping With CPT Codes

Using MDSave And Real Success Stories

Negotiate And Never Sign On The Spot

SPEAKER_02 1:33

Sure. So, really, gone are the days that your provider's office or office staff really understand the insurance world because it's not as black and white. Okay, so they want your insurance because they want to bill, and people in their mind just think, you know, they turn it over, like that's just what they do. But these offices were doing this as a courtesy to you. But now it's like they want that insurance card because they want to be able to bill as much as they can and figure out they know all the ins and outs of it. And so that's why I feel like it's like just a license to steal. Many of my clients will tell me, they'll go into an office and they'll tell them it's$400 and your insurance is only going to pay$100. But then they'll tell them if you don't have insurance, it's$150. And then they they run into, well, then give me the self-pay price for$150. Oh no, I can't do that because you have insurance. Well, number one, that's not true. Okay. And um, I just tell people, you do not have to turn over your insurance card, you pay for it. You're the customer, so you're gonna unfortunately have to take more responsibility because you cannot trust your providers any longer to do that. They're trying to do what they need to do to keep their practice profitable. I mean, that's what it boils down to. I can give you a specific example. I was good, I called a dermatology office to get something really, really minor done. And I literally told them that I was self-pay. And they called me up the day or two before, because I'd booked this a couple weeks out and asked me for my insurance. And I said, I'm self-pay, I have the ability to pay. And she just kept insisting that was their policy. And I said, My insurance belongs to me, and I'm not giving you my insurance card, I will pay for the visit. And they wouldn't let me come in. Like, well, you're not the only dermatologist in my city, so okay. So, because they're and and so my guess my point to to people is you need to stand up for it. You're the one that spends that money every month on those premiums. They don't, so you have to take in this day and time take a little more control. Um, and so when you go into an emergency room or urgent care or whatever, you also need to understand that you have a legal right to a diagnosis before you pay anything. So that idea how they sort of circumvent you right to the whatever, you have a right to a diagnosis, they present to you the diagnosis and the treatment plan and the cost. And if you don't like what they have to say, then you can get up and leave and you don't owe them anything. And there's some urgent cares that really that do operate that way, and others that don't, but they don't because there's everybody follows along and just gives turns over the card and such to them. So you you don't need to do that. You can go in, you can ask for the self-pay price, and I would use the word self-pay as opposed to cash pay because oftentimes you'd want to use your you know your credit card, and you can file your own claims. Now, is it a little more difficult? It might be for some carriers, but is it worth$200 to you? Probably, right? So you just need to kind of become empowered and be able to do that so you're not just throwing money away and ending up with bills or paying them unnecessarily and that sort of thing. I mean, you you can shop, you can negotiate. Everything in life is negotiable, you can get learn codes, like if they give you a code for like if they tell you a specific thing, like let's say you're gonna have some sort of outpatient surgery, you get what is called a CPT code and go online, find out what that code is for, and you know, there are websites that you can enter that in and kind of find out what the average price is. I I have a favorite one, um, it's mdsave.com. And I don't get you know reimbursed for talking about them. They're just there's several. That one's just to me the most user-friendly, but it's huge. I had a specific client that was getting um broke his he broke his ankle. I think a cow stepped on it or something, and he was getting a plate in his ankle. And he called me from the doctor's office and said they'd wanted$23,000 for to fix his ankle. And I asked him for the code while I was on the phone. We looked it up and I said, Well, in your area, that surgery is about eleven thousand dollars. So he literally turned around and told them that MD Save had it for$11,000, and just like that, they dropped it to$11,000. His plan was going to cover something like$8,900 and some change. So that worked out, you know, fine for him. So I I have so many stories like that where if you just don't let them take advantage of you, that you'll be okay. Um, I had a couple that took their two-year-old into an emergency room and calls me and says they want$39,000. And I was like, wait a minute, time out. Um, the bottom line is to that story, and we can talk about that in more detail another time, but he walked out of there with paid less than$2,000 after he called me. So don't blame your agent, don't blame your insurance company. You have to empower yourself to pay attention, ask questions, don't just roll over and be like, okay, well, you know, I'll pay it. Never sign anything. Um, because once you sign it, there's nothing you can do, okay? You other than not pay. Don't sign anything. You need to ask questions and wait. In an emergency situation, it's the same thing. You don't have insurance, they're gonna bill you, or you give them a credit card, but you just you have to protect your money or they're gonna take it. That's really what it boils down to.

SPEAKER_01 8:11

This is amazing advice. It's such an eye-opener. I'm sure so many people don't know this. Like, like you said, we have the legal right to a diagnosis before money's discussed, as you said. So that also means that we don't legally need to show our insurance card because they we kind of feel like that's the impression that we're getting when we go to check in for any appointment or check in online, or you go to the kiosk before they even let you in the office that you have to show your insurance card. So we don't have to do it.

Defined Benefit Plans And Control

SPEAKER_02 8:39

No, you don't. That's the thing. It started years ago as a courtesy filing insurance for you, but you do not have to do that. You can file your own. And there are some companies that are easier than other companies to do that with. Um, you know, when when I was in um before I was on Medicare, I was on a defined benefit plan my entire life, and I made money because a defined benefit plan pays, and we'll have to talk about that sometimes, but it pays what it pays. So if you're a good negotiator, which obviously I've had a few years' experience, then I would negotiate a price, and my plan would pay a price, and if it was more, I made money, right? So there are other options than just you know letting it happen the way it is, because that's kind of what's got us into trouble, in my opinion. That's why insurance prices are high, because they charge and then the insurance company pays. But if you handled it the other way, that might not be the case.

SPEAKER_01 9:43

So, do you foresee a big change in pricing overall in the industry if a majority of people were self-pay and they did try to do it this way instead?

SPEAKER_02 9:53

Yeah, that's probably a little bit more like over my head, you know, because there's so much going on. I do see because the prices are, you know, getting a little outrageous. I do see the defined benefit plans becoming more um prevalent, and it's really worth a separate discussion because they have been around um the longest because they uh they fought all the way to the Supreme Court to stay in business. Um and uh I do see it moving more in that direction, and it's really a better value for somebody who wants to take control.

Call Ahead And Compare Prices

SPEAKER_01 10:38

And you you mentioned just a last question for you, too, that it's better to call ahead before appointments and ask about self-pay. How do you go about that?

Closing And How To Get Help

SPEAKER_02 10:46

Yeah, I I always tell people that they should call, you know, in this day and time, they don't usually know who you are, right? They don't know if you're a client, I mean a patient or not. But just say, hey, you know, I don't have an insurance and I want to do this, come in for this. What's a self-pay price? Um, you know, uh, then you might call back or ask them in their same conversation uh what their network price is, because there is a law in place where they have to be transparent with their network pricing. So this means they have a contract with one of the uh networks, Cigna, Blue Cross, you know, PHCS, First Health. And that contract is typically of like 50% less than the retail price. So most doctors' offices or providers, what they're gonna do is let's say the network price is$100, okay, and the retail price is you know$200. Self-pay is probably in the middle, like maybe$125 or something, because they like getting that cash and it does it doesn't cost them as much. They don't have to pay somebody to file your insurance and everything. And it's a little bit more than they're this because they don't really they kind of resent having to pay that network price because it's like you know, Blue Cross or whomever comes to them and says, Hey, you know, I have a million subscribers, and you know, they can come to you, but I am on a negotiated rate, right? Yes, and and they get this hundred dollars, and then you are paying like$500 a month so that you have the right to pay$50 copay. Well, who's winning in that situation? The insurance company's winning, right? And so, um, so yes, it's um it's definitely um better to ask those questions, and then you can make a determination how how you want to handle it.

SPEAKER_01 12:41

Oh yes, well, Catherine, this is an eye-opener. Thank you so much. We always appreciate your heart and your expertise, and we're looking forward to the next session. Thank you so much.

SPEAKER_02 12:50

Thank you.

SPEAKER_00 12:54

You've been listening to the Frederick Insurance Brokers podcast with Catherine Clark and John Frederick. Health insurance brokers with a heart. If you're ready for health coverage that actually fits you, not the other way around, schedule a no-obligation consultation today. Visit Frederick Insurance Brokers.com or call 972-375-0507. Because peace of mind shouldn't be a mystery, and your health insurance shouldn't need a translator.