EP425: Three Ways for "Regular" Clinical Practices to Take Cash When It's Cheaper for a Patient Than Using Their Insurance, With Marshall Allen

About half the time, the cash price for a medical service is actually cheaper than the "negotiated" insurance rate — a fact that matters enormously given that roughly 90% of patients never meet their deductible in any given plan year. Marshall Allen, investigative journalist and founder of Allen Health Academy, joins Stacey Richter to explain, in concrete operational terms, how a "regular" clinical practice that still takes insurance can also accept cash from insured patients when it's the better deal — without abandoning insurance altogether, and without running afoul of contracts that sound like they forbid it.

WHAT YOU'LL LEARN

✅ Why nearly half of insured commercial patients say they're delaying or forgoing care due to cost — and why those patients are invisible to clinicians who only see the people who show up

✅ How offering a clear, fixed cash price can reduce costly no-shows, which run practices as much as $7,500 a month, by giving patients pricing certainty for a next-day appointment instead of a six-months-out unknown

✅ The practical building blocks a practice needs to start taking cash from insured patients: a proper form, an actual set cash price, and a plan for how to market that option

✅ How Marshall Allen addresses the biggest objection practices raise — the belief that health plan contracts legally forbid accepting cash from an insured patient — including how HIPAA gives patients the right to request this

✅ Where to find fair-pricing benchmarks for setting a cash price, including tools like FAIR Health Consumer, BILLY, ColonoscopyAssist, Jason Health, and Green Imaging

WHY THIS MATTERS

This isn't a pitch for cash-only concierge medicine; it's about giving ordinary insurance-taking practices a legitimate, patient-friendly option for the very common situation where insurance makes care more expensive, not less. Practices that ignore this reality lose patients to care abandonment and revenue to no-shows, while patients who could have simply paid cash instead absorb costs they can't actually afford. Marshall Allen's framework turns a widely misunderstood pricing quirk into an accessible fix that benefits both sides of the exam table.

MENTIONED IN THIS EPISODE

EP363 with David Scheinker, PhD: Apple Podcasts | Spotify | Other Apps

EP413 with Will Shrank, MD: Apple Podcasts | Spotify | Other Apps

EP297 with Jerry Durham: Apple Podcasts | Spotify | Other Apps

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction.

07:04 What Allen Health Academy is doing.

11:01 What's the problem with the system now?

14:19 EP363 with David Scheinker, PhD.

14:27 EP413 with Will Shrank, MD.

14:34 What's the hack Marshall Allen shares for insured patients paying cash?

15:06 How can patients cite HIPAA to pay cash instead of using their insurance?

19:00 What's the first recommendation Marshall Allen has when dealing with healthcare billing?

21:26 EP297 with Jerry Durham.

21:48 What are the other benefits of a clinic accepting cash payments?

25:36 Why do we need to have more direct pay happening?

26:36 How should a medical provider set a cash price?

27:12 Research tools for fair pricing: fairhealthconsumer.org, BILLY, colonoscopyassist.com, Jason Health, Green Imaging.

32:36 How do you find the win-win between a patient and a doctor?

32:51 What's the final tier of partners in creating more direct-pay opportunities?

34:30 What's Marshall Allen's opinion on having to pay credit card fees?