About Trinity Heart and Vascular Group
An Overview of Our Practice
- You have access to cardiac testing at a fair-market price
- You only pay one flat rate for each service rendered, and there are no hidden costs (all prices can be viewed on our website)
- You can get scheduled for a test or office visit within days (instead of waiting several weeks or months)
- You can spend more time with your medical provider during your office visits (compared to a hospital-based, outpatient setting)
- You get to decide if you want to pursue cardiovascular testing (no ‘pre-authorization’ required)
Table of Contents
How We're Different: The 'Self Pay' Model
As an independently-owned cardiology practice, we want to spend our time caring for our patients. When insurance companies are involved, it takes away our ability to fully focus on what really matters — your heart health.
As such, we don’t participate with any insurance plans. While this may sound surprising, removing insurance from the equation allows our patients to receive prompt cardiac care (often through same-day or next-day appointments), and can also help them save hundreds or thousands of dollars.
Here’s how it works: Instead of submitting claims to insurance companies, all of our patients pay us directly when they come in for their appointment.
It’s the same payment setup that is used in everyday life, such as getting your oil changed, getting a haircut, and so on: You pay a one-time, flat rate for each service, and there are no surprise bills in the mail afterward.
When it comes to the financial aspect, it’s as easy as 1-2-3:
Why We've Chosen The 'Self Pay' Model
We gladly welcome anyone who has health insurance — we just don’t submit claims to those insurance plans. The ultimate reason for this is twofold:
1.) We don’t want insurance restrictions to negatively impact any of our patients’ cardiac health. When patients don’t have timely access to exams and cardiac testing — or worse, can’t get access at all due to a denial from their insurance company — it can cause a stressful situation.
Cardiac Testing: Sometimes insurance companies refuse to give patients “approval” for necessary testing. Even when testing is approved, patients often have to wait a month or more to get their cardiac testing done.
At our practice, you don’t have to ask an insurance company for permission to get cardiac testing. Since we don’t have contracts with insurance companies, you’re the one who ultimately gets to decide if you want to receive any recommended testing.
If you’re currently in a situation where your insurance company refused to authorize your cardiac test, all we need is a referral order from your current cardiologist or other medical provider, and you can have it done here.
You can usually get your testing done the same week that you contact us (and sometimes even the same day)!
Office Visits: If you need an office visit, we can get you in quickly for that too. If you currently don’t have a cardiologist and you’re using your insurance plan, it can often take 8 to 12 weeks to get a new-patient appointment with a cardiovascular specialist.
At our practice, you can usually be seen for an office visit within days of contacting us (and sometimes the same day that you call). And if one of our providers recommends outpatient cardiac testing, you can get it done at our private facility instead of going to a hospital-based facility.
2.) We want our community to have access to cardiac tests that are priced fairly. If you go to a hospital for outpatient cardiac testing, you’ll most likely be charged 2 to 10 times more than what the test is actually worth.
At our practice, we don’t charge overinflated prices for cardiac tests, and as a result, we can help uninsured and insured* patients save a significant amount of money on their cardiac testing. (*Patients with a high-deductible plan.)
We also want individuals to know what their outpatient test(s) will cost before they have testing done, so that they have the tools to budget accordingly.
Would you agree to purchase a car, an appliance, or a home without knowing the cost upfront? Of course not. You expect a reputable business to tell you what you’ll owe for your purchase before you pay for it, and that’s a very reasonable expectation!
We believe that the same rules should apply to healthcare facilities when it comes to outpatient testing — which is why we publicly list all of our prices on our website.
We want patients to not only have access to cardiac testing at a fair-market value, but to also have the opportunity to consent to the costs of those tests before they come to their appointment.
In order to achieve these goals, our practice doesn’t accept payments from any health insurance plans (whether they’re private plans or government-funded plans).
This means that we don’t participate with:
- Any other type of third-party payer
Who Can Benefit from Our Cardiology Practice?
While our third-party-free cardiology practice isn’t going to be a perfect fit for everyone (and that’s okay), there are many situations where it’s an ideal way to receive cardiovascular care.
If you have one or more of the following needs, our practice could be a good fit for you:
- You have a high-deductible insurance plan (with or without a Health Savings Account)
- You are uninsured
- You are self-insured (or work for a company that self-insures)
- You are a member of Samaritan Ministries, or a member of another type of medical health sharing program
- You are a patient at a Direct Primary Care practice and/or a patient at other types of third-party-free medical practices
- You desire to have cardiovascular testing that was recommended by your medical provider, but you’ve been denied by your insurance carrier
- You desire to develop and maintain a trusting, long-standing relationship with your cardiovascular specialist, and want to obtain clear diagnoses and treatment plans in a compassionate environment
- You value privacy, and want to be part of a practice that will never share your medical records with an outside party unless you expressly authorize us to do so (or in rare circumstances, if it is required by law)
- You are willing to participate in our ‘self pay’ setup, with the understanding that you are getting fair-market prices for cardiovascular services (which is typically much less than the fees you will find elsewhere)
- You are part of an organized athletic program, and want a cardiac risk assessment
Patients Who Want to Use Their Insurance Coverage for Cardiac Testing
Here’s how your health insurance plan can still be used for your cardiac-related needs.
Since our practice doesn’t participate with insurance plans, we are considered ‘out-of-network’ providers. All office visits are “cash pay” / “self pay,” which simply means that you pay a fixed price for your office visit or cardiac test when you come in for your appointment.
Here are two ways that we can accommodate your needs if you have a health insurance plan:
1.) For those with low ‘out-of-pocket’ expenses: If you have an insurance plan with a low deductible and a low out-of-pocket maximum, and want to become a patient at our practice, we are happy to help you save as much money as possible.
If you’re willing to pay the ‘self-pay’ price for your office visit at our practice, and one of our providers recommends cardiac testing during your visit, we can refer you to an outpatient testing facility that accepts your insurance.
If your insurance plan provides full or almost-full coverage for ‘in-network’ cardiovascular testing (whether you have a low deductible, or even a high deductible that has already been met for the year), this could be a good option for you.
We call this our ‘hybrid’ approach since you would pay us directly for your office visit at our facility, but then you would be able to use your insurance at a different facility for any testing that you may need.
Again, in this approach, you pay a flat fee for your office visit at our practice (not submitted through insurance), and we can refer you to a facility that accepts your insurance plan if you need cardiac testing (where your test would be submitted through your insurance plan).
2.) For those with high ‘out-of-pocket’ expenses: If you have a high deductible and a high out-of-pocket maximum, paying our ‘self-pay’ prices can save you a significant amount of money. If you have out-of-network benefits, you may be able to save even more!
If you know that your insurance company will reimburse you when you’re treated by ‘out-of-network’ providers (which is what we are), we can provide a ‘charge sheet’ for you to submit to your insurance company.
Our charge sheet will provide your insurance company with the information they need (i.e. diagnosis codes, treatment codes, etc.) in order to start the reimbursement process.
Additionally, regardless of your ‘out-of-pocket’ amount, you can still use your insurance plan for any lab work, medication, and standard imaging that we prescribe (e.g., x-rays, CT scans, or MRIs), as those can be done at facilities that accept insurance.
Our Attention to Detail
Are there any other advantages to becoming a patient here?
Absolutely! One of the benefits of becoming a patient at Trinity Heart and Vascular Group, is that we offer generous appointment times. We don’t sit with you for five minutes, and then hurry out the door.
Instead, we spend time helping you determine the best treatment for your cardiovascular issues. You can expect us to:
- Listen to your concerns with compassion
- Answer all of your questions in a detailed manner
- Thoroughly explain how we can effectively treat your condition(s)
- Customize your treatment plan based on your personal health needs (not based on insurance restrictions)
- Provide detailed, clinically relevant office notes that clearly outline your diagnosis and treatment plan
- Perform affordable, on-site testing to facilitate diagnosis, and follow-up of, a wide range of cardiac issues
We want to make it clear that our cardiology practice is not “superior” to other practices – it’s simply an alternative for those who want something different than what can be provided in the traditional healthcare setting (where third parties are involved).
If you’ve been searching for a cardiac center in Johnson City, TN, Greeneville, TN, or the Tri-Cities area, we’re ready to serve you.
Whether you become a patient here or not, we want you to be able to make an informed decision about your cardiovascular healthcare, which is why we offer detailed explanations regarding how our practice operates.
We encourage you to read our educational resources (links are below), as they provide an in-depth look at our unique approach to cardiovascular care.
Our Resource Center
We understand that modern healthcare is complicated, and we also know that our practice isn’t a one-size-fits-all approach for every person.
If you want to find out if we’re a good fit for you, we encourage you to learn more about the principles behind our practice model.
Click on any of the titles below for an in-depth look at your selected topic.