Published Thursday, July 27, 2000, in the Miami Herald

Health-care program eliminates middle man

Q. I'm a senior citizen with no health-care program. I recently heard about something called SimpleCare. It's a program of the American Association of Patients and Providers. Can you tell me more about this?

Blossom Williams,
Kendall

A. From what we could learn, it sounds interesting and innovative but not well-known.

SimpleCare is a nonprofit health-care program that cuts out the middle man in health-care payments. You pay the doctor at the time of the visit. In turn you're charged the lowest price possible because the doctor has no papers to file with insurance companies, no bills to process and mail, etc.

The philosophy of AAPP is that people should have the freedom to choose health-care services based on quality, price and customer service, just like most other purchases.

SimpleCare can help patients who have no medical insurance, have insurance with a high deductible and pay most costs out of pocket, or have insurance that doesn't cover certain procedures.

``Doctors have been very receptive to the idea because it's to their advantage as well as the patient's,'' said Keri Andrews, operations manager for SimpleCare. ``We encourage patients to let doctors know about SimpleCare. Many aren't involved because they haven't heard of us.''

SimpleCare and the American Association of Patients and Providers was started by two Seattle-area physicians, Dr. Vern Cherewatenko and Dr. David MacDonald, when they realized they were losing money despite their practices being as busy as physically possible.

Cherewatenko writes that the cost of claiming reimbursement from insurance companies and other health payees such as Medicare was eating up their business. While the number of nurses dropped, the number of clerks jumped from two to six because so much time and effort was being taken up by paperwork and coding.

``We were able to reverse our ``patient-to-paperwork ratio'' from 1:7 (one minute with the patient, seven minutes on paperwork) to 7:1 (seven minutes with the patient and one on paperwork), resulting in increased quality time with the patient,'' Cherewatenko said.

The main problem seems to be that there aren't many physicians participating in South Florida. By joining, you can then ask doctors if they'd be willing to participate.

Of the 36 Florida doctors listed on the organization's Web site, only six are in South Florida. We called the four for whom we could find phone numbers and reached two.

Linda Lehrman, office manager for surgeon David Lehrman of Miami Beach, said he joined because he endorsed and admired what these doctors are trying to do. ``The doctor/patient relationship is being whittled away by the morass of paperwork,'' Linda Lehrman said. ``He's being dictated to by the insurance companies and the level of frustration among doctors is very high.''

Robin E. Miller, a hand therapist at the Fort Lauderdale Hand Clinic, said she learned about the program in an American Academy of Orthopedic Surgeons newsletter. She enrolled but has yet to put it into practice since all her patients come by way of referral. ``I thought it was a clever idea, an interesting approach.''

American Association of Patients and Providers is a membership organization, not an insurance company. It doesn't set prices; that's up to the doctor. The cost to join is $20 for an individual and $35 for a family.

For more information, call Andrews at 206-362-1111 ext. 139 or go to the Web site www.aapp.net or www.simplecare.com