17. Working with cash-pay specialists
Cash-pay founders; providers of specialized services Planned episode, referrals and the system. Finding specialists who publish prices, see shared patients and write back.
Listener title: Working with cash-pay specialists who write back
Listener description: A cash-pay specialist talks with the host about how independent practices find specialists who publish prices, see shared patients and write back, how the two practices divide the work, and how patients respond to a published price. For founders of cash-pay practices and the specialists they work with.
Run of show (about 40 minutes)
| Time | Segment | What happens |
|---|---|---|
| 0:00 to 2:00 | Opening | The host introduces the topic and the guest's role, a cash-pay specialist. The guest discloses any industry relationships and notes that they speak for themselves, not for the network. Prices come up only as method, never as what anyone should charge. No patient information on this episode. |
| 2:00 to 10:00 | How the relationship started | Talking point 1. How did the guest's referring practices find them, and how did the guest find the primary care practices they work with? What did each side check before the first shared patient? The host compares the answers with the specialist roster's vetting criteria: a practice the specialist founded or co-founded, with more than half of revenue from patients rather than payers; published consultation prices; willingness to see a patient with the anchor physician's summary in hand; and a written reply to the anchor on the CCN consult reply within seven days of the visit. |
| 10:00 to 19:00 | Who does what | Talking point 2. The guest explains how they and a referring anchor physician divide the work for a shared patient: who orders, who follows up results, who holds the long-term plan. How do they put that split in writing, and where has it gone wrong before, described without the patient? The host points to the "Who does what next" lines on the CCN consult reply. |
| 19:00 to 28:00 | A published price in the room | Talking point 3. How do patients react when the specialist's price is known before the visit? The guest explains how they publish it, what a consultation includes, and how they answer questions about it. Method only: how the guest decided what a consultation covers, not what it costs. |
| 28:00 to 35:00 | Composite scenario, not a real patient | A cash-pay primary care practice has a patient who needs a specialty opinion. Host and guest walk the steps: finding a specialist who writes back, confirming the patient knows the price (the "Cash price" line on the CCN referral), sending one question, and agreeing in advance who follows up which results. |
| 35:00 to 38:00 | Building the roster | The specialist roster is forming, with cardiology, neurology and GI recruited first because each serves two of the three patient cohorts. The guest says what would make a specialist willing to be listed, and what would make them hesitate. |
| 38:00 to 40:00 | Closing | One practical takeaway: before the first shared patient with a new specialist, agree in writing on who follows up which results. Specialists who publish a consult price and write back can express interest at coloradocarenetwork.com/join, members can propose a specialist in #cohort-specialist on Slack, and anyone can reach the network at hello@coloradocarenetwork.com. |
Guest prep questions (sent to the guest a week ahead)
- How do most of your referring clinicians find you today, and how do you find primary care practices you trust to share a patient with?
- When you share a patient with a primary care physician, how do you decide who orders tests, who follows up results and who holds the long-term plan? How do you put that in writing?
- How do you publish your consultation price, and what does a consultation include? We will discuss method only, not amounts.
- What do patients ask most often about your price, and how do you answer?
- The CCN specialist roster asks for a published consult price and a written reply to the referring physician within seven days of the visit. Which of those comes easily in your practice, and which takes work?
Show notes
A cash-pay specialist joins the host to talk about the working relationship between independent primary care and specialists who publish their prices. They cover how the two practices found each other, how they divide orders, results and the long-term plan, and how patients respond when the specialist's price is known before the visit. Prices are discussed only as method, never as what anyone should charge.
- Sources and tools:
- Specialist: https://coloradocarenetwork.com/cohorts/specialist/
- Referral standard: https://coloradocarenetwork.com/referrals/
- CCN referral: https://coloradocarenetwork.com/referrals/referral-form/
- CCN consult reply: https://coloradocarenetwork.com/referrals/consult-reply/
- How the network works (the roster's three conditions): https://coloradocarenetwork.com/how-it-works/
- Literature: no reference on the site bears directly on this episode. Sources: the guest supplies them before recording (PubMed, DOI, GeneReviews or guideline sources only).
- No patient information is discussed on this episode.
All planned episodes. To be the guest for this episode, email hello@coloradocarenetwork.com with the episode number.