Virtually every medical office employes at least one full time person in charge of trying to get paid by the insurance companies. Sometimes, it takes months for a legitimate bill to be paid. This can present a cash flow problem if the office manager isn't careful. In addition, insurance companies and HMOs often tend to micromanage medical care. Doctors end up spending a lot of time on the phone fighting with the insurance company to get a treatment authorized. That's time they could've spent treating patients instead of being on the phone.

I've never done it but I've heard others who work a deal with their doctors for cash payments. In exchange for getting paid immediately, quite a few doctors will accept a lower fee. The examples I've heard were somewhere around $60 for the normal visit with insurance but $40 or so if you pay cash.

On the other hand, my company pays several thousand dollars a year for my family's health insurance. I pay about $67 every two weeks for my part of the insurance bill. In an average year, my wife and I combined might go to a doctor maybe 5-10 times and that's only because we're now both on daily medication. Before that, I'd maybe go to a doctor once or twice in a year.