In my hospital, we give people their choice of the private LC's in the
community or coming into the hospital for an outpatient visit.  So many of them
choose to come in for two reasons.  One, they already have a relationship with us
as we have seen them in the hospital, they feel safe with us, not sure of
someone they do not know.  Two, they are billed only after insurance refuses to
pay.  The private LC's require payment and submit to insurance themselves (not
that it matters, most insurance companies do not have the foresight to pay.
Therein is the answer....third party payment!
Judi Hall

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