What is “direct access” care?
This medical practice model helps us deliver personalized care in an unhurried, comfortable atmosphere. It is a return to old-fashioned, patient oriented care without the intrusion of insurance or Medicare restrictions. Our model emphasizes easy access to the physician 24/7 in the office, by mobile phone, or via e-mail depending on the particular need. Patients pay an annual retainer fee for this extra service and do not have to rely on their insurance or co-payments for covered care.
How do I get in touch with the doctor?
Call the office during normal business hours. On weekends and holidays call the office exchange to have your call routed to the provider on call. Calls to the provider cell phone should be used for urgent matters. We always want to be available to you. E-mail may be used for non-urgent matters after you sign a HIPAA release at your first office visit.
What is included in the retainer fee?
All office visits and monitoring your care while hospitalized are included. Also included are routine immunizations like influenza and tetanus, when available. Most office procedures such as EKG’s and oxygen evaluations are done without charge.
What other benefits are part of “direct access” care?
Same day or next day urgent appointments, with minimal if any waiting times, are the norm. You will receive test results by phone, mail or email. Most medical forms are filled out for you promptly and without charge. If an out-of-town family member or friend has a simple medical problem while visiting, we will arrange to see them for a small office fee without requiring an annual retainer fee.
Are there any additional costs?
All other immunizations (pneumovax, shingles, hepatitis, etc.) will be ordered at your preferred pharmacy. Visits for out-of-town family or friends and house calls are billed separately and directly to the patient.
Is there a limit to the number of patients you accept?
Yes! Our commitment to you can only be fulfilled if we limit the number of patients enrolled in our practice. This is generally less than 20% of usual patient population. Waiting lists for our services will be created when we reach our limits.
Do I still need health insurance?
Yes! Our retainer fee is not a substitute for insurance and only covers care from our office. You will still need private insurance or Medicare for tests, x-rays, hospitalization costs, medication, and other physicians’ fees. Insurance requirements for Medicaid or any Health Maintenance Organization (HMO) plan will not cover any care to patients participating with these plans.
Does my insurance cover the annual retainer fee?
No. You must pay the retainer fee annually and it is never covered by private insurance or Medicare. However, the cost to you may be substantially reduced by using a Health Savings Account (HSA) or Flexible Spending Account (FSA). You should consult your employer’s benefits manager, your accountant, or the government web site for details on whether this is a covered expense under your HSA program.
Who does pre-authorizations or medical approvals from my insurance company?
Although we will no longer be part of commercial insurance, Medicare and PPO Medicare Advantage plans, we will keep a record of your insurance information so we can work with your insurance companies to pre-authorize tests or medications not usually covered by your plan. Because of the provider participation requirements for HMO plans and Medicaid, all tests or medications ordered by our office will not be covered by these plans.
What happens if my doctor is not available?
The physicians will cover for each other should one of them be at a medical meeting or on vacation. During an extraordinary circumstance when neither is available, we will designate another physician for back-up call.
How do I join your practice?
Based on space availability in our practice, we will mail you a packet with additional information and forms to initiate your membership in the practice. Your initial membership and renewal occurs when payment is received unless you decide to cancel.
More questions?
Call us at 314-747-1970.