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?
During regular office hours, calling the office is recommended. After hours, you will have the doctor’s mobile phone for urgent matters. Due to the variability of cell phone coverage, we also employ a medical exchange that can contact us for urgent matters if the cell phone does not work. 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 hospital visits at Barnes-Jewish Hospital are included. Also included are routine immunizations like influenza and pneumovax, when available. Most office procedures such as EKG’s, pulmonary function tests, oxygen evaluations, and TB skin testing are done without charge.
What other benefits are part of “direct access” care?
Same day or next day 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?
Some immunizations (tetanus, shingles, hepatitis) will be given when indicated with an additional fee. 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 our 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.
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 insurance plans and Medicare, 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.
What happens if my doctor is not available?
The physicians will cover for 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 membership will be renewed automatically unless you decide to cancel.
More questions?
Call us at 314.747.1970.