FREQUENTLY ASKED QUESTIONS:
What is Concierge Medicine?
What it boils down to is a model of medical practice design in which patients are required to pay an ongoing membership fee to be part of the practice. There are growing numbers of doctors doing this now, many with their own unique criteria and fee. Many patients are finding that the benefits of this approach to medical care are: getting seen when you need to be seen, less time spent in the "waiting room", more time spent with the doctor, being able to see the doctor every time, being able to call my cellphone afterhours, receiving respect for your time and concerns.
Why do some doctors choose Concierge Medicine?
.....Over the past thirty years insurance companies and government organizations like Medicare and Medicaid have gained increasing control of medical practices (not only fees/reimbursement but what is and isn't covered) through the use of contracts. Doctors sign the contracts so they can see more patients but then find themselves working on a volume basis and making decisions based on insurance protocols. Patients often don't understand their complex insurance plans and feel slighted when the doctor has to deliver the bad news: "I'd like to but it's not covered by your plan". The result, in my opinion, is the slow demise of the doctor patient relationship. We have become the enforcers of insurance protocols that patients don't understand and are stressed and overwhelmed by the patient volume we have to see on top of the bureaucratic paperwork. The average doctor in a traditional practice today can't wait to go home at the end of the day!
.....Concierge Medicine restores the time honored doctor patient relationship. By not having to rely solely on insurance payment we can slow down, take more time with patients, enjoy what we do again and gladly take those afterhours calls because we really want to help.
How much is your membership fee?
For the past seven years I've been charging $1500.00 per year or $125 per month (subject to change). To help put this into perspective, consider what you are paying for medical insurance, would you be willing to pay a small supplement in order to have the privileges of a Concierge Medical practice?
What are the benefits of membership?
Availability is a big one.
.....Same or next day appointments, walk-ins are never turned away (if you think it's important enough to drop in, so do I). I am even able to be flexible enough to take patients an hour early, several hours late (funny thing happened on the way to the doctor, right?) or I've even had people come in a week early!
.....Afterhours you simply call my cellphone.
Communication
.....Afterhours I'm directly available on my cellphone, I don't use an answering service or pager. I'm happy to answer texts and emails for those less urgent messages too. This includes my vacations, I like to know what's going on with my patients. It's easier for both of us to have me try to handle issues and if necessary refer you to the right place to get you help.
.....During office hours I answer all phone messages as promptly as possible but definitely before going home.
.....I personally call patients with all tests results within hours of arrival even if they were ordered by other doctors. No "no news is good news" or making another appointment to review your results (your time is valuable).
.....My office phones are answered by my friendly and responsive staff, not a machine with a menu.
Service
......I have assembled an experienced team to efficiently provide patients with assistance.
......We gladly schedule appointments within a network of top specialists in the Bay Area if needed.
For tests that need to be done outside the office we will schedule and even call around to get you the soonest available time. When prior authorization is required, we'll get it for you.
......I have two full time employees for in house insurance billing for you, including billing secondary insurances and filing appeals. They also are available for consultation if you have billing questions.
......Same day prescription refills are the norm, whether written, called, or e-prescribed. We also file prior authorizations and appeals when medications are denied coverage.
.....Short waits. Average waits are less than five minutes, sometimes before you even sit down.
.....Comfortable, non-clinical office setting.
.....Wide range of in office procedures including EKG, X-Ray, and minor surgeries/stiches/biopsies. These are usually done at the time of discovery to avoid delay in diagnosis (ie. if I discover a suspicious mole it's biopsied right then).
.....I personally draw blood for testing. I have arranged for LabCorp and Quest Diagnostics to pick up specimens daily, run the tests at their labs, and the results are usually available the next morning.
.....House calls. Yes, I will make house calls when needed.
Time
.....Longer appointments. Standard appointments are 30 minutes, Annual Executive Physical Exams are 2 hours.
Time to listen. Time to address all of your concerns in a single visit. Time to care for complex patients, especially geriatrics. Time to develop a relationship,
Annual Executive Physical Exam
Please click on the tab above for a full explanation, it's a benefit you'll find nowhere else!
Is the membership fee covered by insurance?
This fee is not covered by insurance and can not be used to pay for any services that insurance covers.
The membership fee is not a substitute for health insurance, as of January 2014 you are required by the Affordable Healthcare Act to have health insurance.
Is the membership fee tax deductible?
For patients who itemize medical expenses on their tax returns the fee may be considered a medical deduction, you should consult with you tax expert. For those patients who have a Flexible Spending Account or Health Savings Account with their health insurance it may be eligible to be paid through that spending or savings account.
Do you charge for missed appointment?
Of course not.
How many patients do you limit your practice to?
The maximum that I can handle and still provide the level of service and personal attention that patients deserve is 300 patients.
Which insurance plans do you participate in?
I'm a Medicare provider, take most insurance plans (except HMOs) and am on all of the Covered California plans, except MediCal, Alameda Alliance and HMO's. However, just to be sure before a new patient comes in we will ask for your insurance information and verify eligibility before accumulating charges. Please feel free to call anytime to ask about current participation.
Do you have a Family Plan?
In all fairness, any patient who has ongoing medical problems that require management, medications and routine follow-up must be an active member. However, if one of my patients asks me to see a spouse, child, friend or relative on a short term basis for acute illness or second opinion, then I am happy offer them the same level of service that my patients get until that problem is resolved.
Children of a member under the age of 25 are not charged a membership fee.
Is the Annual Executive Physical Exam Transferable?
Not usually but if one spouse of a couple is a member and the other isn't (and doesn't have chronic medical problems) I will allow them to alternate years if they like, up to the age 50 at which time they both must be members.
Do you treat Geriatric Patients?
Yes. Through preventive care, exercise and nutrition many patients are living well into their 90's. Concierge Medicine benefits geriatric patients in many ways, for one, it has been proven to reduce the number of hospital and ER visits as well as length of hospital stays. Preventive care in the elderly also means preventing illness from rapidly worsening by being available and responsive to calls. Emphasizing exercise and nutrition to older patients is extremely helpful in keeping them ambulatory and independent. Cardiac, stroke and cancer screening add longevity to patients of all ages. With the onset of physical limitations and dementia not only will I start making visits to Home, Assisted Living, Board and Care and Skilled Nursing Facilities but I think it's important to stay in touch with the adult children of aging parents so, with the permission of the patient, I'll call the designated family member after my visits just to keep them up to date.
What happens if I need to drop out or move out of town?
This happens from time to time. I ask, as a courtesy, that you pay the annual amount if you have had your Annual Executive Physical Exam. If you haven't had that done during the year that you have to leave my practice then I will refund you a prorated amount. If you have had it, but can't afford the full amount, then as long as you let me know what's going on we'll work it out and occationally I have to write it off. I won't send anyone to collections or affect their credit over the membership fee. We function on mutual respect built over the development of our relationship.
What is Concierge Medicine?
What it boils down to is a model of medical practice design in which patients are required to pay an ongoing membership fee to be part of the practice. There are growing numbers of doctors doing this now, many with their own unique criteria and fee. Many patients are finding that the benefits of this approach to medical care are: getting seen when you need to be seen, less time spent in the "waiting room", more time spent with the doctor, being able to see the doctor every time, being able to call my cellphone afterhours, receiving respect for your time and concerns.
Why do some doctors choose Concierge Medicine?
.....Over the past thirty years insurance companies and government organizations like Medicare and Medicaid have gained increasing control of medical practices (not only fees/reimbursement but what is and isn't covered) through the use of contracts. Doctors sign the contracts so they can see more patients but then find themselves working on a volume basis and making decisions based on insurance protocols. Patients often don't understand their complex insurance plans and feel slighted when the doctor has to deliver the bad news: "I'd like to but it's not covered by your plan". The result, in my opinion, is the slow demise of the doctor patient relationship. We have become the enforcers of insurance protocols that patients don't understand and are stressed and overwhelmed by the patient volume we have to see on top of the bureaucratic paperwork. The average doctor in a traditional practice today can't wait to go home at the end of the day!
.....Concierge Medicine restores the time honored doctor patient relationship. By not having to rely solely on insurance payment we can slow down, take more time with patients, enjoy what we do again and gladly take those afterhours calls because we really want to help.
How much is your membership fee?
For the past seven years I've been charging $1500.00 per year or $125 per month (subject to change). To help put this into perspective, consider what you are paying for medical insurance, would you be willing to pay a small supplement in order to have the privileges of a Concierge Medical practice?
What are the benefits of membership?
Availability is a big one.
.....Same or next day appointments, walk-ins are never turned away (if you think it's important enough to drop in, so do I). I am even able to be flexible enough to take patients an hour early, several hours late (funny thing happened on the way to the doctor, right?) or I've even had people come in a week early!
.....Afterhours you simply call my cellphone.
Communication
.....Afterhours I'm directly available on my cellphone, I don't use an answering service or pager. I'm happy to answer texts and emails for those less urgent messages too. This includes my vacations, I like to know what's going on with my patients. It's easier for both of us to have me try to handle issues and if necessary refer you to the right place to get you help.
.....During office hours I answer all phone messages as promptly as possible but definitely before going home.
.....I personally call patients with all tests results within hours of arrival even if they were ordered by other doctors. No "no news is good news" or making another appointment to review your results (your time is valuable).
.....My office phones are answered by my friendly and responsive staff, not a machine with a menu.
Service
......I have assembled an experienced team to efficiently provide patients with assistance.
......We gladly schedule appointments within a network of top specialists in the Bay Area if needed.
For tests that need to be done outside the office we will schedule and even call around to get you the soonest available time. When prior authorization is required, we'll get it for you.
......I have two full time employees for in house insurance billing for you, including billing secondary insurances and filing appeals. They also are available for consultation if you have billing questions.
......Same day prescription refills are the norm, whether written, called, or e-prescribed. We also file prior authorizations and appeals when medications are denied coverage.
.....Short waits. Average waits are less than five minutes, sometimes before you even sit down.
.....Comfortable, non-clinical office setting.
.....Wide range of in office procedures including EKG, X-Ray, and minor surgeries/stiches/biopsies. These are usually done at the time of discovery to avoid delay in diagnosis (ie. if I discover a suspicious mole it's biopsied right then).
.....I personally draw blood for testing. I have arranged for LabCorp and Quest Diagnostics to pick up specimens daily, run the tests at their labs, and the results are usually available the next morning.
.....House calls. Yes, I will make house calls when needed.
Time
.....Longer appointments. Standard appointments are 30 minutes, Annual Executive Physical Exams are 2 hours.
Time to listen. Time to address all of your concerns in a single visit. Time to care for complex patients, especially geriatrics. Time to develop a relationship,
Annual Executive Physical Exam
Please click on the tab above for a full explanation, it's a benefit you'll find nowhere else!
Is the membership fee covered by insurance?
This fee is not covered by insurance and can not be used to pay for any services that insurance covers.
The membership fee is not a substitute for health insurance, as of January 2014 you are required by the Affordable Healthcare Act to have health insurance.
Is the membership fee tax deductible?
For patients who itemize medical expenses on their tax returns the fee may be considered a medical deduction, you should consult with you tax expert. For those patients who have a Flexible Spending Account or Health Savings Account with their health insurance it may be eligible to be paid through that spending or savings account.
Do you charge for missed appointment?
Of course not.
How many patients do you limit your practice to?
The maximum that I can handle and still provide the level of service and personal attention that patients deserve is 300 patients.
Which insurance plans do you participate in?
I'm a Medicare provider, take most insurance plans (except HMOs) and am on all of the Covered California plans, except MediCal, Alameda Alliance and HMO's. However, just to be sure before a new patient comes in we will ask for your insurance information and verify eligibility before accumulating charges. Please feel free to call anytime to ask about current participation.
Do you have a Family Plan?
In all fairness, any patient who has ongoing medical problems that require management, medications and routine follow-up must be an active member. However, if one of my patients asks me to see a spouse, child, friend or relative on a short term basis for acute illness or second opinion, then I am happy offer them the same level of service that my patients get until that problem is resolved.
Children of a member under the age of 25 are not charged a membership fee.
Is the Annual Executive Physical Exam Transferable?
Not usually but if one spouse of a couple is a member and the other isn't (and doesn't have chronic medical problems) I will allow them to alternate years if they like, up to the age 50 at which time they both must be members.
Do you treat Geriatric Patients?
Yes. Through preventive care, exercise and nutrition many patients are living well into their 90's. Concierge Medicine benefits geriatric patients in many ways, for one, it has been proven to reduce the number of hospital and ER visits as well as length of hospital stays. Preventive care in the elderly also means preventing illness from rapidly worsening by being available and responsive to calls. Emphasizing exercise and nutrition to older patients is extremely helpful in keeping them ambulatory and independent. Cardiac, stroke and cancer screening add longevity to patients of all ages. With the onset of physical limitations and dementia not only will I start making visits to Home, Assisted Living, Board and Care and Skilled Nursing Facilities but I think it's important to stay in touch with the adult children of aging parents so, with the permission of the patient, I'll call the designated family member after my visits just to keep them up to date.
What happens if I need to drop out or move out of town?
This happens from time to time. I ask, as a courtesy, that you pay the annual amount if you have had your Annual Executive Physical Exam. If you haven't had that done during the year that you have to leave my practice then I will refund you a prorated amount. If you have had it, but can't afford the full amount, then as long as you let me know what's going on we'll work it out and occationally I have to write it off. I won't send anyone to collections or affect their credit over the membership fee. We function on mutual respect built over the development of our relationship.