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What is a Concierge Medical Practice ? Q + a for Patients

 

Q. What is a retainer practice, concierge medicine or direct care?

 

Concierge medicine is a revolutionary model of medical practice that puts the patient at the center of the healthcare experience. By retaining the services of a specific physician for a predefined fee, the patient secures unprecedented access to the physician. This allows the physician to know the patient extremely well, and to deliver the highest levels of primary care and service.

Q: What can I expect with a retainer medicine?

 

You can expect a higher level of attention and more focus on prevention than you have ever experienced before because our service and attentiveness to your needs is unparalleled. You will understand the difference from the moment you walk in the door.

Q: Are there family discounts on the membership fee and what does it cover?

 

Yes, discounts are available for additional family members. Ask your patient liaison for details. Your retainer fee entitles you to become a member of the practice. It affords you access to all the amenities and specialized personal care services listed in your membership agreement. Your annual comprehensive wellness examination is part of the membership. Traditional health insurance will still provide for any medically necessary services for diagnosis or treatment. You will continue to pay deductibles and co-payments as outlined by your insurance.

Q: Do I have to pay the annual fee all at once?

 

No. In addition to paying the membership fee annually, you have the option of paying semi-annually, quarterly or a monthly financed option.

Q: Do I still need health insurance?

 

Yes. The retainer fee simply sustains your membership in the practice along with your comprehensive wellness examination; it does not cover medical visits or procedures. Insurance is needed to cover medical expenses such as prescriptions, hospitalizations, surgeries, diagnostic tests (such as CT scans, MRI's, endoscopies, cardiovascular testing, blood work, etc), and specialist office visits and services.

Q: What does my health insurance cover?

 

We will be happy to discuss your specific health plan with you. Each provider is different, but your insurance will usually cover most medically necessary visits and procedures. Most health insurance plans are fully compatible with your membership to the practice. Your retainer fee is for preventive care services that are not covered by your current insurance program.

Q: Does my insurance cover the annual fee?

 

Most insurers view the preventive care services encompassed by the annual fee as non-covered services and, therefore, do not reimburse the annual fee. Nonetheless, some insurers may cover a small portion of the annual fee. Insurance plans vary greatly, so check with your physician at the time of your physical examination. You should not join the practice expecting any reimbursement for your annual fee.

Q: Do I still pay co-pay?

 

Yes. Patients are responsible for all deductibles and co-payments required by their insurance company.

Q: What is the advantage of having electronic medical records?

 

The practice provides you with on-line access to your personal medical records, which facilitates the communication process and leads to a better healthcare partnership because accurate, easily accessible medical information is available to both parties. Studies have shown that use of electronic medical records improves overall patient care because medical errors are reduced and efficiency is increased. Electronic medical records are available to our patients through the patient portal.

Q: How do I become a member of this practice?

 

Signing up is easy. Simply call XXX-XXX-XXXX and a team member will answer your questions and assist you with completing the membership form.

Q: What are the benefits?

 

There are many benefits to participating in this kind of practice, but most importantly, you will have a personal relationship with your OWN doctor. He will know you well and as a result, the quality of your care will be significantly greater. Additional benefits include:

Ø Direct access to your physician any time of the day or night

 

Ø Same or next day appointments

 

Ø 24/7 availability

 

Ø House or office calls when necessary

 

Ø Longer appointments:

 

o Routine visits are a minimum of 30 minutes long

 

o Annual exam comprehensive wellness exam is a minimum of one hour

 

Ø Minimal wait in the waiting room

 

Ø Health Planning

 

Ø Personalized research and health information

 

Ø Referral coordination with specialists

 

Ø Electronic medical records

 

Ø Aesthetic and day-spa credits for those participating in the concierge model

 

Ø Individualized treatment strategies

 

Ø Referrals will be made by your physician fitting your needs with the best possible specialist who can address those needs. Your concierge physician will be happy to review your visit and discuss any test results too.


Q: How will I contact the doctor?

 

Once you are a member, you will be provided with your physician’s cell phone number, which will ring directly to him, or the person on-call. No impersonal answering service takes your call first.

You can also log-in to the patient portal to send your physician an email or review test results on-line.

Q: What happens if I need the doctor after hours? Or away from home?

 

Simply call your physician’s cell phone or access him via the internet. Your physician will respond to your concerns no matter where you are or when you call. He, or someone from his staff, is directly available to you on call 24 hours a day, every day of the week, including holidays.

Q: What is the Patient Portal Web site and how does it work?

 

The patient portal is a password protected site that allows patients to communicate directly with your physician and his staff. This portal allows appointments to be scheduled, prescription refills requested, lab tests reviewed and billing information

 

verified.

Q: When does my physician make a house call or workplace visit?

 

These types of visits will be handled on a case-by-case basis. Your physician will evaluate whether such a visit is essential to your health and well being. These visits are rarely necessary given the availability of the doctor for patients at the office. But don’t worry, if it makes sense, your physician will make it happen.

Q: My insurance already provides for an annual physical. What is different about this?

 

Your concierge physician limits his practice to no more than 500 patients, which allows him to provide a comprehensive wellness examination with dramatically broader scope than that which may be covered by insurance. After the physical examination, each patient receives a detailed written report and a personal wellness plan to be implemented during the year.

Q: Can I first meet with the concierge physician before I sign up?

 

Absolutely! Please contact us to schedule an informational visit at your convenience. We encourage you to come in for a tour of the office, to meet the physician and staff, and to review the service with our patient liaison, which is in the office to help our patients with all of their non-clinical concerns. Please feel free to meet with us and ask us questions before making your decision.


Q: What if I have to go into the hospital?

 

Your concierge physician will admit and supervise patients at several local hospitals, contact the office for specific locations. If you choose a hospital where your physician does not have admitting privileges, he will arrange for a hospitalist or a physician on that medical staff to supervise your care. Your concierge physician will consult with the hospital’s physician to ensure appropriate management and progress.

Q: What do I do when I need to see a specialist?

 

Your concierge physician is a completely independent physician and is free to select the best specialist for your needs and consults with a full spectrum of specialists. He is happy to coordinate your appointment for you and will closely monitor your progress while under a specialist’s care. If you already see a specialist you like, you may certainly continue to see him or her.

Q: For whom is this type of practice most appropriate?

 

Anyone who is serious about maintaining and improving their health will benefit from this type of care. Our patients receive the highest quality healthcare and service levels that exceed any they have experienced before.

Q: What if I move away or leave my physician’s practice?

 

Upon your request, we will gladly transfer your medical records to your new physician. The unused portion of your retainer fee will be refunded within 30 days notice, calculated from the first of the month following the month of the notice given. If you are relocating, we will be happy to assist you in finding a new physician.

Q: How does this work with my corporate benefits plan?

 

Each plan is different, but there is the possibility, though nothing is guaranteed, of using a pre-tax account to pay for some or the entire fee. Employer Section 125 plans may cover the annual fee. Other potentially compatible accounts include:

 

Flexible Spending Accounts (FSAs)

 

Medical Savings Accounts (MSAs)

 

Health Reimbursement Accounts (HRAs)

 

Health Savings Accounts (HSAs)

We are not an accountant firm or a financial advisor and you should ask your employer or your accountant if you can use your pre-tax accounts to pay for this practice.

Arney Benson

Dynamic and multi-faceted Senior Executive with broad and deep experience in healthcare operations, project management, managed care, consulting, sales, infrastructure restructuring, employee relations, corporate training and strategic planning. Change agent and accomplished problem-solver at the highest strategic levels. Nationally recognized writer, presenter and trainer. Results-driven ethical leader with the ability to create vision, get results and drive the achievement of ambitious goals.
Graduate of the Massachusetts College of Pharmacy & Allied Health. M.B.A./B.S.Pharmacy

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