FAQ

About Retainer-Fee Practices

Q:     What is included in the monthly fee?

      A: Most of the medical care that people generally need:

• Annual exams including gynecologic/pap.

• Routine office care.

• Minor surgical procedures done in-office.

• Injections.

• Referrals to specialists.

• Routine office lab actually performed in-office; blood draws for outside lab.

• Electrocardiograms (ECG or EKG).

• Home visits when circumstances warrant them.

• Twenty-four hour access directly to your doctor by phone.

• Supervision of hospital care.

Q:  If I only need a visit once in a while, why can't I pay for that month?

A. The monthly fee level was set low on the assumption that most patients would NOT need monthly visits, but could spread the cost of their care out more evenly.

Q:  Why should I pay extra for your care when my insurance pays for regular visits at most doctors' offices?

A: Many people don’t realize how much their care in other offices truly costs them, even with insurance. Add up yearly deductibles, co-pays, loss of work to make multiple visits to take care of different problems, and out-of pocket expenses for services excluded by your policy (such as physical exams with Medicare and some private policies), etc. Try looking back at what your premiums and out-of-pocket expenses were for last year, and then look at what your insurance company actually paid for. 

Q:  How will this work if I am on Medicare

A: Although our retainer fee is not reimbursable by Medicare, most services outside of this office that we order for you should be covered. This would include imaging or laboratory studies, specialty consults or hospitalization.

 

Q:  Will my insurance reimburse my monthly fee?

A: It is unlikely they would reimburse for the retainer fee per se, but we can generate a billing form for single visits which reflects your specific care here, and some insurance may thus reimburse part of your costs.

Q:  What about lab, x-ray and specialty fees?

A: There is no charge for us to draw the lab or make referrals but all outside services will be billed directly to your insurance or Medicare, or to you if you have no insurance. For specifics, check with your insurance company.

 Q:  What about prescription medicine costs?

A: We can often supply some samples to get patients started, but if you take several regular monthly prescriptions, you might want to consider joining a prescription discount program or getting separate pharmacy insurance. We have information on these which may help.

 Q:  Do I even need insurance if I sign with you?

A: We encourage patients to carry at least catastrophic or major medical insurance to cover the unlikely possibility of some devastating illness or accident. In general, the premiums for such insurance are much lower than traditional medical insurance, so if you pay your own premium, it may be worth a look at changing to a higher deductible policy.

 Q: What is the financial advantage with this kind of practice

A: The best part is that we can limit the financial waste that exists in the standard system. We can eliminate the significant cost of the insurance companies’ cut, a great deal of the administrative cost of large clinic corporations, and most of the billing expenses of an ordinary practice. This allows us to cover most of your office care for much less overall cost than most clinics.

 Q:  What is the medical advantage of this kind of practice?

A: There are many:

• We can cover overhead with far fewer patients, thus allowing us to spend as much time with each patient as they need, and allowing us

  to get to know each patient personally.

• Because patients are “pre-paid”, there is no downside for them to come early to see us when they need care, and no advantage in postponing preventive care, so we essentially get paid to keep people healthy rather than to cure their ills.

• There is plenty of time to allow for patients to ask questions and get a little education along the way.

• Continuity of care is better because patients see the same doctor virtually every visit and that doctor personally knows their case. Personal access to the doctor is much easier so messages do not usually get lost in the telephone shuffle.

• One doctor knows your entire case history and can better orchestrate any needs for outside services.

Q:    Who stands to gain most from such a plan?

A: Basically anyone who is dissatisfied with the current state of their health care delivery system, but specifically:

• Self-insured people, especially young families, who are unable to pay the ever-higher premiums of standard insurance.

• Small businesses who find group health plans non-responsive to their employees needs.

• Patients who get most of their care from their family doctor anyway and rarely need specialty referrals.

• Those who need longer than standard visits to deal with multiple problems at a time.

• Elderly or disabled patients who find transport for multiple visits burdensome, and who might need an occasional home visit when transportation is not available.

• Busy people whose time is too valuable to waste waiting around for doctors’ offices to get back to them or respond to their needs.

• Those who miss having a personal and working relationship with a doctor who knows and  CARES about them.