I take people, not insurance! Let me explain why. The reason I do not work directly with insurance is that I want to work directly with you. The for-profit insurance industry is largely what has industrialized our medical profession, putting more layers between people and their doctors, less time with our doctors, more visits where we actually don't see our doctors and end up having to see someone who likely isn't a doctor and certainly doesn't know us as well. And on the doctor's end of things, we often feel rushed, overwhelmed and pulled in too many directions when we'd like to just be sitting with you, fully present and getting to the bottom of things with you. By not working directly with insurance, I am able to: • Keep my costs much lower • Spend a lot more time with you • Be available to you in many more ways, including email, phone, group visits and classes, and home visits Also, have you ever considered a cost-sharing program? Check out Liberty HealthShare! It's a wonderful example of a not-for-profit alternative to insurance that was approved of in the Affordable Care Act that would even pay part of your monthly membership! Note: The only reason you indicate your insurance on the enrollment page is to make the process smoother if I need to refer you to a specialist at some point or for a test outside my clinic. I do not bill your insurance for my care.
What about Medicare?
Because Medicare does not acknowledge or pay for many of the unique and helpful services I offer, which are inspired by our community's needs, the best way for me to provide the same level of care to patients with Medicare is to not bill Medicare. This allows me to give people with Medicare the same level of outstanding, compassionate, accessible care I am able to give everyone else. If you are enrolled with Medicare, you will be asked to sign a form at or before your first visit that shows you understand I will not bill Medicare for any of my services and that you agree to not bill Medicare for any of my services. However, your Medicare may still be billed for any and all services outside my direct care, including but not limited to labs, radiology, specialist visits, and hospital care. Seeing me doesn't impact your ability to use Medicare for everything else!
Do I need health insurance to become your patient?
I recommend everyone have some form of health insurance, but health insurance is not required simply to be a patient of mine. Health insurance helps pay (hopefully) for labs, radiology, specialist visits, and hospital care -- things that happen outside of my clinic. The ideal situation is to either join a cost-sharing program like Liberty HealthShare (which may pay part or all of your monthly membership to me!) or to have a high deductible plan that covers catastrophic events. An affordable membership like what I'm offering would then cover most of your basic primary care needs for a predictable, transparent monthly price.
I already have health insurance. Why would I pay for this?
This is a great question! Health insurance is NOT the same as health care. Health insurance doesn't guarantee you access to a doctor or to quality care or to the care you want when you want and need it. What I offer is a reliable, continuous relationship with my patients--a doctor who really knows you. I offer the ability to communicate directly and in a timely manner. If you call for a visit, we will typically meet that same day or the next day if that’s what your problem requires. Also, many people never reach their deductible, and end up paying for most of their care out-of-pocket. For these people, a model like this can save a lot of money. This model may not be for everyone, but many are finding it ideal for their medical care.
Can my HSA/FSA dollars be used towards the monthly membership fee?
Currently the laws state that HSA dollars cannot be used for your membership fee, but can be used for all other medical care you receive, including labs, radiology, hospital care, specialty visits, etc. FSA's may be used depending on the employer's FSA criteria, so check directly with your employer or plan administrator. The laws may change in the future, so keep your eyes peeled if this applies to you
But I only go to the doctor once a year! I pay for you every month whether I see you or not?
You've probably never been part of a clinic like this before. It's not just focused on chronic disease care and sick care. Here we get to work together in so many ways, typically in whatever way feels best for you and best addresses your concerns. Together, you and I will work to achieve the best health for you in the form of unlimited clinic visits (typically whenever you need them), home visits (when appropriate), messaging through your secure electronic medical record, and phone calls. We can also work together through quarterly or monthly group visits focused on wellness, cooking, nutrition, movement and other topics. And you'll be receiving a monthly newsletter with health updates from me as well.
However, some people would rather pay for each visit rather than pay on a monthly basis. I have a "Fee For Service" option which allows you to enroll as a patient and pay based on time for all visits, email visits, and phone visits. Here are my "fee for service" costs, which are a fraction of what most clinics bill to insurance for their visits:
15 minute visit: $72
30 minute visit: $144
45 minute visit: $216
If I get really sick will my fees go up?
No. I take care of you for the same fee. This fee covers 8 clinic visits a year and up to 1 home visit (if needed). Additional clinic visits are $50 and additional home visits are $75.
Is this a "concierge" or "boutique" medicine
No. This is truly individualized care with excellent access to your doctor. "Concierge" practices typically bill insurance companies as well as charging some kind of fee, and I do not bill any insurance. The only form of income I have is from the monthly memberships of my patients. My fees reflect the costs of running my practice. I work for my patients, not for insurance companies.
Do you provide vaccines in your clinic?
Vaccines are provided throughout our community, and I will partner with the resources already available for vaccine care. Our Public Health Department and local pharmacies are excellent options for getting vaccines. Medicaid and most insurance companies cover vaccines for children. Medicare and most insurance companies cover most vaccines for adults. Contact your insurance carrier if you have questions about what is covered in your plan. And contact me if you have questions about where to go for vaccines or alternative vaccination plans.
Do you treat chronic pain?
Of course! We are learning each year about safe and effective ways to improve the experience of daily pain. We also have been learning for years that opioids (pain medications like oxycontin, morphine, methadone, oxycodone, hydrocodone, etc.) typically don't make people's pain or wellbeing better when used for months or years. And we also know many people experience accidental overdose and even death from these medications (~400 people/year in the state of Washington die this way). So, in general, I do not prescribe opioids on a long-term basis. The main exception to this is buprenorphine, also known as suboxone, which is used to treat both pain and also opioid abuse/addiction. While there is no magic bullet, this is still a life-changing medication for many, and I have the license and experience to prescribe it.
What's not covered?
The cost of anything that happens outside of my clinic would be your, or your insurance carrier's, responsibility. This includes, but is not limited to, hospital and emergency care, visits with other doctors and specialists, radiology, labs, and pathology. For example, if I do a biopsy, performing the biopsy in my clinic is included in your membership (no additional fee). The fee for the pathology report, performed by a pathologist outside the clinic, would be your, or your insurance carrier's, responsibility. Any changes I make to services I provide I will communicate on both my website and in writing to current patients.
What happens if I get admitted to the hospital?
Great question! I will work with the hospitalist team at Olympic Medical Center through your hospital stay and be prepared to help with your care after you leave the hospital. While the hospitalist doctors will be directly involved in your moment-to-moment care in the hospital, I will be able to see you daily, if needed, and also communicate with your hospital doctors about your care. That way you get the best of both worlds: doctors caring for you who are physically in the hospital 24/7 as well as regular input from the doctor who knows you.
What happens when you go on vacation?
My goal is to create a model where being your doctor in this way blends well with my role as a mother of two little boys. I will typically be able to communicate with my patients as long as I have cell connection or internet connection (and at least one free hand!). I am married to a family doctor who often has to run to the hospital on short notice and I may be wrangling two spirited little boys. So there will times when I can't answer the phone immediately and will instead return a call as soon as I humanly can. And there will be times when I am out of cell coverage and away from my computer. In those instances, I recommend utilizing one of our 3 urgent care clinics in town if you have a problem that can't wait until I return. Most things can wait, and I do my best to answer my messages as soon as possible. I will also let my patients know in advance when I plan to be away so that any refills or other issues can be addressed before I leave. Also, there will be times when I am out of town but still have cell coverage and internet service and thus can communicate with my patients as usual, other than clinic visits.
What if I want to cancel my membership or change enrollment options?
I want you to be exceptionally happy with the care you get. If for any reason you want to cancel, you may do so at any time. To cancel your membership, give notice to me in writing. I will then communicate with you and end your enrollment, returning the rest of that month's billing cycle back to your account. To re-join the practice at the monthly membership rate after leaving there is a $300 re-enrollment fee.
Also, for those who wish to leave the practice and want their records sent to another practice, there is a $25 processing fee.
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