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VERTEX

Frequently asked questions

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?
If I only need a visit once in a while, why can't I just pay for that month?
A.
The monthly annual 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 care when my insurance pays for regular visits at most doctors' offices?
A.
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 serves 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.  It is unlikely that they would reimburse for the retainer fee.  Also, outside lab work, x-rays and consultations may be covered by your insurance.
Q?
What services are covered in the fee?
A.
Medical care that people general need:
Annual exams including gynecologic/pap
Routine office care
Minor surgical procedures done in-office
Injections
Referrals to specialists
Routine strep, flue and urinalysis performed in-office
Blood draws obtained in office and sent to lab preferred by individual patient's insurance
EKG's
Home visits when circumstances warrant
Twenty-four hour access directly to your doctor by phone and email
Supervision of hospital care
Q?
Who stands to gain the most from such a plan?
A.
Basically anyone who is dissatisfied with the current state of their health care, 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 and rarely need specialty referrals
Those who need longer than standards 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
Q?
What are the medical advantages of this type of practice over a standard one?
A.
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 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 every visit and that doctor personally knows their case
Personal access to the doctor is much easier so messages do not get lost in the telephone shuffle
One doctor knows your entire case history and can better orchestrate any needs for outside services
Q?
What is the financial advantage of this type of practice over a standard one?
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 offices.
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.
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