WHAT IS A PATIENT-CENTERED PRACTICE?
Physician’s Promise is a patient-centered practice. A patient-centered practice is any medical practice where care is financed directly by the patient, not a third party payer (TPP) such as the Government or commercial insurance. Recognize that every medical decision is “payer-centered,” meaning that the payer dictates medical care. To be “patient-centered,” the patient must be the payer. In traditional practices where physicians work for the third party payers, they receive low reimbursements and have high overhead expenses. They are forced to see more patients, and have less time to attend to each patient.
In a patient-centered practice, your physician works for you, not the payer. This allows you improved access, time, and services. You also have true privacy. In a traditional practice, HIPPA does not protect your privacy from the third party paying your bills. When you self-finance your care, your physician answers to only you.
DO I STILL NEED HEALTH INSURANCE IF I ENROLL WITH YOU?
We strongly encourage you to purchase health insurance to protect against unexpected events just as you do for your home, car, and life. The ideal type is a High Deductible Health Plan (HDHP) tied to a Health Savings Account (HSA). For more information, please consult your financial advisor for guidance.
WILL PRESCRIPTIONS FOR LAB WORK, X-RAYS, PHYSICAL THERAPY, AND MEDICATIONS BE COVERED WITHIN MY HEALTH PLAN?
Yes, Dr. Schreckengost is enrolled as an out-of-network physician with insurance companies. We work with your company to use in-network services when reasonable for laboratory, radiology, physical therapy, and specialty services.
MY INSURANCE REQUIRES PRIOR AUTHORIZATIONS FOR CERTAIN TESTS SUCH AS MRIs. WILL I STILL BE ABLE TO GET THESE TESTS COVERED?
Yes, if your payer allows it. Since Dr. Schreckengost is a licensed physician, we can request prior authorizations. As with traditional practices, it doesn’t guarantee they will approve payment. You are entitled to an appeal process directly to your insurance company should they deny payment. We will assist you with this if necessary.
WHAT IF I HAVE AN EMERGENCY OR NEED HOSPITALIZATION?
If you have a life-threatening emergency, call 911.
YOUR CONTRACT INCLUDES A MEDICARE OPT OUT AGREEMENT, WHAT DOES THAT MEAN?
Physician’s Promise is a “fee-for-care” model which requires Dr. Schreckengost to completely Opt-Out of Medicare. This means that Dr. Schreckengost may not submit any Medicare claim or receive any payment from Medicare services that he provides to you. This does not change your Medicare benefits in any way. All services Dr. Schreckengost prescribes to you that are provided by outside agencies (lab, x-ray, physical therapy, etc.) will continue to be covered by Medicare. Only services performed by Dr. Schreckengost are not.