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.
WHAT DOES THE ANNUAL FEE COVER?
The annual fee covers a yearly comprehensive wellness exam, up to two office visits per month, up to two osteopathic manipulative therapy sessions per month, and unlimited contact with Dr. Schreckengost via phone, text, and/or email 24/7/365.
HOW MUCH IS THE ANNUAL FEE?
Our annual fees are customized to meet your specific needs. We offer individual, couple, and family plans. We would be happy to assist you in determining the right plan for you. Please contact us for more information.
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.
Physician’s Promise gives you easy access to comprehensive primary care, which in return gives you the best opportunity to avoid expensive emergency room visits and hospitalization.
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. For example, if your insurance company uses LabCorp for blood work, we draw the sample as part of your fee and LabCorp bills your insurance for the testing.
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. Patients are asked to contact Dr. Schreckengost day or night before going to any facility for non-emergency care. He will make every effort to address urgent needs. If you require an emergency room visit, he will be available 24 hours a day for consultation with emergency room personnel and for coordination of your care. Specialty referrals will be discussed with the emergency room physician if warranted.
DO YOU MAKE HOUSE CALLS?
We understand that an occasional situation may arise where a patient is physically unable to get to the office. In these extenuating circumstances, Dr. Schreckengost may be available to see you in your home. An additional fee will apply.
WILL MY INSURANCE REIMBURSE ME FOR ANY OF YOUR ANNUAL FEE?
Possibly. At each visit you will be given a receipt for the care you receive. You will not need to actually pay an additional fee for that care since you have already paid for it through your yearly retainer fee. If you have an out of network option with your insurance (PPOs, POSs, high deductible plans), you may choose to submit the receipt to your insurance for reimbursement. If you do not have out of network options (HMOs, Medicare), you may be able to claim it as a tax deduction if you meet the “health expense” threshold. This potentially lowers your net out of pocket expense to our office significantly.
IS THE ANNUAL FEE TAX DEDUCTIBLE?
Some Flexible Spending Accounts (FSA), Health Reimbursement Arrangements (HRA), and Health Savings Account (HSA) plans may pay for all or part of the annual fee. Patients are advised to consult with their benefits advisor or tax consultant to clarify qualification.
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.
WHAT HAPPENS IF I MOVE OUT OF THE AREA AFTER I ENROLL?
If you must transfer your care, we will assist you in finding a new doctor. Your medical records will be promptly sent upon receipt of your Medical Release Form. The unused portion of your fee will be refunded.
CAN I WAIT AND JOIN LATER?
Our practice is a concierge practice with a limited enrollment. Once our enrollment limit is reached, a waiting list will be established. Every effort will be made to accommodate interested patients, but the enrollment limit must be honored in order to continue to provide the highest standard of personalized care and service to all participating patients.