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FREQUENTLY ASKED QUESTIONS (FAQ)
Why is
there an annual fee?
In order to offer the highest level of personal health care
and to maximize our access to you, we will limit the
number of patients in each physician’s practice. The
annual retainer fee assures you of this service and
further, that your physician will be available to you
whenever needed, whether in the office, in the hospital
or for telephone calls or e-mails. This fixed fee also
ensures that your medical costs for primary care will be
completely predictable.
Can you
explain how a retainer practice works?
Rather than using insurance, the only charge is an annual
professional fee, which essentially covers all physician
services. There are no other bills. The office does
not bill insurance. This level of service is virtually
unheard of these days at any price.
I
already have good insurance. Why would I pay extra to
join?
Even people with excellent medical coverage often find that
they do not have access to the medical care they need.
For example, when they call their doctor's office they
may be placed on hold or they have to press numbers on a
voicemail line to get through. When they are finally
offered an appointment it may not be soon enough or they
may not be able to convey to the assistant exactly what
their needs are. They may wait an hour or more in a
crowded waiting room to be seen and then feel rushed
through the visit before all their questions are
answered. Simple questions are not answered over the
phone and they cannot send an e-mail to their doctor
when they have a concern.
What
does the professional fee cover?
It includes all office visits, a comprehensive annual
physical examination, routine immunizations (tetnus,
diphtheria, influenza and pneumococcal vaccinations),
and a thorough panel of blood tests; included on an
as-needed basis are EKGs, DEXA bone density scans and
pulmonary function studies. Diagnostic lab studies,
outside of your annual physical, will be drawn in the
office and sent to the appropriate lab, who will in
turn, bill your specific insurance company.
What if I need to be hospitalized?
Each
physician will continue to maintain admitting privileges
at Howard County General Hospital. Your physician will
facilitate communication with the different
specialists. Your doctor will not bill you or your
insurance company for the time spent at the hospital or
the emergency room or at nursing homes. This is
included in the annual professional fee.
I am covered by Medicare. Can I still see the physicians in Charter
Internal Medicine (CIM)?
The
Charter Internal Medicine doctors have opted out of
Medicare. Medicare will not cover any portion of the
professional fee or any other related expenses.
Medicare patients may, however, sign a waiver
acknowledging that they agree to a private relationship
with the physicians in CIM and are welcome to join a
practice. Of course, your Medicare coverage with other
doctors, hospitals, imaging facilitates, and
laboratories remains intact.
Is this an insurance plan?
No,
absolutely not. This is simply a plan to see a doctor
without the restrictions and frustrations associated
with insurance companies, billing headaches, and
paperwork.
I have medical insurance. Does it matter what kind?
No.
The CIM program is not dependent on insurance. Your
insurance is used only for other doctors, hospitals, and
tests, etc. In fact, it is not necessary to have
insurance at all to be in the practice though it is
strongly recommended for catastrophic problems that can
arise.
I am in a preferred provider organization (PPO). Can I join?
Yes,
while you are responsible for the annual professional
fee, you may be able to submit bills to your insurance
company for reimbursement. Since we are not affiliated
with any insurance companies, any reimbursement is
appropriately yours to keep. For insurance purposes,
each physician is considered an "out of network"
physician. Reimbursement levels are determined by your
particular policy and may be subject to an annual
deductible.
I have a flexible spending plan or medical savings account through work.
Can I use that for the annual professional fee?
Check
with your plan administrator and accountant. By using
pretax dollars designated for medical expenditures many
patients may find these plans may reduce their out of
pocket costs by as much as 30-40%.
Can you explain a Health Savings Account (HSA)?
A Health Savings Account is an interest bearing savings
account that allows you to put away tax-free money for
your future health care needs. For example, in 2008, an
individual can contribute $2,900 per year and a family,
$5,800 per year.
Can I
use HSA money to cover my retainer medicine fee?
The IRS web site, which was designed
for non-accountants, reads that the simple answer to
this question is yes. There seems to be no reasonable
argument that could be made that the medical services
offered by a retainer physician are anything but
legitimate medical expenses, especially when the law
allows you to pay for health care expenses like eye
glasses, dental care, and over-the-counter medications
using HSA funds. If you decide to use your HSA money to
pay for retainer fees, consult your accountant first.
If you are able to use pre-tax dollars to pay for part
or all of your retainer care, you will save even more
money than you will save by switching from a low
deductible to a high deductible health plan. For
further information, go to
www.Treasury.Gov/Offices/PublicAffaris/HSA/.
**Taken from Concierge Medicine, Steve Knope M.D., 2008.
I have high school or college age children. Can they be seen?
Yes,
children ages 14 through 25 can been seen. The annual
professional fee is reduced to $500 per child if at
least one parent is also seen by any one of the
doctors.
How is the annual payment fee paid?
It is
paid by cash, personal check or credit card.
Do I need to pay the fee all at once?
No.
You may choose one of two options: once a year or twice
a year. The fee changes slightly depending on which
option you choose.
Will I be charged anything beyond an annual professional fee?
No, not
usually, however, there are some services which are not
covered, such as the cost of more exotic immunizations
for travelers to foreign countries, but even then the
vaccine would be purchased by the patient (when
available) and administered at our office at no
additional charge
This is an interesting concept. Are other doctors doing it?
Yes, a
small, but growing number of doctors around the country
are changing to smaller, more service oriented practices
as the intrusions and frustrations of modern medicine
become more difficult for patients and physicians
alike. All of the practices charge additional fees for
improved services, easier access, and longer unhurried
appointments. This one of the few practices on the east
coast that we are aware of that does not additionally
charge insurance or Medicare for each visit.
Can I reach my physician whenever needed?
Yes,
your personal physician can be reached 24 hours a day 7
days a week through their office or answering service.
Non-urgent questions are answered via e-mail as time
permits. If your physician is out of town, another
physician in Charter Internal Medicine will cover the
practice for emergencies and remain in touch with your
personal physician.
Do you really make house calls?
Yes!
All the doctors will continue to make house calls when
it is not practical or possible for the patient to be
seen in the office and when hospital evaluation and
tests are not necessary. It is very gratifying to see
someone in their home environment and it can be a relief
to the families of elderly or physically challenged
individuals. When your physician believes a house call
is appropriate, it is included in the annual fee and
there are no additional charges for this service.
Who can I contact for further information?
If you
have any further questions, please contact our Practice
Transition Coordinator, Brenda Katz. Brenda can be
reached during normal business hours by telephone at
410-910-2315 or by email at BKatz.CIM@comcast.net. | 
