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© 2017 Harmony and Direct Primary Care

Frequently Asked Questions

What is Direct Primary Care?

Direct primary care is a direct relationship between patient and physician.  Dr. Law’s primary focus is on you and your health.  Affordable monthly membership fees cover the vast majority of primary care services in our office.  We offer both affordable and personal care.  We are a caring and compassionate type of office that puts the patient first and allows for a more personalized healthcare experience. 

 

How many times I can be seen under this Direct Primary Care agreement with this office?

You may be seen as often as you like. There are no limitations to the number of visits. 

 

How long is the wait to get an appointment?

Usually you can be seen the same day or the next day.  Also, Telemedicine (videoconferencing) is available. 

 

What is the co-pay for each visit?

Good News!  There is NO co-pay for each visit.

 

Do you accept New Medicare and Medicaid patients?

No, these are Government regulated insurances and will not provide reimbursement for Direct Primary Care offices.

Will my insurance pay for the enrollment fee?

No, The enrollment fee is separate from any fees paid to or by your insurance company. The patient is personally responsible for this fee.

 

Do I still need health insurance?

We highly recommend that you do have insurance to comply with Federal Law.  HarmonyMD does not replace insurance as we are a membership plan and do not qualify as a health insurance policy and ideally we encourage our patients to carry a high deductible or major medical plan or a plan with a health savings account, thereby ensuring financial help should hospitalization or referral to a specialist be necessary. You may also look into Faith Based plans that will also qualify for the Affordable Care Act and will help pay your membership fee up to $60 in some instances and therefore you only owe $5.00/mo to HarmonyMD/Dr. Law for the membership plan.  You should consult with your insurance provider to help you find a plan that works best with our medical model and that will meet your specific needs.

 

What services are Non-Covered?
  • Chronic anti-anxiety or ADD/ADHD medication

  • Chronic pain management

  • Specialist Care

  • Immunizations

  • Pathology Fees

  • Lab Work

  • Surgical Procedures

  • ER Visits

  • Radiological Studies

  • Physical Therapy

 

Can I walk-in without an appointment?

It is best to call us first so we can make sure you are not waiting a long time to be seen.  We would like to make sure all of your concerns are addressed in a relaxed atmosphere.  Also, we can save you time and money because a telemedicine visit (videoconferencing) may be sufficient. 

 

Can I still just pay per visit without becoming a Member?

No, in order to provide continuity of care we are requiring all cash paying patients to become a member.  In the past, there continued to be constant management of the patient i.e. discussion of labs, follow up of procedures, medication refills, pre-authorizations, etc. and the patient did not want to pay the cost/visit and this resulted in inadequate care on the part of the patient. 

 

What if I miss paying my membership fee, can I still be seen?

No.  It is understood in the signed contract that all members will not be scheduled for a patient appointment until the membership fees have been paid up through or beyond the desired appointment.

 

If I already pay for Health Insurance, why would I join your membership plan?

If you have a high deductible health insurance plan and have a large deductible, then you have to pay full price no matter where you go for medical care.  For ex. If your plan’s deductible is $1500, this means for most services you are required to pay 100% of your medical and pharmacy bills until the amount you pay reaches $1500.  After that payment is reached then you share the cost with your insurance plan by paying coinsurance and copays.  Coinsurance can be 20% or more of your office visits.  So, if your office visit is $150 and your coinsurance is 20% that is $30 + $30 for your copay = $60 and up per visit.  But, many plans have >$5,000 deductible and that is usually not reached each year.  We have had patients in the past with insurance go to an urgent care facility and get bills >$400/visit.  Our goal is to help you avoid or minimize severe or chronic conditions that trigger high out of pocket costs.   Improved access to your own personal physician can lead to better health outcomes.  Many of our patients discover that our reduced prices for labs, imaging, medication, etc are MUCH LESS than using their own insurance!

 

Is this concierge medicine?

No.  However, the terms are often used interchangeably.  Direct Primary Care physicians do not bill insurance for those enrolled in the membership plan.  Concierge Medicine and Direct Primary Care Offices’ main focus is the patient.  The main difference between the two is the cost and billing structure.  Concierge Medicine physicians tend to have higher annual retainers typically >$1500 per year.  Direct primary care offices tend to have very affordable monthly fees which tend to be <$125/mo and generally do not bill insurance for other services that they may provide.  It is important to note that both Concierge Medicine and Direct Primary Care offices both strive to put the patient first by listening to their concerns in a non-rush type of environment and making the patient feel like they are a VIP. 

 

What is the cost to be a member?

There is a Nonrefundable $99 Registration fee per household.

We aim to keep the costs affordable.  Therefore it is only…

$65/mo for individuals

$120/mo for couples

$230/mo for families (up to 4 members)

 

Are the membership fees eligible for HSA (Health Spending Accounts) or FSA (flexible spending accounts) reimbursement?

Please consult your tax advisor for guidance on your particular circumstances.  But, many patients across the country are finding out that their Direct Primary Care fees are reimbursable through their HSA or FSA. 

 

Once I become a member will you bill my insurance plan for office visits?

No, Dr. Law is considered an “out of network” provider and does not have a contract with your insurance company.  Also, membership fees are not reimbursable.

 

What do I do in the case of an Emergency?

In the event of a medical emergency, patients are advised to call 911 prior to calling our office to begin evaluation and treatment as soon as possible.  In certain medical situations you will be advised to seek treatment in the Emergency Room.  Dr. Law does not directly admit patients to the hospital.  Please let us know if you are admitted as we always want to be involved in the continuity of your care. 

 

What are the Covered Services?
  • Management of Chronic Illness (Diabetes, Hypertension, Thyroid, High Cholesterol, etc.)

  • Comprehensive Physical

  • Sports/ School Physical

  • Acute Visits Dr. Law will be available to you by phone, text, email or telemedicine.  There may be medical

  • Preventive Care

  • Nebulizer Treatments

  • Joint Injections

  • Antibiotic Injections

  • Steroid Injections

  • Laceration Repair

  • Mole/skin tag/cyst removal

  • Skin Biopsies

  • Exercise Recommendations

  • Dietary/ Nutritional Counseling

  • Ear Wax Removal

  • 1 B-12 shot/mo.

 

How do I pay the membership fee?

You will be directed to a 3rd party website called Hint via our link. 

We accept fees paid annually by cash, check, debit or credit card.

We accept fees paid monthly by automatic bank debit (ACH authorization) or credit card.

 

Can the membership fee be cancelled at anytime?

Yes. However, please be mindful when you sign up you are agreeing to a minimum time period and you are responsible for that time period and those fees are not reimbursable.  Please make sure you read the contract thoroughly.  The enrollment fee of $99 is also nonrefundable.  Due to the fact Dr. Law has tried the Direct Primary Care model in 2012 and has learned a lot from the mistakes made when patients would sign up and get a complete physical exam, medications refill, etc and then cancel their membership plan.  Policies have been put in place to avoid these types of mishaps in the future which cost the practice a lot of money.  Also, once a patient has cancelled their membership it is understood that the patient will not return back to the practice. 

 

What if Dr. Law is out of the office or on vacation?

Well if you know Dr. Law she is rarely out of the office or on vacation due to the fact she absolutely loves her job.  The exception is when she attends meetings across the country keeping up with the latest and bringing the information back to her patients.  But, in the event this should occur the patient will be notified via our e-mail messaging system that another health care provider will be available to cover all messages.

 

I am an Employer, can I sign up my employees for your membership plan?

Absolutely.  We will schedule an appointment with the employer first and then schedule a meeting with the employees making sure this is a great fit for their needs.  Also, we recommend the employer meets with their financial planner and insurance provider to make sure this will be a right fit for their business.