Is Personalized HealthCare of Tucson a Concierge Medical Practice?

The term “concierge” medicine is used to describe many types of medical practices, such as direct care and membership medical practices, where a fee is collected to provide benefits that are not covered by insurance.  PHC is a membership medical practice and charges a membership fee, bills insurance, collects co-pays, and co-insurance. In return for the fee, the patient receives benefits such as faster appointment scheduling, adequate time to address your medical needs, enhanced access to your physician and many additional services.  PHC maintains accreditation with Medicare and most private insurance companies.

Other types of Concierge Practices such as direct primary care practices typically charge a much higher fee than membership practices and do not bill insurance. Direct primary care is considered by the State of Arizona to be a service distinct from health insurance. Direct primary care Providers do not participate in any insurance plans and therefore do not maintain accreditation with Medicare and most private insurance companies. Direct primary care practices collect a fee from the patient to belong to the practice and provide unlimited outpatient access. However, the patient must still have health insurance that meets the minimum essential coverage mandated by the Affordable Care Act.

Why should I pay an annual membership fee?

The primary benefits to the patient of belonging to the PHC primary care practice include services that are not available in traditional medical practices. This includes more time with your Medical Provider, same day or next day appointments for urgent medical issues, timely scheduling of routine appointments, and access to a Medical Provider from the practice after office hours and on weekends. There are many more benefits, which are described in the topic heading “Benefits of Belonging” section of this website.

Do I need health insurance?

You should maintain your insurance coverage. Although many of the wellness services we provide are not covered by traditional health care insurance, all of the traditional medical services are. These traditional medical services are billed to your medical provider. In addition, medical insurance coverage is strongly recommended to cover the costs of hospitalizations, surgery, medical imaging, laboratory analyses, medical therapies such as cancer treatment, etc.

Do I still need to pay my copays?

If you are seen for a medical visit, whatever co-pays your insurance provider requires will be charged at the time of the office visit. Co-pays are a requirement imposed on medical practices by insurance companies. It is considered fraud by Medicare and private insurance plans if the required co-pay is not collected, and a physician may lose their credentialing with Medicare or a private insurance company.

When is the annual fee due and what are the payment options?

The Annual PHC membership renewal process begins on July 1 of each year, and the patient membership year begins September 1. The annual membership fee can be paid once a year, or monthly. There are no administrative fees for monthly payments.

Will I have to wait to get an appointment? 

Patients needing urgent same day or next day appointments will be accommodated. In the event that your personal physician is not available due to scheduling issues or vacation, urgent medical issues may be handled by the available Medical Provider.

Is there an extra fee for immunizations, lab tests and procedures done at the office?

Immunizations are available at the office for Influenza, Tdap, Tetnus, Pneumo-Vax, Previnar, Hep-A, Hep-B, Hep A-B ComboFlu shots, depending on availability of the particular vaccine. Medicare does not cover immunizations for Tetnus, TDap or Hepatitis. If you need an immunization that is not covered by your insurance or medicare, you are responsible for the entire cost. Immunizations covered by Medicare or individual insurance plans, lab tests, and procedures such as Spirometry, EKG, Joint Injections, and Incision & Debridement are billed to insurance. A co-pay is not required for immunizations if they are administered separately from a scheduled Medical Provider visit.

If I have to go to the hospital, will you oversee that care? 

In Arizona, a patient’s care in a Hospital is overseen by a Hospitalist. This is more efficient and safer for a patient, as the Hospitalists are in the Hospital 24 hours a day, seven days a week. Our Medical Providers provide coordination of care and work closely with your Hospitalist while you are in the Hospital to provide coordination of care.

How do I join your practice?

Please contact Personalized Healthcare of Tucson at 520-795-4100, ext. 101 to speak to our membership coordinator or email membership@phcoftucson.com.