Is Personalized HealthCare of Tucson a Concierge Medical Practice?
The term “concierge” medicine is used to describe many types of practices, including direct primary care and retainer primary care. In general, a fee is collected that is not covered by insurance. In return for the fee, the patient receives benefits such as faster appointment scheduling, adequate time to address your medical needs and enhanced access to your physician. A retainer primary care practice collects a membership fee for access to these benefits and other, more individualized benefits. Retainer practices maintain accreditation with Medicare and most private insurance companies. PHC is a retainer practice and as such bills insurance, and collects co-pays. Direct primary care practices charge a higher fee 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 physicians do not participate in any insurance plans. Direct primary care practices collect a fee from the patient to belong to the practice and provide unlimited outpatient care. The patient must still have health insurance that meets the minimum essential coverage mandated by the Affordable Care Act.
Why do I have to pay an annual membership fee?
The primary benefits to the patient included in the annual membership fee include services that are not available in traditional medical practices. This includes more time with your physician, no delay in scheduling appointments, and access to a physician from the practice after office hours and on weekends. Same day and next day appointments are available for urgent medical issues. There are many more benefits, which are described in the topic heading “Value-Added Health Enhancements” in the website banner.
Do I need health insurance?
It is suggested that you maintain your insurance coverage. Though many of the wellness services we will be providing are not covered by traditional health care insurance, all of the traditional medical services are, and will require billing to your provider.
If you are seen for a medical visit, whatever co-pays you currently pay will be charged at the time of that visit.
Do I still need to pay my copays?
Copays 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.
How much is the annual membership fee?
The annual membership fee is $1750 per person.
When is the annual fee due and what are the payment options?
The annual membership renewal begins on July 1 of each year, and the new patient membership year begins September 1. The annual membership fee can be paid once a year, every quarter, or monthly.
Will I have to wait to get an appointment?
Patients 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, which may be a Physician or a Nurse Practitioner.
Time spent in the waiting room will be brief, if you have a scheduled appointment.
Is there an extra fee for immunizations, lab tests and procedures done at the office?
Immunizations are available at the office for Influenza, T DAP, 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, DDap 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 physician visit.
If I am under care by a specialist or I have to go to the hospital, will you oversee that care? And will I have to pay extra for that?
There is no additional charge for hospital visits or coordination of care.
How much is your annual fee?
I charge most patients $1500 per individual, or $2500 per couple. Certain patients requiring intense medical care coordination may be charged a higher rate, but that will be determined on a case by case basis.
How do I join your practice?
You may contact my office at any time to inquire about spaces on my patient panel.
What happens if I’m hospitalized? Will I see Dr. Wool or a hospitalist?
Doctor Wool will make every effort to visit you in the hospital, and will coordinate your care while you are admitted. You will be assigned to a hospitalist however, while you are under the hospital’s care. Dr. Wool has screened and selected several hospitalists that he will refer you to, so that you know you will be seen by someone who has the qualifications you require for your condition.