How does the General Preventive Medicine program work?
A patient enrolled in the General Preventive Medicine Program pays an annual enrollment fee, either in one discounted lump sum each year, or monthly to spread the payments out over the year. The fee is paid with the assumption the patient will see the doctor at least once every 4 months.
How many times I can be seen under this agreement?
You will be seen in the office once every four months at a minimum. If you wish to be seen in the office more frequently for other needs, you can schedule periodic office visits and pay an office visit according to the fee schedule.
How much time will I spend with the doctor at each visit?
Generally these visits last 1 hour. The annual visit is scheduled as (2) 1-hour appointments typically within 2 weeks of one another.
What are the limitations of the General Preventive Medicine Program?
The annual enrollment fee does not replace the patient’s health insurance. For example, it does not cover many lab or X-ray charges, or referrals to other doctors or hospitals. Certain insurances (HMOs, Medicare, etc.) will not work with retainer-based practices. Dr. Ward has made the decision not to participate in filing for ‘traditional’ insurance reimbursement and thus is considered an Out-of-Network provider for all insurance plans. With regard to Medicare, Dr. Ward is not a participating provider, and thus will not provide nor file Medicare insurance billing forms.
How many patients will be accepted in this practice?
Dr. Ward has a limit of 300 patients. This is set in order to maintain the best availability and care for those enrolled in the practice, and will not be increased. Once the limit has been reached, people wishing to become patients will be placed on a waiting list.
Will my insurance pay for the enrollment fee?
The enrollment fee is separate from any fees paid to or by your insurance company. This is a separate fee for which the patient is personally responsible. Documentation for services rendered under the General Preventive Medicine Program (invoices) will be provided to each patient, but there are no promises or representations made with regard to insurance reimbursement for these services. With regard to Medicare, Dr. Ward is not a participating provider, and thus will not provide nor file Medicare insurance billing forms.
Will the enrollment fee cover labs, X-rays and specialist visits?
The enrollment fee covers only services provided directly by Dr. Ward. Additional labs, X-rays and specialists have their own charges and will bill the patient’s insurance a separate fee. Anything not covered by the patient’s insurance is the patient’s personal responsibility.
Can the fee for General Preventive Medicine Program count toward my deductible?
The insurance company has to have a bill from a doctor’s evaluation and treatment before they will allow money from the enrollment fee to cover part of the deductible. Patients participating in the General Preventive Medicine Program send the insurance company an invoice containing this information. Part of the enrollment fee may be counted toward the patient’s deductible, but there are no promises or representations made with regard to insurance reimbursement for this service.
What if I don’t have insurance?
The annual enrollment fee covers all General Preventive Medicine services by Dr. Ward, regardless of whether a patient has insurance or not. There is no penalty for those without insurance.
Is this a one-time fee?
No, the enrollment is meant to be renewed annually. The fee may be paid once a year or on a monthly basis over the course of the year.
Can the agreement be canceled?
Yes. The agreement usually renews automatically each year, but the patient or the doctor may cancel the agreement instead of continuing in the practice. If this happens during the middle of the enrollment year and the patient has paid to the end of the year, Dr. Ward will refund the part of the fee that has not been used. Once a patient has canceled the agreement, the doctor requires that the patient not return to the practice for a period of at least one year. (For example, a patient cannot pay for one month when they need to be seen, cancel, and then return with payment two months later to be seen again.)
Will I have to use an Urgent Care or Emergency Room?
Please remember that this practice is a Preventive Medicine practice, and therefore operates differently than Internists or even Family Practitioners. There may be acute medical situations that require more care than Dr. Ward can provide. In these cases you would be advised by the doctor to present to an Urgent Care or Emergency Room. In the event of a medical emergency, patients are advised to call 911 to seek evaluation and treatment as soon as possible.
What happens if I have to be admitted to the hospital?
If you are admitted to the hospital through the Emergency Room, they will contact a hospitalist for admission. You or a family member are advised to contact Dr. Ward to let him know about the admission. He will be available to coordinate your medical records with the admitting hospitalist and treating specialists. In this way, he can help more clearly explain your situation, test results and give you a better idea of what to expect during admission and after discharge from the hospital. Dr. Ward does not directly admit patients to the hospital.
What are your office hours?
Office hours are by appointment only and are scheduled in order to give each patient adequate time to deal with all of their concerns. Generally, these may be scheduled Monday through Friday, 8am – 5pm.
What if I need medication refills?
Program patients can utilize the secure messaging service (CampfireNow) for after hours contact. Responses via this system are within 24 hours. If a patient has discovered they are unexpectedly out of medication outside of office hours, they should contact the pharmacy to have them fax or call the office to issue a refill in order to avoid missing a dose.
What if Dr. Ward is on vacation or attending medical conferences?
In the event that Dr. Ward is out of the office for a vacation or attending medical training, he will usually still be available by phone or the secure messaging service.