Frequently Asked Questions
Questions About Our Concierge Practice
What is the mission of your practice?
Our goal is to provide the highest-quality medical care with an emphasis on patient safety and comfort, and a proactive, comprehensive approach to both disease prevention and wellness. We strive to provide excellence in care that is both compassionate and truly patient-focused. From the moment you call our office, we want you to be completely satisfied with every aspect of your care.
How is the practice different from a traditional medical practice?
In order to devote more time to each patient’s care and individual needs, we have intentionally limited the size of our practice. We also offer certain non-covered amenities and benefits designed to personalize and enhance the health care experience. In-office appointments will start promptly, with little or no waiting time; virtual visits via telemedicine are offered as an option upon patient request. This practice model also enables us to schedule longer patient appointments (approximately 30 minutes for routine appointments and approximately 60 minutes for the Comprehensive Annual Health Assessment). If an issue requires extra time for evaluation or discussion, we will accommodate you to the best of our ability. Also, after hours for urgent issues, you will be able to contact us on our personal cell phones, making it easier than ever to communicate.
At which hospitals are you on staff?
All of the local hospitals now utilize hospitalists, which means we do not admit to any hospital. However, we are affiliated with Torrance Memorial Hospital and Little Company of Mary Providence. Should you need to be hospitalized, we will be able to communicate with the hospitalists at these two facilities. If you are at any other hospital, we will make ourselves available to communicate with you and to serve as an advocate on your behalf, if hospital protocol allows.
Who will cover for you when you are not available?
Our goal is to be available to our patients 24 hours a day, 7 days a week. However, there will be occasions when we are out of town or otherwise unavailable. In these situations, a trusted colleague will serve as a covering physician.
Questions About Insurance & Medicare
Do I still need health insurance if I enroll with you?
Yes. Your annual fee only pays for the non-clinical, non-covered amenities and benefits that are described in the Highlights & Details document. Neither the fee nor the amenities take the place of general health insurance coverage. You are advised to continue your Medicare or other health insurance program coverage.
Will you be a provider on my insurance plan?
We intend to remain an in-network provider for many major PPO insurance plans and will bill your insurance directly for professional services that are covered by those plans. (Professional services are not covered by your annual fee.) If the terms of your insurance plan require a co-pay, we are obligated to request payment at the time of service. Even if we are not a provider for your insurance plan, we will attempt to refer you to in-network physicians for any necessary consultations and to in-network facilities for diagnostic tests and hospitalizations as medically indicated. Those services will likely be covered by your insurance plan.
Will you be a participating provider for Medicare?
Yes. Our office will file your claims with Medicare as well as with your supplemental insurer on your behalf, as required by law. Office visit fees that are not reimbursed by insurance will be the responsibility of the patient.
Will my private insurance or Medicare reimburse my annual fee?
No. The annual fee is not covered by private insurance or by Medicare.
Questions About Membership
What are my annual fee payment options?
Your annual fee may be paid annually, semiannually, or quarterly by ACH bank account payment or credit/debit card. The first payment will be charged upon enrollment. The remaining balance of your annual membership/enrollment fee (if any) will be charged automatically in installments, accordingly. Until we hear otherwise, payments will be processed continually
Will I be required to pay my annual fee even if I do not use your services?
Yes. Paying your annual fee allows you to be a member of our practice and to be in touch with us whether you are sick or well. We strongly encourage you to utilize the benefits offered, regardless of your state of health, to proactively safeguard your well-being.
Who is Specialdocs?
Specialdocs Consultants, LLC, is the outstanding company long respected for its expertise in membership medicine, who assists with the membership aspect of my practice. They can help answer your questions related to enrollment, membership billing and renewals. They can be reached at 847-432-4502 or by calling my Membership Information Line.
Questions About “What If” Scenarios?
What if I have an emergency?
Please know that you can contact us at any time. However, if you have a life-threatening emergency, call 911 immediately. You can then call us or ask the hospital personnel to contact us so we may assist in your care. If you have a non-urgent problem, feel free to contact us first.
What should I do if I become ill while traveling or away on an extended vacation?
If the problem is minor, call us first. However, if you have a life-threatening emergency, call 911 immediately, then you can call us. With the exception of controlled substances, we will seek to accommodate your prescription requests if state/local law allows. If you seek care at an emergency room or urgent care center outside my area, you should feel free to ask the doctor seeing you to call us for coordination of your care. If you should require hospitalization while away, at your request, we will attempt to establish regular phone communication with you and your attending physician(s) to ensure continuity of care.
What if I need to see a specialist or a surgeon?
Should you request, we are available to help you decide which specialist to see and to coordinate such consultations. This will ensure the most appropriate resource is used, the earliest arrangements are made, and your applicable medical information is sent in advance of your specialist visit.
What about labs, X-rays, specialists’ fees and hospitalization?
All medical procedures and services, whether performed in our office or by other providers or health care facilities, will be billed by the performing physician and/or entity.
What happens if I move out of the area and need to terminate after I enroll?
Your membership agreement can be terminated after the initial one (1) Service Year upon 30 days’ written notice to us/our practice.