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Membership/Fee for Service Model

Membership/Fee for Service Model

green-heart.pngAfter long and careful consideration, Good Medicine will officially transition it’s billing model to a  Fee for Service structure, also known as cash pay.  This will take effect June 1 2017. At that time, Good Medicine will cease all agreements with Insurance Providers and Medicare as well as submission of any claims to insurance. The annual membership will continue unchanged.
 
This will be a monumental transformation for our practice; a decision which is critical to maintain our vision of providing the highest standard of patient-centered care possible. The Good Medicine membership model was created to deliver care without compromise, however, the continued pressure from the insurance industry is requiring us to spend more and more time filing requirements, leaving us with less time to focus on our patients. Industry experts are predicting this pressure will not only continue but will get progressively more complicated in years to come. Due to these changes, we can no longer responsibly partner with insurance companies and still remain true to the standard of care that is Good Medicine.

 

What does this mean for you?

The annual membership fee remains the basis for participation at Good Medicine. The Member Information Packet outlines all the benefits of the practice; if you have not taken the time to review your benefits, we highly recommend reading through the packet that is available here. To find out if you can submit claims for reimbursement with your insurance company, review your specific insurance contract to determine your policy's out of network benefits or contact your carrier with questions.

Reimbursements:

Each visit you will receive a super bill that includes standard billing details should you choose to submit your claims to insurance. You may have the option of submitting your super bill to receive reimbursement, from your insurance provider, based on your out-of-network benefits in your plan.

Ask your insurance company about their Non-Network-Claim Form and Non-Network-Claim filing addresses. In addition, you will still be able to use HSA (Health Savings Accounts) and FSA (Flexible Spending Accounts)  to cover medical costs. My fee for services will now be $70.00 per 15 minutes, well below the industry standard. Routine follow up office visits will now be $140.00 and 30 minutes long. Acute visits (addressing one acute problem only, i.e: sore throat, cough, fever, etc.) will be $70.00 and 15 minutes long.

Primary Care Coverage:

I am a solo medical practitioner and I specialize more in the role of a functional medical consultant.  There will be times that having an additional primary care doctor will be advantageous to address the acute issues that may arise.  In addition, I will also no longer be prescribing Opiates or Stimulants on a chronic basis. These prescriptions will be used only for a short term issues (less than 30 days); therefore, if you are intending long term use of these items, you will need to arrange for another provider before June 1st 2017.

Most Importantly, it is my honor and pleasure to have a care partnership with you.  We, as a team, appreciate your loyalty. We understand that just as we have made critical decisions based on our priorities, you will be making the same important decisions for yourself. If you choose to have another physician oversee your care, as a courtesy via your previous membership, we will continue to extend your membership discount for supplements. Online ordering is available. Remember to create an account to keep record of your purchase history.  If you need your member discount code for online supplement orders or have any further questions, please call our Clinical Coordinator at our office 513-273-9944 ext 1.

 

Sincerely,

 

Dr. Nathan Morris, MD

 
 
 

 

 

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