At Twardon Family Care, I will seek to provide the same high level of care for which I always strive. I will not be providing Emergency Care or Hospital Inpatient Care (head trauma, major burns, hospitalization) nor care for any problems (such as obstetrical care) beyond the scope of a solo Family Practice outpatient clinic.
We will have two pricing structures for patients.
1. MEMBERSHIP
I prefer and hope that as many patients as might need regular (even if intermittent) care will enroll as regular Members of the clinic. Membership will include
- An Annual Complete Physical Exam
- Access by phone after hours (including HIPPA-protected EMR portal interaction)-- I or clinic staff will be generally accessible 24/7.
- Telephone consultation as medically appropriate without additional fee
- Unlimited follow up office visits at $25/visit (not including procedures or labs-- fees will be posted at the office, as available).
- At my discretion, I can see patients outside of "usual office hours," for their usual $25 fee.
- At my discretion and for a travel fee depending on mileage, I would be happy to schedule home visits.
- All standard labs available at discounted rates (if you do not want the lab to bill your insurer).
- No charge for managing prescription refills, prior authorizations.
- Priority access for appointments.
- Coordination of care with specialists, hospitals, and other care providers.
The annual fee is not insurance, but does support my ability to be available for the patient member, at a level that I think patients should have for their primary health care.
1. MEMBERSHIP Fee Schedule:
A Care Contract and payment will occur in advance of being seen for routine care, and emergency care will be referred onwards appropriately. These terms may change, though I do not anticipate such in the near future.
Annual Adult Membership paid in full $650/year from date of transaction
Annual Adult Membership $700/year if paid quarterly ($175/quarter)
Children (<23 yrs) Annual Membership paid in full $400/year from date of transaction
Children (<23 yrs) Annual Membership $440/year if paid quarterly ($110/quarter)
For all newly enrolling patients, a minimum initial down payment for 2 quarters would be required, to then transition to quarterly payments after that.
For families with more than 1 child or for single parents with 1 or more children, further discounts may be available; contact us if interested.
2. FEE FOR SERVICE (FFS)
There are a few patients I see who truly only have a few medical problems, where they can potentially be managed with an annual physical exam with rare office visits in between.
I will charge $100 for every 20 minutes with me, recognizing that patients with more than 2 issues or concerns or even a single, more complicated issue can end up taking 40 or more minutes.
Complete physical exams that usually take 60 minutes would be charged at $300 (for adults 23 years and older) or $210 for (1- 22 year-olds). For all other office visits, charges would be based on time spent.
I will be on-call for all of my previously established patients, including FFS patients, but for any FFS (non-Members), I would need to charge a nominal fee of $30 per phone consultation or treatment. If their issue cannot be properly/safely medically managed by phone, I would offer to schedule an office visit during normal business hours at the usual rates. Or, at my discretion and availability, I may offer a more prompt after-hours office consultation for an additional fee. This often will still be more cost-effective with less waiting than going to an urgent care. Patients may always opt for urgent care if they choose.
Any patients who are new to me, (who have not been prior long-term patients of mine) will need to establish care at their first office visit which would require a minimum of 40 minutes (or $200).
Here's a breakdown of prices as of 11/25/17:
All fees are non-refundable. Complete Annual exams are almost always 60 minutes or more, and additional fees for studies may apply.
For NEW, Adult patients (not established at TFC in the last 2 years, and 23 years or older):
· Regular Office Hours: $200 for the first 40 minutes, then $100 for each additional 20-minute period of time.
· After-Hours (at TFC discretion): $240 for the first 40 minutes and $120 for each additional 20-minute period of time.
For ESTABLISHED Adult patient (Seen at TFC in the last 2 years, and 23 years or older):
· Regular Office Hours: $100 for each 20-minute period of time with the Physician.
· After-Hours (at TFC discretion): $120 for each 20-minute period of time spent with the Physician.
For NEW, Child/Student patient (not established at TFC in the last 2 years, and Under 23 years):
· Regular Office Hours: $200 for the first 40 minutes, then $70 for each additional 20-minute period of time.
· After-Hours (at TFC discretion): $240 for the first 40 minutes, then $90 for each additional 20-minute period of time.
· Complete Physical/Well Child Check- same as “Regular Office Hours,” listed above.
For ESTABLISHED, Child/Student patient (seen at TFC in the last 2 years, and Under 23 years):
· Regular Office Hours: $70 for each 20-minute period of time spent with the Physician.
· After-Hours(at TFC discretion): $90 for each 20 minute period of time spent with the Physician.
Telephone Consult For ESTABLISHED patients (seen at TFC in the last 2 years): $30/call for 1-2 problems
Fee For Service is overall not my preferred model for maintaining a more full relationship with a primary care provider, but for the more healthy patients or persons visiting from out of town, it might be appropriate.
Lab Fees
Unlike many clinics, I will continue to seek the lowest cost for labs, be completely transparent about the upfront costs (available ultimately at the office), and pass cost savings on to you. Most insurance, including Medicare, will likely pay for lab tests as billed by the commercial laboratory, though most people are very surprised at the relatively low costs of cash rates for some labs.
Pricing for procedures will be reviewed prior to any procedure being done. The same principle applies-- I do not anticipate making much money off the cost of materials (sutures, splints), but seek to be compensated for my time and skills... without paying for materials myself.
Insurance Reimbursement
For any services you receive from me, for which your insurance (including Medicare Advantage plans) may reimburse you, I am happy to help provide the codes and information needed for you to fill out claim forms & provide appropriate coding and proof of payment to assist you. Please alert us before you check out if you intend to try to file an insurance claim for re-imbursement.