What does my family get from paying an annual fee?
Staying healthy now will prevent loss of income, expensive hospitalizations and preventable illness in the future. Dr. Davis believes strongly in prevention of illness. This is why she included the wellness visit as part of the annual fee. Dr. Davis will use this time to help you identify any future health concerns, such as diabetes, stroke or heart disease, at a stage when they can possibly be prevented. An emphasis on healthy living is made and goals will be set based on your individual needs.
Without the annual fee, Dr. Davis would have to serve many more patients and therefore not be able to provide the same level of responsive and personal service. Members are making an investment in their health and in the transformation of our health care system.
Is Meliora Family Medicine an insurance plan?
No. The annual fee provides care only from Dr. Davis, not other health care services or providers.
How does Meliora Family Medicine advocate for patients?
Dr. Davis advocates for her patients by asking hospitals and other health service providers to reveal their prices so her patients can make informed decisions regarding the least expensive option for good medical care.
She also does not contract with any insurance companies, so it is clear that she is working in her patient's best interest, not for hidden corporate agendas that may directly conflict with her patient's care.
Do I need insurance if I am a patient of Meliora Family Medicine?
No. Dr. Davis' goal is to increase access for uninsured patients by keeping fees simple and reasonable. However, she has no control over costs of health care services outside of Meliora. Unexpected health emergencies do occur, so we strongly encourage enrollment in some form of insurance plan to cover emergencies, such as catastrophic coverage. Enrollment in traditional health insurance, Medicare, or other major medical plan should also cover services provided outside of Meliora Family Medicine.
How does your practice work with insurance?
Patients with any insurance can enroll in the practice, but your insurance plan is between you and your insurance company. Dr. Davis does not contract with any insurance plans, and is therefore considered an "out of network provider."
When you receive office services, Meliora will provide you with paperwork that you will submit to your insurance. Your insurance company then determines your reimbursement. You will continue to give your insurance information to the lab, specialist office, or hospital for services outside of Meliora.
Certain HMO's usually require you to have an "in network provider" for referrals outside of Meliora to be covered. Be sure and check your plan's details regarding their practices, as this responsibility now falls to you. The annual fee itself is not covered by any insurance or Medicare.
Why are the charges for office services and the access fee not reimbursed by Medicare?
Patients with Medicare are welcome to join the practice, but Dr. Davis is nor contracted with Medicare. Any services provided by Dr. Davis are not covered by Medicare due to federal regulations. Services ordered by me, such as your prescriptions, oxygen therapy, physical therapy, home health care and the like, will continue to be covered by Medicare, as long as you are not enrolled in a Medicare HMO plan. You must find out the rules of your particular agreement.
As long as your Medicare service provider is not an HMO, services provided by other facilities and physicians who are contracted with Medicare will continue to be covered by Medicare, even if you are a member of my practice.
Can I use my Flexible Spending Account (FSA) or Health Savings Account (HSA) plan to cover office visits and procedures done at your office?
Individual office services, including office visits, office procedures as well as labs done in the office may qualify for use in HSA and FSA's. It is the annual fee that is unclear as to whether it legally qualifies. Seek assistance on this question from your authorized plan representative. You are responsible for knowing your plan's rules and regulations.
Can my pre tax dollar insurance plan (such as HSA and FSA) be used to specifically cover the annual fee?
Probably not. Check with your plan administrator or Human Resources representative for clarification and exploration of my vision to provide primary services in an enrollment practice using pre-tax dollars. Since the annual fee is for medical services, Health Care Savings Accounts and Flex Accounts should be able to be used, but you are responsible for investigating these benefits. Because insurance and benefit plans vary, Meliora Family Medicine cannot advise you regarding reimbursements.
How will you have enough time to care for me and my family?
At Meliora Family Medicine, a limit is placed on the number of patients so that you are given timely and complete care. This allows Dr. Davis to give her full attention to each one of her patients. Most primary care physicians care for several thousand patients, with the national average being 2,300 patients. Working forty hours a week for fifty weeks a year gives the doctor only 2000 hours per year, not including administrative and educational time. This means each patient gets less than one hour of their doctor's time each year. In contrast, the patient panel at Meliora will be limited to around 300 patients.
Will I be required to pay the annual fee even if I do not get sick?
Yes. Preventive care is an important focus of Dr. Davis' practice. She strongly encourages wellness consultations and regular care for chronic illnesses. The annual fee allows the patient panel to remain small so that you can have access to Dr. Davis whether you are sick or well.
Why do you charge additional fees for certain services?
By charging fees for services, such as office visits, e-mail visits and phone consultations, I am able to keep the annual fee lower, so those who do not require those services do not have to pay for those who might need them more frequently. Most current practices charging an access fee cost at least double to triple my current rate. Some of these practices with much higher fees include all care in the annual fee. I believe in you paying for what you need as an individual and not subsidizing the care of others.
I am really interested in supporting this concept of health care. Are there other ways I can help?
Yes. Dr. Davis is always interested in new ideas that can aid in providing care for those who can not afford her annual fee. Talk to her if you have any ideas and she would be delighted to include you in her journey to providing equal access to superb care.
Will this style of practice result in a greater shortage of primary care physicians, due to the fact that they are not taking as many patients under their care?
No. Fifty percent fewer US medical students are choosing careers in primary care today compared to just ten years ago. Practices like Meliora can inspire more interest in primary care by showing future physicians a new model of care.
United States senior medical students are avoiding specializing in primary care in favor of specialty training. During medical school, our future doctors see current primary care providers suffering from early burnout, frustration, depression and anger mainly due to increasing loss of control in patient care decisions, loss of respect, and steady decrease in income in spite of increasing hours worked.
Why does Dr. Davis not contract with insurance companies or Medicare?
Dr. Davis went to medical school and specialized in Family Medicine so she could help individuals and families through all stages of life to maximize wellness and face health challenges with confidence. Her patients' success in health translates into her success as a physician. This is how she earns her living. Insurance companies are in the business of making money. Medicare is now being used for political gain, not for providing sustainable health care benefits for seniors and people with disabilities. Both of these health care financing systems are costly and currently do not have mechanisms that support the pursuit of exceptional primary care and prevention of illness.
How can I access these online tools and resources if I don't have internet access at home?
No one is absolutely required to use any of the online tools, but Dr. Davis encourages everyone to try. Keeping the office paperless and efficient helps keep overhead and fees down. Receiving information electronically allows Dr. Davis to review it thoroughly before your visit. If you have no access at home, or find dial-up connections too slow, remember that the local public libraries have free internet access. There are plans to have a computer station in the waiting room that will be available for patient use. Perhaps you also have relatives or friends with high speed internet that would be willing to help out.
