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personalized medical care
 
 

YOUR QUESTIONS ANSWERED

What is Personalized Medical Care?
How is this achieved?
How does the Annual Physical work with the Enrollment fee?
What is the main difference between Personalized Medical Care and general primary care practices?
What does this service cost?
Will you take care of my existing medical problems?
Do I need Health Insurance if I enroll with you?
Will my private insurance reimburse my annual Personalized Medical Care fee?
What about lab, x-ray, specialists’ fees and hospitalization?
Do you take my insurance?
What if I have Medicare insurance?
What do I do in an emergency?
Will you really be available 24/7 to your patients?
Are you concerned that you will burn out being on-call 24/7?
How do I reach my doctor after hours in case of emergency?
What happens if I need to see a specialist?
Can I still see my gynecologist?
What about the cost of prescription medicines?
What if I travel?
What do I do if I become ill while out of town?
Will you make house calls?
What if I have to go to a hospital?
Can I wait and enroll in Personalized Medical Care later?




What is Personalized Medical Care?

This is an innovative practice design which allows us to limit the size of the practice to a few hundred rather than several thousand patients, enabling us to offer faster access, more time for each patient visit, and 24/7 direct cell phone access to the doctor. To provide this higher level of service each member patient is asked to pay an annual fee to participate in the practice. This fee also pays for periodic, detailed, preventive medical (wellness) examinations. We are dedicated to improving the overall health and wellness of our patient-clients. Topics

How is this achieved?
Our focus is on prevention. We individually cater an approach for optimizing the healthcare of each client, rooting out potential problems. We then make sure that the client has improved access to the doctor to deal with problems that might arise. Topics

How does the Annual Physical work with the Enrollment fee?
Included in your annual fee is a comprehensive annual exam complete with physical, basic labs, and EKG. Other recommended testing done outside the office such as X-rays and other advanced imaging and special-order labs, will be billed to your insurance by the providing facility. Topics

What is the main difference between Personalized Medical Care and general primary care practices?
Personalized Medical Care provides our patients with solutions to their frustration related to the current healthcare crisis. No longer will you have to sit in a waiting room, schedule appointments months in advance or be ignored by a physician that doesn't have the time to listen. Topics

What does this service cost?
The annual membership fee is less than $3.30 a day. You can pay annually or in four equal payments. Imagine having dedicated healthcare and medical management for less than it costs for your morning coffee. Please contact a Personalized Medical Care representative for details. Topics

Will you take care of my existing medical problems?
Of course, the technological and scientific advances over the last several decades allow us to provide better care for many diseases such as diabetes, asthma, hypertension, and atherosclerosis. Careful monitoring and management of patients’ health on a one-to-one basis improves their well-being. Personal management of chronic diseases such as asthma, congestive heart failure, depression, diabetes, high cholesterol, hypertension and others, combined with patient education, results in improved outcomes.

The Personalized Medical Care model takes financial incentives out of the disease management equation and focuses care where it should be – on the patient. Personalized Medical Care strives to comply with the “best practice guidelines” that have been established to optimize the care of various medical problems. Topics

Do I need Health Insurance if I enroll with you?
Yes, Personalized Medical Care is a medical practice not a health insurance program. We advise patients to keep their HSA, PPO, Medicare or other insurance programs. Insurance is needed to help with the cost of tests, specialist care, hospital care, etc. You may decide to switch from a low-deductible PPO plan to a high-deductible PPO plan, the savings in insurance premiums will more than make up for the practice membership fee. A high-deductible insurance plan is designed for catastrophic healthcare, as insurance was originally meant to be.

Compare this to automobile insurance, which you similarly hope to never need, however you maintain on your car. You pay separately, as needed, for routine servicing (equivalent to a preventive care visit) and for mechanical problems (equivalent to an office visit for an acute illness). By not paying an HMO to manage your healthcare dollars you instead get to decide how you want to spend (or NOT spend) your healthcare dollars.

Your health insurance will also cover additional visits and procedures and testing that is not included in the annual fee. Additionally, you will use your insurance coverage for services outside my office such as specialist visits, hospitalization, labs tests, X-rays, and prescriptions. Topics

Will my private insurance reimburse my annual Personalized Medical Care fee?
In most cases it will not. However in some cases Personalized Medical Care fees can be paid for through Flexible Spending Accounts through employers. Health Savings Accounts can at times be used to pay for Personalized Medical Care fees. Members are advised to consult their human resources representatives at work, their FSA and HSA plan managers, their tax consultants or attorneys to clarify these issues in their particular circumstance. Topics

What about lab, x-ray, specialists’ fees and hospitalization?
Your Personalized Medical Care fee pays only for membership in the practice and for your periodic wellness exam and wellness tests. All other services are the patient’s financial responsibility, but are often covered by his/her health insurance policy, HSA or by Medicare. Topics)

Do you take my insurance?
We are providers for most major insurance plans, including Blue Shield, Blue Cross, Medicare, Tricare, and Aetna. However, it really makes little difference if we are on your plan or not. We will always take care of billing your insurance for you for covered services and we will accept their allowed amount as payment in full. You have the same co-pays and deductibles that you would have in any other office. If we are not on your plan, we work diligently to get paid by insurance and we make every effort to keep your out of pocket costs about the same as they would be if you saw an "in-network" provider. The key difference is that you pay the extra monthly fee to us for the premium, non-covered services. Topics

What if I have Medicare insurance?
Medicare will not be billed for the services that are included in the annual fee (the Comprehensive Preventive Medical Examination and Personal Wellness Plan) because they are not a Medicare covered benefit. Other services, such as follow-up office visits, will be billed as usual and co-pays and deductibles will remain unchanged. As in the past, you may use your Medicare coverage for laboratory tests, X-rays and diagnostic testing, other specialist physician services, and hospital services. Topics

What do I do in an emergency?
In any emergency, you should call 911 or go directly to the nearest emergency room. The emergency room staff can page the doctor. Other after hours calls are handled by direct cell phone contact with the doctor. We will attempt to do whatever is necessary to deal with your urgent after-hours problem directly. If we recommend you go to the hospital Emergency Room, we will be in close contact with the treating physician to coordinate your care. I am available 24 hours a day for consultation with emergency room personnel and for coordination of your care. Specialty referrals will be arranged with the emergency room physician if warranted. Topics

Will you really be available 24/7 to your patients?
Yes, I will be on-call for myself daily and will arrange coverage by a colleague only in very limited circumstances such as personal illness or travel out of cell phone contact. Topics

Are you concerned that you will burn out being on-call 24/7?
With fewer patients, it is possible to provide excellent preventive care and personalized, immediate urgent care. The number of calls outside office hours is minimized. Being available 24/7 is therefore not a burden. Furthermore, since my patients will know that they can easily reach me the next morning, the necessity for night calls is reduced. I trust that my patients will know when to call 911, when to call me for a less urgent after-hours problem, and when they can wait until the next morning.

When the necessity does arise, I will be available to respond without hesitation or fatigue. I want my patients to know they are able to reach me whenever they need me. I am confident they will not abuse that trust. Topics)

How do I reach my doctor after hours in case of emergency?
You will be provided with my personal cell phone number for emergency after-hours availability. If I am, momentarily, not available, leave a message and I will call you back promptly. Topics

What happens if I need to see a specialist?
We refer patients to specialists, and for laboratory and radiological services as needed. Naturally, our patients are free to see any specialist they wish any time they wish. We do suggest our patients allow us to help decide what specialists to see and to coordinate such consultations. In this way the most appropriate resource is used, the earliest arrangements are made, and your applicable medical information is sent in advance of your specialist visit. Often direct doctor to doctor discussion of the reason for consultation is done, before such consults. Coordination of follow-up after the consultation is also a high priority.Topics

Can I still see my gynecologist?
Of course, Personalized Medical Care does not wish to disrupt any medical relationship you already have with any specialist. However, we do offer fairly complete office gynecologic services if you wish to make use of them. Topics

What about the cost of prescription medicines?
Often we can start treatment with samples from the office. To the extent we have samples in the office we are happy to supply them to our patients. We work with patients to keep their costs down whenever possible. However, ultimately the cost of prescription medicines is the patient’s responsibility or covered by their insurance plan. Topics

What if I travel?
Major medical plans cover you wherever you are worldwide, as do most standard medical insurances. Medicare does not provide coverage overseas, however Seniors can get traveler's plans for about $50. We are also available 24/7 from wherever you are. Topics

What do I do if I become ill while out of town?
Call 911 if you have a life threatening emergency. Call us first if the problem is more minor. It is often possible to deal with your urgent medical problem on the phone, and most states will accept prescriptions called in from out of state doctors. In case you must seek care at an emergency room or urgent care center out of the area, be sure and give the hospital personnel our card, your detailed medical information can be invaluable to a doctor who has never seen you before. Topics

What about yearly PAP tests for women?
They are all totally covered. We do routine female physicals on a daily basis including PAP tests. If you want to have this done by an OB GYN physician, we will be happy to schedule it. The advantage of having us provide all of your primary care is that your health issues can be considered as a whole. Topics

Will you make house calls?
Yes, when medically indicated. Topics

What if I have to go to a hospital?
You can go to any hospital you want. You will be covered by your insurance or Medicare if you are over 65. Those with major medical insurance may have a deductible. Doctor maintains full staff privileges at St. John’s Regional Medical Center in Oxnard and Community Memorial Hospital of San Buenaventura in Ventura. Topics

Can I wait and enroll in Personalized Medical Care later?
By design, Personalized Medical Care is a membership practice with a limited enrollment. Once that enrollment limit is reached a waiting list will be established. Every effort will be made to accommodate interested patients, but the enrollment limit must be honored in order to provide excellent service to the existing enrollees. Topics

Contact Us
We are located at:
1901 Outlet Center Drive, Suite 220
Oxnard, CA  93036
Phone: (805) 988.4118
E-mail us at: alinemedical@yahoo.com

 

 

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