Bayside Family Practice, LLC
Easton's first Direct Primary Care!!

Bayside Direct

Direct Primary Care

 

Specifics of Coverage

In exchange for the monthly fee, the patient gets the following at no additional cost:

·         Office visits-wellness, acute care, disease management, sports physicals (DOT exams are NOT included as they require a special certification)

·         Ability to communicate with me and my staff via text messaging, email, portal

·         Access to me or my staff via phone, email, portal or text messaging including after hours

·         In office lab testing –urinalysis, strep test, pregnancy test, etc as available and appropriate

·        Coordination of care with specialists

Included in the monthly fee

·         Office visits-up to 8 per month

·         In office labs

·         Office procedures

·         Access.  They can access me via phone, text, portal, or email.  Since I no longer have to see them to get paid, I can handle many of their problems without requiring them to leave work or home or school.

Regarding insurance

The biggest difference between this type of practice and other is the monthly fee in place of insurance.  Why do this?

·         Provide excellent care regardless of insurance

·         Answer questions and handle problems without requiring an office visit

·         Spend more time with patients

·         Provide short wait times

·         Focus on what patients really want: less office visits, less drugs, less testing, less visits to the hospital

·         Be freed from burdensome documentation rules

·         Find innovative ways to meet patient’s needs like video visits

·         Negotiate lower cash rates for labs and radiology testing (in the future)

What about people who have insurance?

This fee covers only my services, not the cost of visits to the specialist or the tests I may order.  This means that insurance may still be needed or desired for much of the care that I may order. 

All patients, regardless of insurance status, pay the same monthly “subscription” for care and receive the same services.  No one is turned away for lack of insurance or pre-existing conditions. 

What about labs, prescriptions, or x-rays?

For patients with insurance, these things can be billed to your insurance by the lab, pharmacy, or radiology provider in the usual manner at your insurance negotiated pricing.  For those without insurance, or those that choose to NOT use their insurance, we will work to find ways to significantly reduce the costs of tests, labs, and prescriptions whenever possible. 

What about ER visits, hospitalizations, or visits to specialists?

Any other contact with the rest of the health care system will be covered as usual.  I will refer patients to specialists or for procedures as appropriate, and those providers will submit this to the insurance provider (if there is one).

Covered procedures and tests

·         Urinalysis

·         Rapid strep for strep throat

·         Urine test for pregnancy (up to 2 per year)

·         EKG (heart testing)

·         PFT (lung function testing)

·         Removal of warts

·         Collection of pap smear

·         Basic vision testing

Tests are performed at the discretion of the clinical staff

Patient will responsible for lab charges for any specimens sent to the lab for analysis. 

Monthly Payment Policies

This agreement works on a monthly payment system.  It is not a fee for service as is the relationship for most doctor/patient relationships.

·         The relationship between us and our patients is maintained by on time payments

·         Failure to pay monthly payments within a reasonable length of time is regarded as termination of our relationship

We have the following policies:

·         The practice requests that patients set up recurrent billing via automatic draft from credit card/debit card or funds transfer from a bank account/automated checking to ensure that payments are made on time

·         Credit card or debit card payments that are rejected will incur a $10 processing fee.

·         Checks will be accepted for payment if they are paying 6 months or more in advance.

·         Bounced checks will incur a $25 bounced check fee.

·         Failure to make your payment within 30 days of the final due date will cause the membership to be terminated.  In addition, if you desire to be seen after your subscription has run out then you have two options.  You can either catch up on your payments (including the 3 month buffer) OR you can pay the regular office visit prices.

Established patient

A person is considered an established patient in the practice when the following conditions are met:

1.       They (or their representative) have paid the registration fee, have signed the terms and conditions, and have sent in their registration forms.

2.       They have come to the office for an appointment in the last 2 years.

3.       They (or their representative) has signed the practice fee calculation agreement and paid their first three month advance payment.

Family unit

A family unit is defined as the members of a single household who are under direct care of the head of that household.  This includes:

·         Head of household

·         Spouse or partner

·         Children-biological, adopted, or those under the guardianship or the head of household or their partner

·         Children away at college/other school who are still considered members of the family unit

It does NOT include:

·         Grandparents or parents of the head of household

·         Non-family members living with the family

·         Family members living at another residence

Services

The following services are given to active member patients:

·         Office visits up to 8 per month at no additional charge

·         Office procedures and labs listed elsewhere

·         Phone/email/messaging

·         Coordination of care and record keeping

·         After hours care-answering phone calls and messaging as needed

Regarding hospital care:

The practice does not provide hospital care.  The doctors who work full time at the hospital will provide care while you are in the hospital or emergency room.

Registration fee:

You will need to pay for 3 months up front.  After the first month you will be charged your monthly fee on a monthly recurring basis.  You can leave the program at any time.   (When you give notice to leave you will have 2 months left of your subscription.)  If you leave the program entirely, either voluntarily or via nonpayment, then you cannot sign up again for a year from the date of termination, unless you pay for all the monthly fees between your lapse and the current date.  If you leave the program then your prices for visits return to the regular office charges.

Monthly subscription fee

The monthly fee depends on the age(s) of the member(s) in the household unit:

Age 30 and under:           $50 per month

Age 31 to 60:                      $60 per month

Age 61 and up:                  $ 70 per month

Family fee (up to 5 family members) $160 per month

A student who is away at college (who is not head of household) is discounted to $10 per month while they are away at college and out of the local area.

Service fees

Service fees include those fees for services outside of those covered by the monthly payment.  These include:

Lab tests sent out to the local lab, which are not billed to insurance

In office tests/procedures not covered by the monthly payment

Other services outside the list of covered services

Payment for these procedures is expected at the time they are performed.  The member gives the practice permission to send charges to the credit card/debit card on file.

Termination

Termination of the agreement between members and the practice can occur by the member or the practice in the following circumstances:

1.       The member patient requests in writing that the membership be terminated.

2.       The practice informs the patient in writing that the relationship is terminated. 

3.       The member is delinquent on the account.