Direct Primary Care

After extensive deliberation, I have made the decision to change the billing model of my practice to maintain personalized and patient-centered healthcare. I hope you’ll embrace these changes by joining my direct primary care model at Tree of Life Wellness, starting January 1st, 2024. By transitioning from traditional insurance plans, I aim to continue to provide exceptional, customized care.

Here are the key benefits of the new approach:

Three membership payment options to choose from, ensuring you get the care you need at a cost you can afford (see pricing below).
A transparent contract process with payment at the time of service for those plans with a pay per visit cost.
Streamlined communication, without the hassle of insurance billing and coding.
Inclusion of all brief communications in the monthly fee, making it even easier to stay connected.
Three-month advance notice for any fee adjustments.
Cancellation of your membership at any time with 30 days written notice.
Switching the option type of your membership once per year.

I would like to provide a more detailed explanation.

I understand the importance of personalized care, unhurried visits, and direct patient-doctor communication; many of you have also expressed appreciation for this type of primary care. By transitioning to a direct primary care model, I can continue offering these benefits without the constraints imposed by insurance reimbursement. Many private practice and integrative medicine doctors who provide personalized care do not accept insurance plans. This is because insurance reimbursement for the time and effort we provide for each patient is insufficient to maintain a practice. A conventional medical practice can get around this issue by having a much higher volume of patients, much shorter appointments, and less personalized care. I’ve worked in these practices and felt I was providing subpar medical care. That is why my own practice is mindfully unconventional.

The new model will help maintain the high level of communication and accessibility you’ve come to expect from me, covering many of those additional interactions outside of appointments.

I am committed to offering a personalized healthcare experience, and this change ensures the sustainability of my clinic. I understand that this might be a new concept for some, and Mary and I are here to support you through the transition with any questions or concerns you may have. I completely understand that this will not be an option for everyone and may not align with your concept or goals for cate with your primary doctor. If you decide to seek a new primary care provider, simply let us know by replying to this email.

I understand that many of you will have questions. Please reply to this email and be patient for a response. I will be collecting questions and for any repeats / those that apply to everyone, I will be sending out large responses. I hope that by giving everyone significant advance notice, there will be time for you to prepare for the changes or find a new primary care provider.

I ask that everyone choose a plan OR a new provider by October 31st, 2023. Reminders, contracts and further information will be forthcoming.

Thank you for your understanding and continued trust. I am excited to embark on this new journey as it, hopefully, ensures the sustainability of Tree of Life Wellness.

DPC Fee Schedule

Monthly fees:

Option A – Maximal, Includes up to 4 in-clinic or video visits per MONTH and up to 36 visits per YEAR. Additional appointments will be billed at $30 per 30-minute visit. (will be prorated/projected for 15 minute, 45 minute and 60 minute visits as needed)

Option B – Includes one in-clinic visit and three (30 minute) in-clinic or video visits per year, additional appointments will be billed at $30 per 30-minute visit. (will be prorated/projected for 15 minute, 45 minute and 60 minute visits as needed)

Option C - includes one in-clinic visit per year, additional appointments will be billed at $50 per 30-minute visit (will be prorated/projected for 15 minute, 45 minute and 60 minute visits as needed)

Even with the above plans, I will not have unlimited availability. Unlike more costly concierge medicine, I still have a limit on the times I am available for visits and communication but I will make every effort to accommodate patient needs. The shift to DPC is to maintain, not increase, my current availability.

For a small number of patients who see me on a consultation only basis AND have a separate PCP for urgent needs, well visits, etc, a pay per visit option is available:

Non primary care / pay per-visit-

$150 for 45 minute integrative consultation

$100 for a 30 minute follow up visits / lab review / plan review

This is NOT primary care. You cannot make these appointments if you require ongoing care including medication refills, screening tests, etc.
This does not include ANY communication outside of visits – no email, texts, message or phone follow ups (except as stated). All questions, paperwork and follow up must be completed in the time allowed.

Included in monthly fee – not charged as additional appointments

Brief calls, text, emails, portal messages (requiring <5 minutes of time)
Medication refills
Requests for referrals that do not require an appointment/exam
Requests for lab testing
Triaging urgent issues / need to go to ER
1-2 page paperwork or letters needed

All patients are required to be seen in clinic once per year to maintain active patient status.

One well visit annually is required for individuals 40+ due to yearly recommended screening discussions.

10% discount per member for individuals in the same household.

I reserve the right to indicate the need for an appointment OR recommend an adjusted option based on a patient’s communication needs.

I will do my best to be available after hours and on weekends but request that non-urgent issues be saved for weekday business hours.

You may adjust the option of your membership ONCE per calendar year.

You may cancel your membership at any time – please provide a 30 day written notice.

Superbills will NOT be provided as I will not be doing any kind of insurance coding.

Frequently asked questions:

- What happens with labs? Imaging? Referrals to specialists or physical therapists?

-- This will not change at all for you. The lab, hospital, or specialist will get my order and bill your insurance as they always have.

-- Certain plans, such as Blue Care Network, require that your in-network PCP write referrals, but as I have never been a BCN PCP, I have never been able to write referrals for those folks. Similarly, folks on Medicaid who get prescriptions from me will still have to pay out of pocket for those prescriptions. Many DPC doctors work with labs and pharmacies to get discounted pricing for members and this will be something I will be looking into.

- Can I use FSA/HSA funds to pay for your services?

-- It is imperative that you speak with your insurance provider for HSA and accountant for FSA funds, in speaking with other DPC doctors, it should not be an issue to use these accounts to pay for the monthly fee and per appointment fees. A letter of medical necessity can be provided as needed.

- Do I have to pay monthly or can I pay the year in advance?

-- You can pay for the year in advance and receive a 2.5% discount.

-- If you pay monthly, you are required to have an active card on file for auto-billing.

-- If you have a fee per appointment, payment is expected at the time of the service.

- Do all members of the family have to choose the same option, or can we choose different options based on need?

-- Family members can definitely choose different options based on need.

- Is there a discount for large families?

-- Families including 4 or more individuals who are my patients can receive an additional discount. Please email me directly for rates.

Contract