Frequently Asked Questions
Financial:
Why $100/month? That’s a lot of money!
A regular doctors visit without insurance in Ohio County can cost as much as $180. $180 for one visit! For the same price you can be seen multiple times for almost 2 months!
$100/month = $3.33/day (30 day average). That is less than the price of a cup of coffee or a pack of cigarettes.
WV Minimum wage is $8.75. Working for 22 min a day at minimum wage would pay for the membership. Your 15 min break/daily bathroom breaks could pay for your membership.
You are paying for increased access to your doctor that is often reserved for the famous or wealthy.
Average annual deductible for single coverage in 2022 was $1,763. In 2021 it was $1,669. https://www.healthaffairs.org/content/forefront/employer-health-insurance-premiums-steady-2022
Why a $100 registration Fee
Because my $100/month fee can be cheaper than going to an urgent care, some people may sign up and only pay once to get cheaper care, and then I never see them again.
I’m looking for a patient that wants to build a relationship with their doctor. For example: I just finished Residency training: during residency, I was responsible for answering night time and weekend calls from thousands of patients while their Doctor was sleeping or enjoying their weekend. Of the thousands of patients, I had no idea who most of them were other than a quick read of their medical records. Now I don’t know about you, but if I’m sick, I want to speak to my doctor. My doctor knows my medical history, knows my medications, and knows that I don’t typically call, so if I am calling, something must be wrong. And you can only have that type of insight if there’s a strong doctor-patient relationship.
I am limiting my patient panel to 500. If my practice is full at 500, and someone joins to get a cheap acute care visit and then doesn’t pay for the next 2 months, they could be taking the place of someone who wants to be in the practice. The $100 sign up fee filters this out.
About The Practice:
What is Traditional American Medicine all about?
T.A.M. is a Family Medicine practice that is affordable, accessible, comprehensive, and personalized. The focus is to provide quality healthcare at a reasonable price while granting patients better access to their Doctor.
What sets T.A.M. apart from other Family Medicine practices?
I have completely eliminated the bureaucracy. In refusing to recognize any interference with the sanctity of the patient-physician relationship, I have returned Family Medicine to its root values of clinical excellence and compassionate knowledge of every patient. In every aspect of Family Medicine care provided, we deliver affordability, accessibility, comprehensiveness, and personalization.
What kind of access to my Doctor can I expect?
The goal of T.A.M. DPC is to provide high quality Family Medicine with unheard of access where patients can speak directly to their Doctor. No front Desk Staff, no Medical Assistant, no Nurse, no Physicians Assistant, no Nurse Practitioner. When you call/text/email, the only person responding will be YOUR Doctor. This removes any chance of miscommunication or messages not being relayed to the Doctor. I have worked in multiple Family Medicine clinics and this happens all the time. I have been a Doctor who was not informed that a patient called and wanted to speak with me a week ago. When you call me, you get me.
What about referrals, testing or prescriptions?
Nothing changes. As your personal doctor, I will be able to coordinate appointments, and, to the best of my ability, will expedite the waiting time for the visit. When you see a specialist, it will be a normal visit using your Medicare, Medicaid, Medical Insurance or Medical Cost-Sharing Plan. We are then able to follow-up with you and your specialist about the visit. All studies are ordered and scheduled just like in any other regular Family Medicine practice. Your Medicine prescriptions go to whatever pharmacy you choose. It it that simple and seamless.
Will I still benefit from T.A.M. DPC even if I don’t require frequent medical attention?
The goal of T.A.M. DPC is to not just see you when you are sick, but to see you when you are healthy. We take our cars in to get an oil change and tires rotated, so why not treat our bodies half as good as we treat our cars? Every Patient is asked to be seen for an Annual Physical Exam, a Summer Skin Check, and a Winter Health Maintenance Exam. This allows me time to get to know my patients, and to catch things early. After all, if you only see your doctor once a year, there are 11 months out of the year where they don’t know how you are doing. Flying blind is not a recipe for success.
Is my membership to the T.A.M. DPC tax deductible?
Please consult with your tax consultant to clarify tax consequences in your particular circumstances.
Can children become members of the T.A.M. DPC?
Yes! We are happy to accept the children (birth to 17 years of age) of our enrolled patients. We do not provide routine vaccinations for children at the clinic, and instead we will write scripts for them to be given at your local pharmacy or public health department.
Can I contact my physician after hours?
By all means, yes! Because illness and injury do not respect regular clinic hours, you may call your physician any day, at any hour for urgencies. Always call 911 for medical emergencies!
What if I need medical attention while I’m away on a trip or I’m unable to leave the house and can’t come to my appointment in clinic?
We provide virtual visits if needed.
Are my medical records ever shared with insurance carriers or pharmaceutical companies?
At T.A.M. we believe in privacy. Unless you specifically ask us to share your medical records, they will remain between the Doctor and you, the Patient. For example: You may wish for your Doctor to perform a prior authorization and speak with your insurance company if they do not cover a certain medication or do not want to cover certain imaging.
How will I know if T.A.M. is the right Doctors Office for me?
Please schedule a FREE visit to discuss your needs for healthcare. It’s the only reasonable way to begin what, we trust, will be a long, productive, altogether healthy relationship. (This will not be a medical visit but a visit to answer remaining questions and see if this practice is right for you).
What hospitals do you go to?
You can go to the hospital of your choice. We are able to stay in contact with the hospital staff during your hospital stay so long as you provide them with our contact information and permission.
Does my monthly fee apply to my insurance deductible or can it be made tax deductible?
Your monthly fee does NOT count toward your medical insurance deductible. Please speak with your tax professional for further guidance.
What is Direct Primary Care?
Direct Primary Care is a nation-wide movement of Primary Care doctors who have disembarked from the insurance companies and their assembly-line model of medicine in favor of re-establishing the patient-doctor relationship. It is a form of concierge medicine but we don’t charge your insurance company. We operate on a monthly membership fee, much like a gym, which allows patients to receive unlimited office visits and access to their Doctor via multiple forms of technology (email, phone, text messages and through various forms used through the EMR ATLAS MD).
Why is a Direct Primary Care practice a better option?
Many patients today and in the near future will end up having high deductible plans, where the insurance won’t cover the first $2,000-$5,000 that they spend anyway, but with our membership model, they can maximize the amount of healthcare they get and minimize their cost to $1,200/year for a membership. In this new model of care, we work with our patients DIRECTLY through a monthly membership so they get unlimited office visits and virtual visits. There are NO CO-PAYS for anything in our office. Any procedures we can do in our office like: EKG, biopsies, cryotherapy, joint injections, osteopathic manual treatments (OMT), etc., are included in the traditional membership.
In addition, we can also get labs at wholesale pricing as well, which will be a substantial savings for the patient. We also have access to basic imaging for a cash price.
The most basic Family Medicine visit (Billing code 99213) in Wheeling, WV cost $192 without insurance.
An Urgent Care visit in Wheeling, WV costs $149-$249 without insurance
How do I join if the practice is full?
In order to provide the highest possible level of personalized, quality care to patients who choose our practice, we must limit membership.
As a result, once our practice is full, a waiting list will be established. As openings become available, you will be contacted by a member of our team regarding membership.
What costs are involved in becoming a patient?
There is a 1x sign up fee of $100 and then a monthly Membership fee of $100.
Alternatively, if you pay the Membership in full at signing, we will waive the sign up fee.
The will be additional charges in clinic for procedures such as joint injection where you will only need to cover the cost of the medications used.
Can you help with the costs of prescriptions? What about labs?
We have a contract with LabCorp to purchase lab testing at wholesale prices with these savings passed directly on to you.
Finally, we have a direct relationship for imaging studies at a cash price discount that we pass onto our members.
Much like a membership at Sam’s Club, membership in our practice gets you these cost-saving discounts on lab tests and imaging studies.
What happens if I need to go to the hospital or see a specialist?
At present, our patients, if hospitalized, are seen by the hospitalist. Perhaps down the road we may consider offering hospital care, but for now, we do not treat patient while they are in the Hospital. Our commitment is to help you avoid being hospitalized by early detection of disease and/or subtle signs that an existing disease state is worsening. Having a non-pressured doctor who is always available to assist in your health care is key to helping to reduce hospital stays.
We will still refer patients to specialists as necessary.
Insurance:
Does T.A.M. DPC accept health insurance?
No! And we consider that a good thing! Perhaps the most critical distinction of my Family Medicine practice is that it focuses on a direct, personal relationship between you and your doctor. That directness carries over to our business model as well. I forgo insurance payments in order to save my patients from the arbitrary, intrusive decisions that inevitably come with third-party payers. Furthermore, this direct membership arrangement frees us from the typical contractual agreements that prevent physicians from offering wholesale prices on laboratory tests and imaging.
Why would I become a patient of T.A.M. DPC if I already have insurance?
We accept all patients (insured, Medicare, uninsured, etc). We just don’t bill these third parties. But just because you have insurance doesn’t mean you still don’t pay twice. Each copay and office visit adds up. Remember, before Insurance even kicks in you will have to reach your deductible. So, you may SAVE money if you have insurance and join our practice!
Average annual deductible for single coverage in 2022 was $1,763. In 2021 it was $1,669.
click on the link: https://www.healthaffairs.org/content/forefront/employer-health-insurance-premiums-steady-2022
If I have Medicaid, can I still join T.A.M. DPC?
Yes! You need only sign a waiver declaring that neither you nor your Doctor at T.A.M. will directly bill Medicaid for our services. Medicaid will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by my office.
How does insurance work in all of this?
You should have some type of medical insurance or medical cost-sharing for any medications, ancillary testing, specialist consultations or hospitalizations that you may require.
How does this work with ObamaCare and the requirement for insurance?
As the Affordable Care Act was being drawn up, several doctors worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Care practices like ours to be a legal option under the health reform bill.
In short, the best option for many patients will be an "exchange qualified" major medical type plan combined with a Direct Primary Care provider like our practice. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients.
As a patient of T.A.M. DPC, will I still need health insurance?
Although health insurance is NOT necessary for membership, it is advised.
We encourage all of our patients to get some form of insurance to cover out of clinic expenses should something unexpected occur ex: you get in a car accident or suffer a heart attack.
Insurance will help cover costs associated with, but not limited to, prescription medications, labs, imaging studies (X-rays, CT scans, MRI's, etc.), specialist consultations, hospitalizations, and surgeries.
If you do NOT have Insurance you can still become a member and your Doctor will work with you to help stretch your Medical Dollars as far as they can go.
Are the membership fees reimbursable by my HSA/FSA?
You may want to check with your human resources department regarding the use of Health Savings Accounts (HSA’s) and Flexible Spending Accounts (FSA’s) as possible payment options for your annual membership. If you are unable to use these funds to pay for the annual membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for other services such as medications, Labs, imaging, or hospitalizations.
If I have Medicare, can I still join T.A.M. DPC?
Yes! You will need to sign a waiver every year declaring that neither you nor your doctor will directly bill Medicare for our services. Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain UNCHANGED and can continue to be used for all other medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations.