Advanced Primary Care Management $20/month charge to medicare

[RetiredHappy]

I was curious if Reno had any concierge doctors and they do. According to my research, they charge between 100–200 per month.

If I had a lot of serious things wrong with me and went to a doctor a lot it might be worth it. But some years, I don’t even see my doctor once a year so it’s not worth it to me now.

I have alot health conditions that are not even very common, and having a concierge doctor to help navigate the top specialists is critical to my well-being, but I do alot of the leg work myself. My husband is abit more impatient than me, and when he wants to see a PCP, he wants to see the PCP now.

 

[Koolau]

The advantage of a good concierge doctor is that you can see the doctor same day PLUS their connection to the best specialists. It is really the network of specialists that give the best value, and sometimes being able to see the specialists sooner than when we call them to schedule.

That's the way my health care system w*rks. I have a PCP and he sends me to specialists within the system as needed. In essence my PCP is my concierge. If I have anything urgent, I can typically get into see PCP within a day or two.

 

[OldShooter]

I was curious if Reno had any concierge doctors and they do. According to my research, they charge between 100–200 per month.

If I had a lot of serious things wrong with me and went to a doctor a lot it might be worth it. But some years, I don’t even see my doctor once a year so it’s not worth it to me now.

We are with a concierge practice, which I selected after a lot of shopping. An important thing I learned is that "concierge" means many things. At one extreme was a solo doc who would not take medicare and left it to the patients to bill any insurance they might have. At the other extreme was a group of three docs embedded in a large health care organization but in a private office area with only two chairs in the waiting room. They would make house calls if necessary. Also, one of the docs would carry the group's cell phone 24x7. So, this is really caveat emptor territory.

 

[RetiredHappy]

That's the way my health care system w*rks. I have a PCP and he sends me to specialists within the system as needed. In essence my PCP is my concierge. If I have anything urgent, I can typically get into see PCP within a day or two.

A HMO like Kaiser has that too. Been there done that.

 

[Crewer]

I don't have 24/7 access to PCP team. I have a friend who pays much, much more for concierge service to get that (and probably other things). The other things I more or less have but haven't really tested since I don't have any ongoing or complex medical issues. My friend does. I can imagine that having 24/7 access to primary care with a doc/team who is well informed and involved with your treatment plan and specialists could cut down on very expensive ER visits.

 

[hesperus]

DW just noticed this, a $20.00/month charge to medicare for each of us. After talking with medicare rep. and then visiting the billing department at our primary doc's office it seems that medicare has changed their reimbursement model and has added a new program called Advanced Primary Care Management. Supposedly there won't be any charge to us but it is something we weren't told about by our doc.
This new program's services includes:
1. 24/7 access to our care team for urgent needs.
2. Communication through MyChart.
3. Offering Telehealth visits when deemed necessary.
4. Coordination of care with other providers and specialists.
5. Access to our individual care plan developed by our care team.
6. Scheduling routine appointments to monitor all health maintenance and our care plans progression.
7. Ensuring that we are up to date on preventative services (i.e. routine immunizations), medication management, and assessing your medical and psychosocial needs.
8. Various health reminders for preventative services like flu shots, colonoscopy, etc.

Has anyone else seen this? All 8 points above were always things we have been receiving. Granted we changed to this doctor this year from another practice.
Thoughts?

It sounds like your new doctor is billing for Principal Care Management or Chronic Care Management codes that Medicare started covering. Even if it doesn't cost you anything directly, they should have informed you before enrolling you in a specific management program. I'd ask their billing manager for clarification.