Concierge Care Services

Barry Rotman office

Concierge Care Services

Services Included as Part of Annual Fee*

Comprehensive annual medical examination (under age 40 will be every 24 months or as deemed necessary).

This is an extended exam, not in connection with any illness or injury, done annually to review all aspects of your health and wellness. After a thorough physical examination, I will discuss any current medical issues and, as appropriate, any psychological or social issues in your life. We will review a battery of screening lab tests and possibly x-rays as appropriate for your age and gender. All lab tests will be done at a lab facility and billed directly to your insurance and are not included in the annual fee. A detailed list of signs and symptoms that can be early warning signs of disease will be reviewed. Furthermore, this visit will include screening and recommendations for proper nutrition and exercise to encourage weight control and a healthier lifestyle.

You will be encouraged and reminded by my staff to schedule this annual exam each year.

I hope that by offering an annual comprehensive wellness exam as part of your annual fee,* it will encourage you to safeguard your health on a regular basis. I believe this comprehensive physical examination is vital for the physician-patient relationship and creates a solid foundation for future care.

Same-day or next business day appointments will be offered.

With the exception of your annual exam, this feature is available even for minor and non-urgent medical problems.

Little or no office waiting time, and typically longer appointments when needed.

Comprehensive exam appointments will be scheduled for one hour and all other appointments for 30 minutes, eliminating the time pressure of moving from patient to patient.

Strong focus on preventive medicine and long-term health and wellness.

My philosophy is to teach and educate you on your personal medical needs and risks. This will empower you to take an active role in managing and maintaining good health.

Direct phone access to my assistants and to me, during office hours.

All phone calls will be returned promptly. However, if you deem your problem “urgent” I will make every effort to speak with you at the time of your call.

My personal cell phone number will be provided.

This will allow easy access to me for urgent medical problems that occur outside of my regular office hours. Ideally, I want to hear from you when you are ill or injured before you go to the hospital or an urgent care center, or immediately after you have called paramedics.

State-of-the-art communications.

I want to be involved in all aspects of your care. We can use email and/or cell phone technology to review emergency room and specialist visits or other quick/non-urgent questions that do not require a trip into the office. Because of privacy concerns, we will develop specific guidelines for what is appropriate use of these media.

Specially trained staff dedicated to your care.

My staff members are an important part of my practice. They will have the expertise to advocate on your behalf and will continue to facilitate your encounters with other aspects of the medical community.

Insurance Information

PPO Patients:

I will be an ‘out-of-network’ provider for most plans. Regardless of your plan, we will continue to bill your insurance for all covered services.  It is our intention that no insurance-covered medical services are included in your annual fee.

Traditional Medicare Patients:

I am a Participating Provider in the Medicare program. We will bill Medicare on your behalf for Medicare-covered services. The annual fee only includes services that are not covered by Medicare and as such will not be billed to, paid for or reimbursed by Medicare. Beginning on January 1, 2011, Medicare will cover an annual ‘Wellness Evaluation’. This examination will be billed to Medicare. You will be given a refund against your annual fee equal to the amount billable to Medicare for the annual ‘Wellness Evaluation’. Your annual fee is for Medicare non-covered services only.

HMO/Medicare HMO Patients:

I will not participate in any HMO plans. HMO patients will not be able to join the practice until they transition to either a PPO or traditional Medicare plan.

*For Medicare patients, beginning on January 1, 2011, Medicare will cover an annual “Wellness Evaluation.” this examination will be billed to Medicare. You will be given a refund against your annual fee equal to the amount billable to Medicare for the annual “Wellness Evaluation.”

Concierge Care FAQs

Q. What services are provided as a part of my annual fee?

A. Please see Concierge Care for a complete list of offerings and amenities.

Q. What is the mission of Barry Rotman MD, Inc.?

A. I strive to provide the highest quality medical care, emphasizing a comprehensive approach to prevention and disease management. I want my patients to be completely satisfied with every aspect of their care.

Q. Are you on the medical staff of a hospital?

A. Yes. I am on the medical staff of John Muir Hospital. If you require hospitalization, I will make daily visits and coordinate your inpatient care working with physicians who are based at the hospital.

Q. Who will cover for you when you are not available?

A. On the infrequent occasions when I am out of town or otherwise unavailable, I will have another concierge quality physician cover for me. Even while out of town, I will generally be available by phone to my patients and to my covering physicians. For practical reasons, I reserve the right to designate another qualified physician to perform any and all services should the need arise.

Q. Do I still need insurance if I enroll with you?

A. Yes. Concierge medical practices do not take the place of general health insurance coverage. My practice is a primary care medical practice, not a health insurance program. You are advised to continue your PPO, Medicare or other insurance program.

Q. Will my insurance still be billed for my office visits?

A. Yes. I will bill your insurance company directly for office visits. Office visit charges, with the exception of your annual wellness exam, are not included in your Barry Rotman MD, Inc. annual fee.

Q. Are you a Participating Provider for Medicare?

A. Yes, I am a Participating Provider with Medicare and will bill Medicare on your behalf, as required by law.

Q. Do you bill Medicare for the annual concierge fee?

A. No. The annual concierge fee only includes services that are not covered by Medicare and, as such, cannot be paid for or reimbursed by Medicare. I will bill Medicare for your sick visits and for any additional services performed at my practice that ARE covered by Medicare.

Q. Will my private insurance reimburse my annual concierge fee?

A. It is unlikely that this service will be reimbursable. However, some Flexible Spending Account and Health Savings Account plans may pay for all or part of the annual fee. Members are advised to consult their human resources representative at their place of employment.

Q. Is the annual concierge fee tax deductible?

A. Patients are advised to consult with their tax consultant to clarify qualification in their particular circumstance.

Q. What about lab, x-ray, specialists’ fees and hospitalization?

A. Your annual fee pays for membership in the practice, for your annual wellness exam, and for many other amenities listed here. However, all other procedures and services not performed in my office will be billed by the performing entity.

Q. What if I have an emergency?

A. If you have a life threatening emergency, call 911 immediately. After you call 911, please call me. I will attempt to coordinate your emergency care thereafter. Patients are asked to contact me before going to any urgent care facility and at any time of the day or night. I will attempt to address urgent after-hours problems directly.

Q. What do I do if I become ill while traveling or away on an extended vacation?

A. Call 911 if you have a life threatening emergency. Then call me. Call me first if the problem is minor. With the exception of a few controlled substances, most prescriptions can be ordered anywhere in the country. If necessary, it may be possible for me to find you a resource where you are for care. If you seek care at an emergency room or urgent care center out of our area, I request that you have the doctor seeing you call me for coordination. I will be readily available for phone consultation with you and/or other health care personnel. If you should require hospitalization while away, at your request, I will establish phone communication with you and your attending physician(s) to ensure continuity of care.

Q. What if I need to see a specialist or a surgeon?

A. Of course, my patients are free to see any specialist they wish. I am available to help you 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.

Q. What about the cost of prescription medications?

A. The cost of prescription medications are the patients’ responsibility and in most cases should be covered by their insurance plans. We have expertise in assisting patients in purchasing medications in the most cost effective manner.

Q. Will I be required to pay my annual concierge fee even if I do not use your services?

A. Yes. Paying your concierge fee allows you to be a member of the practice whether you are sick or well. However my practice is not an insurance company and does not cover the medical services you receive. I strongly encourage you to utilize the amenities offered including wellness consultations and emails for appropriate non-urgent health related questions, regardless of your state of health.