“Better informed consumers make better patients and unrestricted patients make better consumers.”
Payment & Refunds | Insurance | Medical Records | Services & Fees
About Payments & Refunds
Q: What forms of payment do you accept?
Visa, MasterCard, American Express, Discover and PayPal; or official bank issued check or traveler’s checks. Cash and personal checks are only accepted for established patients in good standing and must be approved in advance. For monthly Membership Plans, a major credit or debit card is required for the recurring charge.
Q: Can I cancel my Monthly Plan?
Yes, a Monthly Membership Plan can be cancelled after 4 months of continuous payments for any reason. Because professional medical services are unpredictable and my availability for questions is essentially 24/7, no partial month refunds or prorates will be issued. For example, if your plan renews on the 5th of every month and you cancel on the 10th, your membership continues until the 5th of the next month.
Q: Can I get a refund on an Annual Membership Plan?
A 90% refund is available for any reason for the first 30 days, provided you have not accessed services. If you have accessed services within the first 30 days and then request a refund, the equivalent pay-as-you-go rate will be used to determine your fee and then deducted from your payment to determine your refund. From 31 – 90 days, a 50% refund will be issued if we receive a written notice 30 days in advance. Beyond 90 days, no refunds are issued for yearly plans. Keep in mind, medical services cease on the date the refund is requested.
Q: Will you bill me?
No. Payment is always made in advance, or at time of services for acute injuries/illness. Payments can be conveniently made here on the website with any major credit or debit card or with your PayPal account. Collecting all fees at the time of service helps me keep my fees affordable.
Q: Where can I find a list of your fees and services?
Q: What if I have to reschedule an appointment?
No problem! Please try to give me as much notice as possible so we can open up your appointment slot to someone else. You can apply the full amount of the fee to a future visit.
About Insurance & related issues
Q: Do you accept Insurance?
“No. Happily, no. While the tender mercies of an insurance company might apply to the fixing of a damaged fender on your automobile, we see no reason for any insurer to have a voice about either the quality or the cost of your family’s health care. We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that inevitably follow with third-party payers.” quote from AtlasMD (www.atlas.md)
Q: What if I need an expensive test, will my insurance or Medicare cover it if you are my doctor and you don’t accept my insurance?
The answer is “Yes” in most circumstances. Ancillary services such as lab, x-ray, and MRI or CT fees are usually covered as stated in your benefit plan (EOB) as long as the order comes from a licensed physician. Always check with your benefits administrator to make sure before you submit to an expensive test or procedure. Exceptions to this might be in a situation where you are assigned a specific Primary Care Physician as a “gatekeeper” in an HMO. Or, if you belong to an ACO (Accountable Care Organization), please check first!
Q: Can I submit your fees to my insurance company to try to get reimbursed?
At your request, we will gladly provide you with a coded statement to send to your insurance company. Whether you are eligible for reimbursement will depend on the out-of-network benefits of your plan and whether you have satisfied your deductible. Keep in mind, based on current IRS guidelines, membership dues to a direct-pay practice are not a qualified expense when it comes to using your HSA. Fair market value statements for services rendered is a legitimate way to help you qualify to use your HSA.
Q: Will fees that I pay you count towards my deductible?
Yes. Generally speaking, legitimate medical expenses incurred outside of your “network” can be applied toward your out-of-network deductible and most all non-network expenses count toward your maximum out-of-pocket for the year.
Q: I am a Medicare recipient. If you are my doctor, can I submit your fees to Medicare for reimbursement?
Generally, no. I have voluntary dis-enrolled as it relates to billing of Medicare for my services; which means I never bill Medicare or file claims on behalf of patients. Most membership fee or yearly fees paid to a physician for ongoing care are not reimbursable by Medicare guidelines.
Q: I am a Medicare recipient. If I use you as my primary doctor, am I still covered under Medicare if I need to see a specialist or have surgery?
Yes. The fact that I don’t bill Medicare does not alter your coverage or eligibility for other participating Medicare providers or services.
Q: My co-pay is less than your fee, why should I use your services?
My services might not make sense for you. If you like the arrangement you have with your doctor, by all means don’t change. Keep in mind, your co-payments don’t go towards meeting your deductible, whereas 100% of my fee can be put toward your out-of-network deductible or toward your maximum out-of-pocket for the year. You’re going to have some amount of out-of-pocket expenses regardless, so you should get the best value for your money. Also, remember that I will never send you a bill and you never have to worry about rejected claims that you are responsible for.
Q: I take some expensive medications that are covered partially by my prescription benefit on my insurance. If you are my doctor, will my medications continued to be covered?
Yes, in most* situations you should be covered. As long as your policy is in force, your medications should continue to be covered, unless it specifically states in your policy that the prescriber must be a network physician, which is not common. Please check with your benefit administrator to be sure. *Special use or off-label drugs or medications that require pre-authorization could be a problem if you use a non-network physician.
Q: Your rates are very affordable, but what if I need lab tests?
Lab tests at Encompass are extremely affordable! I have been fortunate to partner with,PathGroup, LLC for my lab services.
Q: If I want to use my insurance, how do you deal with ordering labs or x-rays?
If you want to use your insurance for ancillary services, I simply write an order for the test and then you take the order to the provider of your choice and have the tests done. Keep in mind, in most cases you will owe co-insurance of anywhere from 10 – 30% of the charges. In some cases, if you haven’t met your deductible you could be responsible for the entire amount of the bill. My fees for lab tests are simple flat fees and there are never any surprise bills to worry about.
Q: Do you do stitches?
Yes! I have a lot of experience with suturing and care of wounds.
Q: Do you test for STD’s in women?
“Yes”, but it depends on the symptoms and circumstances. If the circumstances require a full vaginal exam, then “no”, but with lab tests available today, many STD’s can be detected with testing urine, in both males and females. Others minor vaginal infections, such as bacterial vaginosis, can be tested on a self-obtained vaginal swab or treated based on symptoms. A brief low cost video conference consult can usually determine if it is a problem I can handle for you. If your situation definitely requires a full vaginal exam, then I would refer you to a Gynecologic doctor or other appropriate facility.
Q: Do you test for STD’s in men?
Q: Do you do PAP smears or routine vaginal exams?
No, not at this time.
Q: Do you prescribe weight loss medication?
No. I want to see you get healthy and fit and STAY that way! Generally, medications for weight loss are not sustainable and long term results are not satisfactory. There are always better and safer ways to lose weight. I will be glad to help you devise a personal plan and even help you hook up with a nutritionist and exercise consultant.
Q: Do you treat chronic pain?
A lot of people suffer from chronic painful conditions, which can be very frustrating, debilitating and interfere with the joy of life. While I don’t prescribe narcotics for chronic pain, I will help you get to the proper pain management consultants in an attempt to manage your pain as safely and effectively as possible with minimal medications.
Q: Do you provide Hospice care or end of life care?
I want to be involved with established patients and their families to the fullest extent that they desire in end-of-life situations; I will do all I can to provide compassionate care and support in these situations. As far as more traditional Hospice services and interventions, I do not provide those services. Hospice services require a very high level of expertise that is best suited to specialists in that area.
About Medical Records and Administrative Issues
Q: Where are my medical records stored?
Your medical records are stored on a secure encrypted server. No one else has access to your full chart but me.
Q: How do I get copies of my medical records?
You would simply make that request in-person or fax needed signature/paperwork with name and address of person or facility receiving your records.
Q: How do I become a patient?
Q: What if I don’t live in Georgia, can you still be my doctor?
If you are here if Georgia on vacation or visiting friends or family, then yes, I can provide periodic care if you have something that comes up. I can only provide on-going long-term care to those with whom I can establish a bona fide doctor-patient relationship. That means you have to eventually be a resident of GA and live an area where it is practical to be able to meet periodically for examinations face to face. This is due to State licensing requirements and the importance of establishing a legitimate doctor-patient relationship that is consistent with professionally recognized standards.