1. How does your medical practice differ from a traditional practice?
Personal Physicians of Connecticut, LLC (PPC) employs a unique type of medical practice design that allows physicians to limit the size of their practices to several hundred rather than several thousand patients. This reduced practice size enables us to offer same-day or next-day appointments with little or no waiting time, longer and more relaxed patient visits, dramatically enhanced access (i.e., 24/7 direct physician cell phone availability) and other important healthcare amenities.
2. What is the mission?
PPC seeks to provide intensive primary medical care for patients by offering preferred physician access and exceptional service.
3. Who will serve as the covering physician when my physician is not available?
During the infrequent times when one of us may either be unavailable or on vacation, we will serve as the covering physician for each other’s patients. For practical reasons each of us must reserve the right to designate another qualified physician to perform any and all services should the need ever arise.
4. Do I still need health insurance if I enroll with you?
Yes. Membership in PPC does not take the place of health insurance coverage. PPC is a primary care medical practice, not a health insurance program. We strongly recommend that our members maintain health insurance coverage for all of their healthcare needs.
5. Will my health insurance plan still be billed for my office visits?
Since PPC will not be participating with any commercial or government-sponsored health insurance plans, we will not bill them for any of the services we render. If, however, your health insurance plan provides coverage for “out-of-network” services, our office will be happy to provide you with the necessary documentation to submit to your insurance carrier so that you may obtain reimbursement for our per-visit fee.
6. Is there a copay at the time of an office visit?
No. Since we will not be participating with commercial insurance plans, we will no longer collect copays. The total charge for medical care during each office visit will be a flat, per-visit fee. (Please contact our office for more details regarding this flat, per-visit fee.)
7. Will you still be a Participating Provider for Medicare?
No. As of April 1, 2007 we no longer participate in the Medicare Program and have opted out of the Medicare Program.
8. If I am a Medicare beneficiary, may I still join Personal Physicians of Connecticut, LLC?
Yes. Patients with Medicare insurance coverage may still receive all of the same services that we provide to non-Medicare patients. However, Medicare patients must sign a waiver in our office acknowledging that we, as physicians, may not bill Medicare for our services and that they, as patients, will agree not to seek compensation from Medicare for such services.
9. Will my private insurance reimburse my annual fee?
It is unlikely that this service will be reimbursable. However, certain Health Savings Account (HSA) and Flexible Spending Account (FSA) plans may be used to pay for all or part of the fees for physician services. Members should consult with their human resources representative at their place of employment, or their HSA or FSA plan managers.
10. Is the annual fee tax-deductible?
Patients are advised to consult with their tax advisor or accountant to clarify whether such qualification applies in their particular circumstance.
11. What about coverage for laboratory tests, x-rays, specialists’ fees, and hospitalizations?
All medical services that are currently covered outside of our office by your health insurance plan should not be affected by our change of insurance status, and will continue to be billed directly by the performing entity. (The only exception to this rule is an HMO-type health insurance plan, which requires that such referrals be made only by “in-network” physicians. Please check with your health insurance plan to confirm that you are not currently subject to this restriction.)
12. Will I be required to pay my annual fee even if I do not use your services?
Yes. Paying your annual fee allows access to the practice, regardless of whether you are sick or well. We strongly encourage you to utilize the amenities offered, including preventive health consultations and e-mail communications for appropriate, non-urgent medical questions.
