Re: non covered benefits fee template

January 25, 2012

Not bad. You have my vote and encouragement.

-WK

From: Myria

Sent: Wednesday, January 25, 2012 2:14 PM

Subject: non covered benefits fee template

Well, I've just "jumped in" and decided to charge 100/person or 300/family yearly non covered benefits fee. So far the 7 patients I've talked to have received it well with a couple doing some bartering to cover it. I have not called the insurances but would like to have nice letter on my wall explaining it. Does anyone have a template I can use? (I can't figure how to get into the imp.org site -- been too long since I've been there.) Of course the longer I make the list the better sounding, right? I know it covers my 24/7 acess via home and cell phone and same day appointments (but will the insurances squak about that one?) ly I would rather do this than close the office or have to work somewhere else and that decreases my access to my patients. (Don't think the boss would like me calling my patients on there time if I worked elsewhere part time.) One local doc already works elsewhere to keep his office afloat and that is what his patients complain about. Another sold to a big group and now has to see 30-40 patients a day! Wish me luck! (feels like I did this very impulsively but now I'm gonna run with it =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19130)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19130)http://www.pctools.com=======

January 26, 2012

I worry that my seniors will leave -- I actually think it is too low for all I do but maybe managable by most of my patients. I always find that the poorest are the first to pay or to offer services in barter like my disabled family of two living on 9,000 a year total. I just want a nice long list of what I provide in services and that's hard because I would care whether I get paid or not. My patients don't pay me to care they pay for a service. (can't put a price on caring ) I think Ant said it well about why she doesn't do a NCBF. I know I will get defensive when someone challenges "why now?" and "you/ve always" so I'm hoping to get over it here on the list serve and keep moving forward. When I polled people 2 years

ago everyone was up in arms. So I dropped it. But now it's "help me keep this office open" and since the town people recruited me I'm hoping I won't see too many leave since that would be just the opposite of my intent. I also attached my letter to my new patient packet so it's "up front".

Thanks for the support.

To: " " < > Sent: Wednesday, January 25, 2012 4:01 PMSubject: Re: non covered benefits fee template

Myria,

Your message reads as though you feel guilty about taking this step. Now, I don't know what you charge your patients for visits (which could easily change the equation entirely), but if you plan to be providing top of the line patient care and service, I would be more inclined to question whether your fee is too small, not too large. An exception to that would be for your fairly healthy patients whom you aren't really going to be doing very much for either during or between visits. Even for them, however, you might still think of your NCB fee as what allows you to invest in the kind of overall infrastructure and 'maintenance' operations that allow you to maintain excellence without burning yourself out.

Ken

Well, I've just "jumped in" and decided to charge 100/person or 300/family yearly non covered benefits fee. So far the 7 patients I've talked to have received it well with a couple doing some bartering to cover it. I have not called the insurances but would like to have nice letter on my wall explaining it. Does anyone have a template I can use? (I can't figure how to get into the imp.org site -- been too long since I've been there.) Of course the longer I make the list the better sounding, right? I know it covers my 24/7 acess via home and cell phone and same day appointments (but will the insurances squak about that one?) ly I would rather do this than close the office or have to work somewhere else and that decreases my access to my patients. (Don't think the boss

would like me calling my patients on there time if I worked elsewhere part time.) One local doc already works elsewhere to keep his office afloat and that is what his patients complain about. Another sold to a big group and now has to see 30-40 patients a day! Wish me luck! (feels like I did this very impulsively but now I'm gonna run with it

January 26, 2012

Thanks.

To: Sent: Wednesday, January 25, 2012 5:24 PMSubject: Re: non covered benefits fee template

I agree, it may be too low, but you can always go up next year. My Aesthetician( they pay cash for all her services) said she thought 150$ for a year was reasonable for a good doctor, and that patients spend more every month on their cell phone or coffee bills.

CCote

To: Sent: Wednesday, January 25, 2012 1:04:20 PMSubject: Re: non covered benefits fee template

Not bad. You have my vote and encouragement.

-WK

From: Myria

Sent: Wednesday, January 25, 2012 2:14 PM

To: practiceimprovement1

Subject: non covered benefits fee template

Well, I've just "jumped in" and decided to charge 100/person or 300/family yearly non covered benefits fee. So far the 7 patients I've talked to have received it well with a couple doing some bartering to cover it. I have not called the insurances but would like to have nice letter on my wall explaining it. Does anyone have a template I can use? (I can't figure how to get into the imp.org site -- been too long since I've been there.) Of course the longer I make the list the better sounding, right? I know it covers my 24/7 acess via home and cell phone and same day appointments (but will the insurances squak about that one?) ly I would rather do this than close the office or have to work somewhere else and that decreases my access to my patients. (Don't think the boss would like me calling

my patients on there time if I worked elsewhere part time.) One local doc already works elsewhere to keep his office afloat and that is what his patients complain about. Another sold to a big group and now has to see 30-40 patients a day! Wish me luck! (feels like I did this very impulsively but now I'm gonna run with it =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19130)http://www.pctools.com/?cclick=EmailFooterClean_51======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19130)http://www.pctools.com=======

January 26, 2012

check out my website for the TANC fee www.MyStudioMD.comand you can check another local practice that just instituted something similar http://argyllmedical.com/advantage.htmlthis gives a good break down of all the things a doctor does for FREE!!!!! This practice gives their patient the options of per item or a yearly fee, I do not!Peace and Blessings!Dannielle Harwood, MDTo: " " < >Sent: Wed, January 25, 2012 4:06:21 PMSubject: Re: non covered benefits fee template

I worry that my seniors will leave -- I actually think it is too low for all I do but maybe managable by most of my patients. I always find that the poorest are the first to pay or to offer services in barter like my disabled family of two living on 9,000 a year total. I just want a nice long list of what I provide in services and that's hard because I would care whether I get paid or not. My patients don't pay me to care they pay for a service. (can't put a price on caring ) I think Ant said it well about why she doesn't do a NCBF. I know I will get defensive when someone challenges "why now?" and "you/ve always" so I'm hoping to get over it here on the list serve and keep moving forward. When I polled people 2 years

ago everyone was up in arms. So I dropped it. But now it's "help me keep this office open" and since the town people recruited me I'm hoping I won't see too many leave since that would be just the opposite of my intent. I also attached my letter to my new patient packet so it's "up front".

Thanks for the support.

To: " " < > Sent: Wednesday, January 25, 2012 4:01 PMSubject: Re: non covered benefits fee template

Myria,

Your message reads as though you feel guilty about taking this step. Now, I don't know what you charge your patients for visits (which could easily change the equation entirely), but if you plan to be providing top of the line patient care and service, I would be more inclined to question whether your fee is too small, not too large. An exception to that would be for your fairly healthy patients whom you aren't really going to be doing very much for either during or between visits. Even for them, however, you might still think of your NCB fee as what allows you to invest in the kind of overall infrastructure and 'maintenance' operations that allow you to maintain excellence without burning yourself out.

Ken

Well, I've just "jumped in" and decided to charge 100/person or 300/family yearly non covered benefits fee. So far the 7 patients I've talked to have received it well with a couple doing some bartering to cover it. I have not called the insurances but would like to have nice letter on my wall explaining it. Does anyone have a template I can use? (I can't figure how to get into the imp.org site -- been too long since I've been there.) Of course the longer I make the list the better sounding, right? I know it covers my 24/7 acess via home and cell phone and same day appointments (but will the insurances squak about that one?) ly I would rather do this than close the office or have to work somewhere else and that decreases my access to my patients. (Don't think the boss

would like me calling my patients on there time if I worked elsewhere part time.) One local doc already works elsewhere to keep his office afloat and that is what his patients complain about. Another sold to a big group and now has to see 30-40 patients a day! Wish me luck! (feels like I did this very impulsively but now I'm gonna run with it

January 26, 2012

Myria, YOU GO GIRL!!! I am wishing you wonderful results, both for the benefit

of your practice and as an encouragement for me to try the same thing, as I

think our patient demographics may be similar. I had already decided that I

will definitely try it if it looks like I am really going under, which may

happen soon. Be sure to keep some statistics for us.---Sharlene

>

> Well, I've just " jumped in " and decided to charge 100/person or 300/family

yearly non covered benefits fee. So far the 7 patients I've talked to have

received it well with a couple doing some bartering to cover it. I have not

called the insurances but would like to have nice letter on my wall explaining

it. Does anyone have a template I can use? (I can't figure how to get into the

imp.org site -- been too long since I've been there.) Of course the longer I

make the list the better sounding, right? I know it covers my 24/7 acess via

home and cell phone and same day appointments (but will the insurances squak

about that one?) ly I would rather do this than close the office or have to

work somewhere else and that decreases my access to my patients. (Don't think

the boss would like me calling my patients on there time if I worked elsewhere

part time.) One local doc already works elsewhere to keep his office afloat and

that is what his patients

> complain about. Another sold to a big group and now has to see 30-40

patients a day! Wish me luck! (feels like I did this very impulsively but now

I'm gonna run with it

>

January 26, 2012

Myria,Congratulations on "making the leap" to charge a non-covered benefits fee. It's probably the next biggest leap after deciding to start your own practice. It is taking a chance that your patients value you enough to be willing to pay extra for your services. It also means you are willing to let those who don't value you to go find another provider. Keep in mind when that happens, that the loss of a patient is an opportunity for you to add a patient who values your services enough to pay your fee. It is a step towards establishing your own self-worth, instead of letting others determine it for you (something a lot of us in primary care have trouble doing). Speaking of which, after first instituting my non-covered benefits fee in 2008, I decided to raise it for the 1st time this year up from $120 per family per year to $150 per family per year. I agree with that if you take Medicare, you must be careful in how you apply your non-covered benefits fee since it cannot be applied for ANY service that Medicare already covers. That is why I decided to opt out of Medicare completely in 2008 when I started my fee so as to make sure there would be no problem with them. I know this is not a viable option for most. Nevertheless, you may want to consider not charging your Medicare/Medicaid patients this fee, just to be safe. But that's just me. I know others on the listserv charge their Medicare patients a NCBF. Good luck! SetoSouth Pasadena, CA

Thanks! Those are the pitfalls I don't want to be caught in! Medicare giving me enough grief over home visits! To: Sent: Wednesday, January 25, 2012 9:18 PM

Subject: Re: non covered benefits fee template

Myria, you participate with Medicare, right? Especially if that is the case, you'll actually want the list of services covered by your fee to be SHORT. If even one of the items is considered a covered service by CMS, then the fee is clearly not allowed. Being on call and offering timely appointments are considered covered by Medicare, so your fee agreement should not mention those. My fee only officially covers filling out forms and management of problems by phone or e-mail that are not connected to an office visit.

Haresch

>

> Well, I've just "jumped in" and decided to charge 100/person or 300/family yearly non covered benefits fee. So far the 7 patients I've talked to have received it well with a couple doing some bartering to cover it. I have not called the insurances but would like to have nice letter on my wall explaining it. Does anyone have a template I can use? (I can't figure how to get into the imp.org site -- been too long since I've been there.) Of course the longer I make the list the better sounding, right? I know it covers my 24/7 acess via home and cell phone and same day appointments (but will the insurances squak about that one?) ly I would rather do this than close the office or have to work somewhere else and that decreases my access to my patients. (Don't think the boss would like me calling my patients on there time if I worked elsewhere part time.) One local doc already works

elsewhere to keep his office afloat and that is what his patients

> complain about. Another sold to a big group and now has to see 30-40 patients a day! Wish me luck! (feels like I did this very impulsively but now I'm gonna run with it

>

January 26, 2012

When trying to come up with services to include in our non-covered benefits fee

that won't run afoul of Medicare and other insurers, I think a cap on the number

of active patients in the practice would be one. I would say that one of the

benefits being paid for by the fee is to belong to a practice that has less than

1/2 (or 1/3, or whatever) as many patients as a standard family practice, which

allows patients better access and longer visits. I don't think any of the

insurers could say they already pay for that. Anyone see any flaws?---Sharlene

> >

> > Well, I've just " jumped in " and decided to charge 100/person or 300/family