Services

Also, what happens if your condition calls for an antibiotic? Can you remember the exact names and doses of the medications you take, so you can tell the healthcare provider? If not, will they end up prescribing something that reduces the effectiveness, or interferes with your other medicine? Or what if your symptom is cancer? What happens after you visit? Will you have the insurance necessary to make the recommended follow-up? Will your records be available, or will your Doctor be missing a vital piece of your medical history that might affect future diagnosis and treatment? Don't trade off convenience for piece-meal services which lacks real Continuity of Care that only comes with a Medical Home and a Doctor-Patient Relationship that has been cultivated over time. This is especially important for those with chronic medical conditions of following complicated treatment plans.

Fort Myers Family Medicine offers follow-up care, comprehensive physical exams, and diagnostic testing. This reduces the risk of missing signs of a serious illness, or being diagnosed with the wrong illness altogether. Here, at the Fort Myers Family Medicine/CYBER CLINIC, we give patients easy access for simple conditions, with the peace of mind knowing how much each service will cost.

The development, implementation and delivery of a comprehensive, high quality, and yet affordable healthcare product requires extremely complex data collection, intense risk assessment and actuarial/statistical analysis that defies comprehension by the average person. Only with this data collection can insurance companies calculate risk and provide healthcare coverage for catastrophic illness as well as preventative care and treatment of minor health problems, The trade-off between data collection cost and the benefit of comprehensive health care should not be construed as an issue of discussion here. The following paragraphs merely describes the rationale used at Fort Myers Family Medicine to arrive at the Elective Full-Pay cost out.

When a medical office files medicare, private insurance, health savings accounts, or high-deductible insurance claims, the following expenses are incurred:

1. Personnel IE; billing manager, billing claims data entry, CPT coder and collections manager. Usually services (salaries and benefits) of three to five different employees in a small-to medium sized medical office
2. Electronic claims management programs (billing software), DSL communication lines, "electronic clearing houses", computer hardware, computer software and hardware maintenance by IT (Information systems) technician support, computer and software training and updates for employees.
3. Office supplies (envelopes, stationary, printing supplies, ink), postage, postage meter lease, copy machines  (with maintenance, leases and charges for copy overages), HCFA (government approved) forms.
4. Time deterioration/decay of money due to A/R (accounts receivable) cycle time. For example the turn around time for a filed claim may be as short as two weeks (seldom), or as long as six months. A claim of $250.00 for services today that doesn't get paid for 60-90 days represents a loss of the use of that money without interest for 2-3 months. Immediate use and possession of $200.00 paid now at time of service may be more valuable/desirable than waiting six months for $250.00 (and the certainty that this service has indeed been compensated.)
5. Legal and consulting fees for contract review and negotiations.

When a patient has contracted with a "High-Deductible" insurance plan or a "Health Savings Account", to receive credit from the insurance company for that payment, the patient/medical office still incurs the administrative overhead expenses by utilizing expense categories # 1, 2, 3, and #5. When their deductibles are met and all payments (for contractually covered services) are the obligation of the insurer, then expense categories # 1, 2, 3, 4, and #5 are required for the medical office to collect it's payments for services.

BY Contrast, when an Elective Full-Pay patient pays either by cash, or credit card in full, at the time of service, expense categories #1 is 95% eliminated, #2 is 95% eliminated, #3 is totally eliminated, #4 is totally eliminated, # 5 is totally eliminated.
If payment in full is not possible, then a rate increase for the remaining debt is necessary as that debt will require utilization of the above expense categories.

What Fort Myers Family Medicine intends to do is bill the patients only for the practice costs they actually utilize, provide Transparency to assist the public with the transition to consumer-driven health care reform, and to avoid "cost-shifting".

Guidelines for e-visits:

1. E-Visits are available only to established patients who have previously received care from the physician's practice;
   
   
2. The patient initiates the process, and agrees to e-visit service terms, privacy policy, and charge for receiving asynchronous care from a physician or other qualified health professional;
   
   
3. Electronic communication occurs over a HIPAA - compliant online connection;
   
   
4. An e-visit includes the total interchange of online inquiries and other communications associated with this single patient encounter;
   
   
5. The physician appropriately documents the e-visit, including all pertinent communication related to the encounter, in the patient's medical/health record;
   
   
6. The physician or other qualified health professional has a defined period of time within which responses to an e-visit request are completed; and
   
   
7. E-Visits should be a payable physician service.

(December AAFP 2008)