FAQs
Personalized Membership Care and You
What is Personalized Membership Care?
Personalized membership care is an exciting and rapidly growing model to provide primary care without the costly interference of health insurance companies. Instead, our patients pay us directly through a convenient and affordable flat monthly fee.
This allows us to keep our practice small and provide you with highly accessible, personalized, and preventive care when you need it. Our focus on ensuring a strong and satisfying doctor-patient partnership is the key to helping you stay healthy.
In fact, it's the way we've always wanted and expected to practice medicine.
How does our practice differ from the typical traditional practice?
You will see and feel the difference immediately when you visit us at Primary Care Partnership. Our reception area is relaxing and comfortable, and our office staff is friendly. You will experience very short if any wait times to see us. We can take the time to address your health concerns and questions; your office visits will never feel rushed. Because our practice is limited to just a few hundred, not thousands, of patients, we really get to know our patients so we can take a more proactive role in your health and wellness - and be there when you need us.
Our goal is to provide you and your family with an experience that will not just meet, but exceed, your expectations for a doctor’s office.
How does our model differ from concierge care?
Typically, a concierge style practice remains in the insurance network. They continue to be part of the traditional billing model, billing for office visits and collecting copays. They must follow the guidelines, mandates and rules set forth by the insurance company.
Concierge practices also charge a membership fee to cover benefits not covered by insurance, such as 24/7 direct access to your physician.
Our practice is the Direct Primary Care model. We are not affiliated with any insurance company or third party payer and do not receive income from claims billed. We are solely supported by our patient membership fees.
Without the interference of insurance companies, we are free to practice medicine directly with our patients. The welfare of the patient is the primary focus. Endorsed by the American Academy of Family Physicians, direct primary care practices provide personalized all inclusive care with many significant benefits not found in typical medical practices.
What does membership include?
Your membership covers all of the primary care services we offer in our office.
Also, we can provide care and care coordination by phone, email and text, including virtual visits when appropriate.
We are available to discuss urgent concerns nights and weekends when needed. We are working hard to create a practice where you can reach us when you need us, without having to jump through many hoops.
You will enjoy greater convenience and peace of mind. You may also find a reduced need for visits to specialists and the emergency department.
See the many services you will receive.
Who does this membership plan work best for?
People of all ages benefit from the value-added services we offer at Primary Care Partnership.
It works especially well for:
Patients desiring easy and direct communication with their doctor
Patients who want a doctor to address the root cause of illness, not just treat the symptoms
Those who want to take part in improving their health and staying well
Those with high insurance premiums, high-deductible health plans or no insurance
Appointments, Referrals and Care
What happens if I’m admitted to the emergency room or hospital?
This can be stressful and often confusing for patients and their families.
We will contact those providing your care to make sure they have the most accurate and up-to-date information they need to treat you. We will communicate with the hospitalist, review your plan of care, answer questions, and make recommendations when needed. As your health care advocate, we will communicate directly with you and your loved ones, and help you navigate the health care system.
Do you make home visits or nursing home visits?
We appreciate that it is often difficult, and even expensive to get to the doctor’s office. We will see patients in their home or nursing facility, rehab facility or ALF in medically appropriate situations, on a case-by-case basis.
What if I need specialty care?
As your primary care physicians, our comprehensive training allows us to handle most of your healthcare needs. However, if you do need to see a specialist we will help you find the right doctor and coordinate your care. When making referrals, we can consult with your specialist prior to your appointment, as needed.
After your specialist visit, we will follow up to discuss any questions or concerns you have, and arrange additional testing if needed.
What if I need urgent care?
If you have a life-threatening emergency, call 911 immediately. A family member or caregiver can call us later so we can be in contact with the emergency room.
For urgent problems that are not emergencies, you can contact us when you need to. Often, we can diagnose and treat your need without a visit to the ER. In fact, membership medicine has been shown to result in fewer ER visits for members because we can discuss your medical needs any time of the day or night. And you know you can see us the next day.
What if I need medical attention while I’m away from home?
You can speak with us wherever you are and we will help with any medical conditions that can be done by “virtual visit.” If you have a condition that requires in-person evaluation and treatment, we will direct you to appropriate nearby care, and coordinate follow-up when you return home.
What if my doctor is on vacation?
As a member of Primary Care Partnership, you are never alone. Even when out of town, we will still be available by phone for your urgent needs. You will be notified by email before any vacations. If we are not available, we will always have another trusted physician available to assist you for any urgent matters or to be seen in the office.
How Insurance Works in the Practice
Do you bill insurance plans?
We have chosen not to. Better than concierge medical care, ur practice is unencumbered by the constraints and limited reimbursement from insurance plans so that we may better serve and care for our patients. There will be no charge for office visits or co-pays. You only pay the membership fee.
Our model results in significant savings: money, paperwork and time. The membership fee allows us to keep our overhead low and our practice small, and work for our patients, not the insurance company!
Can you see me if I have Medicare?
Absolutely. Our practice is well suited to handle the more complex medical issues often associated with older patients. We can spend the time necessary to manage chronic disease and the use of medications, and work together to optimize your health and wellness.
Note: As we have opted-out of Medicare, it means neither our practice nor the member can submit a claim to Medicare for reimbursement for primary care. However, Medicare payment will continue according to your specific plan, without change for medications, blood work, imaging tests, specialty referrals and care, or hospitalization.
Do I still need to have health insurance?
Yes, you do. Our medical practice is NOT a health insurance program. It is very important to maintain insurance (and/or Medicare) to cover outside testing and specialists, as well as expensive, unusual and unpredictable events such as surgery, emergency care and hospitalization. BUT NOT for everyday preventive primary care. By providing you with extraordinary and connected primary care, your plan use can often be reduced.
The current insurance-based system makes primary care MORE expensive and difficult, and less effective too. Our practice does the opposite.
By charging a set fee, we can spend more time with you and focus on your individual health needs to maintain and improve your health. We want you to see us as often as you need to, because our goal is healthy and happy members.
What if I have an HMO insurance plan?
If you have an HMO and are interested in joining Primary Care Partnership, please call us at (508) 636-7893 to discuss how membership may work for you.
What if I have a work-related or motor vehicle accident-related illness or injury?
Primary Care Partnership does not submit claims to insurance companies. If you require care or treatment for a work-related or motor vehicle accident-related illness or injury and you wish to file a Workers' Compensation claim or a Personal Injury Claim for the medical services you receive as a result of the illness or injury, we would be happy to help you identify a health care provider who can treat your illness or injury and file the related claim or claims.
How to Join
How much is the membership fee?
Please refer to our Membership Fee Schedule
Can joining Primary Care Partnership actually save me money?
Many people find they can lower the cost of their total medical care by combining a high deductible health plan with a membership practice. Doing so makes joining this practice quite beneficial. Our type of practice is also a good fit for those who have no insurance.
Studies show that direct primary care can lead to:
Less dependency on medications
Fewer specialty referrals
Fewer emergency and hospital visits
Savings on labs and imaging
Less need for expensive test ordering
You won't have any hidden costs or bills that come to you after-the-fact from the office or insurance company. By switching to a higher deductible, lower premium plan, patients may save money.
Will I still benefit from membership even if I don’t expect to need frequent medical attention?
Absolutely. Besides acute care and chronic disease management, our focus at Primary Care Partnership is on screenings and risk assessments, and lifestyle modifications. We want to concentrate our efforts on your long-term health and wellness. We listen carefully to you to understand how your life, work and family may be affecting your health. Together we create a personalized plan to achieve and maintain your optimal health. Advanced diagnostic tests can help us identify risk factors and health issues before they cause disease, saving you money, time, suffering and higher costs in the long run. Unlike the traditional practice environment, we have the time to deliver this type of comprehensive and detailed care.
Is there a limit to how many patients can join Primary Care Partnership?
Yes. One of the most important aspects of personalized membership medicine is limiting the practice size to be able to devote more time and energy to each patient. Therefore, once we have reached our ideal practice size, we will establish a waiting list.
What if I want to cancel my membership?
You are welcome to cancel your membership after 3 months with 30 days notice. We will refund memberships paid for the full year at a prorated rate.
How do I become a member?
Please see our Join Us page for more information.
Please remember that space is limited and we accept members on a first-come, first-served basis. Once we fill all available slots, we will add your name to our waiting list, so we encourage you to act quickly.
I’m still not sure. Can we sit down and talk?
Yes. Call, email, or visit our Contact Us page. We are happy to also arrange a complimentary “meet and greet” with Dr. Cathy Hood or Dr. Karen Ottenstein before joining our practice.
Thank you for your interest in our medical practice. We look forward to hearing from you!