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In the Classroom

Concierge care is what medicine SHOULD be.

Frequently Asked Questions

Bottom Line: How is this different than a regular doctor?

Code 1 Concierge Care (age 5-64):

  1.  one simple monthly fee covers each and every visit. 

  2. Relaxed, unhurried visits.

  3. Fast appointment scheduling.

  4. Increased and better access to your doctor.

  5. A doctor who gets to know the whole you.

  6. A doctor who works for you and not the insurance companies. 

 

VS.

Traditional doctor's office (all ages): charges for each and every visit, including: 

  • Co-Pay: $10-$100 due at each appointment.

  • Unmet deductible costs: Up to several thousand per year.

  • Limited access If uninsured.

In order to pay the bills, a traditional office must schedule up to 20-50 appointments in a single 8 hour day. No wonder a traditional office is so rushed!

Complications of relying solely on Health Insurance-Dependent Care

Ask yourself what would happen if

  • Q:  your company changes insurance companies? 

  • Q: you change or lose your job?

  • Q: you decide to start your own business?

  • Q: What are the long-term financial consequences of paying for a “service” that often doesn’t deliver when it’s most needed? 

  • A: Most of the time the answer to all these is you have to start ALL OVER with another doctor.

    • Just like that, all of the trust, understanding, and comfort you had with your physician is gone.

Code 1 Concierge Care makes primary care what it should be: about YOU. For less than the cost of a latte per day, you have a relationship with a caring and highly skilled physician. One who will guide your care and help your journey to wellness.

How does concierge medicine work?

It's a monthly (or quarterly or annual) MEMBERSHIP based service. Depending on your age and needs, you pay one monthly fee which covers:

  • Unparalleled treatment

  • Cell phone access to your doctor

  • All doctor's visits

  • All telemedicine visits

  • Minor urgent care needs

  • All referrals

  • If sent to the ER or admitted, We will closely coordinate with the ER or hospital staff. 

  • Significant savings on

    • Labs​

    • X-rays, CT & MRI scans ((if not using insurance)

    • Procedures such as IVs, joint injections, lesion removals, biopsies, fracture management, and so on. 

Do you take insurance?

ONLY FOR REGULAR MEDICARE PATIENTS*

 

Accepting commercial insurance means increased costs (staff, equipment, software, and time) and decreased time for your needs

 

Moreover, it causes you more pain:

  • Surprise billing for non-covered costs

  • Hundreds to thousands in out-of-pocket expenses

  • Delays in care.

 

Our experience shows that you are happier and you get better care if we avoid the insurance company altogether. 

(*) Note that we are not contracted with Medicare Advantage Plans. Patients with this insurance plan will be subject to the regular monthly membership fee. There is a waitlist for Medicare patients at this time.

Wait. So you mean there are no co-pays?

NONE

 

Since we don't bill insurance, you don't have to worry about follow up billing from your insurance company. We also do not collect co-pays from Medicare patients (though Medicare may decide that you owe that amount). 

Does this replace insurance?

NO

Serious accidents and medical situations happen. In those cases, you will still need insurance in order to cover:

  • ER Visits

  • Hospitalizations

  • Many specialist visits

  • Outpatient procedures (colonoscopies, sleep studies, etc). 

  • Medications 

Nowadays, there are options other than traditional insurance.  Our friends at Ochna Health (in Georgetown, TX) were kind enough to put together this helpful guide to what are called “Health Sharing” plans. These are non-insurance based groups that agree to cover medical costs (subject to clear rules). My own family is covered by one of these plans, and depending upon your family’s situation, these can be a great choice for catastrophic care.

 

Note: Code 1 Concierge Care is not affiliated with these organizations.  

Concierge Care Sounds So Expensive

NOT REALLY

 

Consider this true story: 

 

A couple joins our practice.

 

Two years later on, they are traveling in Florida. Sunday morning, the wife (let us call her “Mary”) injures her hand the day that she is to fly back to Austin.

 

Concerned that she might have broken her hand, Mary and her husband called & texted, asking whether she needed to go to the ER. After some pictures and a brief phone call, they hopped on the plane home.

 

Immediately after touching down Sunday afternoon, Mary and her husband went straight from the airport to see me in the clinic. I was able to get her pain under control, splint the hand, and arrange for X-rays the next day, which showed a fracture. 

 

Texting my colleague, I was able to get Mary into the hand surgeon within 24 hours.  

 

Simply by being members of Code 1 Concierge care, Mary and her husband were able to completely avoid:

  • Waiting rooms & prolonged wait times.

  • Urgent Care or ER facility fees

  • UC or ER physician fees

  • X-ray costs billed under emergent rules (very expensive), instead of the relatively lower cost outpatient studies.

  • Insurance co-pay and deductible claims for my portion of her care. 

I strongly suspect that the money saved by this incident alone more than paid for their membership for the entire year. 

Ok. So how does this work if I have insurance?

Simple

 

  • Join the  Code 1 Concierge Care family

    • A) Transition to a catastrophic/high-deductible plan, which typically have VERY LOW premiums with HIGH deductibles. OR

    • B) Switch to a health sharing program like Samaritan or Sedera.​

      • Immediately save:

        • Hundreds per month 

        • Thousands per year 

    • C) Continue on with your current insurance plan. 

      • Start saving on co-pays, deductible costs over the course of each year.​

Keep that coverage for:

  • ER Visits

  • Hospitalizations

  • Some specialist visits

  • Medications 

A quick primer on insurance:

  • PREMIUMS (access to coverage)

    • Avg cost

      • (Indiv) $350/month x 12 months = $4,200

      • (Family) $550/mon​th x 12 months = $6,600

  • DEDUCTIBLE (annual cost)

    • The amount YOU pay BEFORE insurance kicks in.​ 

    • Avg cost

      • (Indiv) = $3,000/yr​

      • (Family) = $5,000/yr

  • CRAZY but TRUE!: Using your insurance is like constantly using your auto insurance. Eventually, your rates will increase. ​​

So what if I have to get labs done?

It's a simple process

  • We’ll fax an order to whichever CPL lab location is closet to you. 

  • When you’re ready, go to that lab and have your labs drawn. 

  • We email or call you with the results within 2-3 days of receiving them.  

Can I get a same day appointment?

In many cases. If that can't happen we'll see you the very next day.

What happens if I need X-rays, CT or other scans? 

We have contracted with ARA and other imaging centers in the Austin area to provide you extremely low cost, cash priced imaging.

For example (prices approximate): 

  • Ankle X-ray: $51
  • Chest X-ray: $56
  • Elbow X-ray: $58
  • Hand X-ray: $52
  • Knee X-ray: $78
  • Shoulder: $57
  • US Skin: $60
  • CT Abdomen/Pelvis: $350
  • CT Head: $248

So let's say that I twisted my ankle. How would that work?

If you think that it's an emergency, call 911 or go to the ER.

Otherwise:

  • Call us

  • We'll quickly order an X-ray at the most convenient ARA or imaging center in the Austin area.

  • You can often get the X-ray immediately. 

  • The result will be faxed to us, usually within the hour.

  • We can manage most injuries, including fractures right in the office. 

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