Services and Fees
Our practice is based on a fee-for-service philosophy. Your health care insurance can be used for all services you might require--except your physician visit(s). The physician's fee is based on a cash (credit/debit card, HSA card or cash) basis. We believe our services and fees provide excellent value especailly when the full cost of insurance--deductables, co-pays, etc. are understood. Our approach keeps physician's services reasonably priced for those with and without insurance.
We request payment at the time of service. After your appointment "check out" is completed by documenting the services provided and processing your credit card payment using credit card information on file. A consultation summary and "super bill" are provided at the end of your Initial Consulation. The "super bill" includes information needed for you to submit an insurance claim (level of visit, ICD code, Tax ID etc.).
Follow-up care. At the end of your Initial Consultation a follow-up strategy is discussed based on the preliminary diagnosis and patient needs. The two strategy options are Fee for Service or Memberships.
Services
Our practice serves patients of all ages with consultation and management of:
- Sleep disorders across the full range of types and manifestations.
- General pulmonary disease.
- Acute Covid and Long-Haul Covid and Covid vaccine related illness.
- Patient and family Healthcare Advocacy Services
Fees.*
Initial Consultation. ALL new patients are scheduled for an initial 60-minute appointment. At the end of the initial consultation a follow-up strategy, based on the evaluation outcome and preliminary diagnosis, is developed for follow-up care using a Fee-for-Service or Membership approach based on the patient's needs. Cost: $250
Fee for Service
1) Follow-up consultation. Scheduled for 60 minutes and includes a consultation summary and "superbill." Consultation does not include discounted x-rays, medications, ongoing communications or prescription refills. Cost: $175
2) Telephone follow-up consultation (as needed). 3$ per minute--$25 minimum.
3) Home sleep test (2-night)--adults. Includes a 2-night test, test equipment, supplies, test analysis, and discussion of test results. Cost: $250
4) Home sleep test (2-night)--pediatric. Includes a 2-night test, test equipment, supplies, test analysis, and discussion of test results. Cost: $250
5) Baseline Spirometry Pre/Post-bronchodialator spirometry. Cost $60 / $100
6) Healthcare Advocate consultation. (60-minute consultation). Cost: $250
7) Covid services. (Acute care, Long-Haul, and post-vaccine adverse event care). Prices vary: Prophylaxis-$75, Current Illness w/o risk factors-$125, Current illness w/risk factors-$250. All “Long-Haul” Covid and vaccine related care require ongoing Management Membership--see below.
8) Access to discounted lab fees. Cost + 40% ($20 minimum)
Memberships. Memberships are appropriate for some diagnoses and are evaluated after the initial consultation. The two categories for membership are Active Management and Maintenance Management as described below.
Active Management Membership. 4-month (minimum) subscription at $175/mo. Includes:
1. Follow-up visits (4 each at 30-60 minutes).
2. Ongoing communication via phone, text, email, telehealth.
3. Access to discounted lab fees, x-rays, and medications. Lab fees: Cost + 20% ($15minimum)
4. Discounted pre/post bronchodialator spirometry if needed. $60
5. Script for refill of prescription.
6. Pre-authorization of medications and studies ordered.
7. Calls and letters to school and/or health care provider for accommodations.
8. Consultation /coordinaton of care with other healthcare providers.
9. Review of outside medical records.
Maintenance Memberships. There are two Maintence Membership options available.
Stable Care. This is the most common level of Maintence Membership needed for most patient's care. It requires a 6 -month (minimum) subscription at $65/mo. It included:
1. One Follow-up visit every 6 months (30-60 minutes)
2. Ongoing Communication as needed via phone, text, email, telehealth.
3. Prescriptions as needed.
4. Prior authorizations for medications.
5. Pre-approval already in place but needs update with minimal documentation.
Complex Care. This membership is appropriate for patients needing multistep preapprovals for medications (letters, phone calls, and clinical documentation) often associated with narcoleptic patients. Minimum 6-months @ $75/month. It includes:
1. One follow-up visit every 6 months (30-60 minutes as appropriate)
2. Ongoing communication as needed via phone, text, email, telehealth.
3. Calls and letters to school, health care provider for accommodations.
4. Controlled substance prescriptions every 3 months.
5. Pre-approval already in place but needs update with minimal documentation (one is included)
6. New approvals (e.g. changing insurance company) requiring long multi-step process. $175
* fees subject to change without notice