Charging and Billing for Direct Care Services

So I’ll handle billing internally, then? No third party?

If you have an EMR that allows you to handle billing from right inside your clinic (which we strongly recommend!), then you’re in charge of your revenue stream. EMR, for example, is built for doctors practicing a subscription model of care with additional costs. Subscribers will be billed monthly and sent an electronic monthly statement indicating any additional charges. On top of that, tracks phone/text/email correspondences by patient, so that everyone knows how much of your time has been allocated to their care.

Basically you’re taking this huge thing called billing and breaking it down into small, automated, manageable steps. So manageable, in fact, that when you use the in-app billing feature, you’ll only need the help of a part-time accountant; the EMR takes care of the rest.

If this sounds too good to be true, take a minute to consider how it’s possible.

  • The EMR helps you get the details set from the beginning. When you set up a brand new patient, you enter all their information, including how much they’ll be billed monthly, and whether or not this will automatically adjust based on their age, or if you’ll make those transitions manually.
  • There are no third-party insurance companies muddling things up, so your billing correspondence goes straight from you to your patient and vice versa.
  • Your patients’ invoices will include the monthly charges for the upcoming month as well as the incidental charges from the previous month. Payments can be applied at any time during the month, and the charges will automatically adjust. Any employee discounts will be applied at the end of the month, and you can opt to send out invoices automatically.
  • You can choose which day of the month your patients are billed on.
  • Your clients will receive automatic notifications regarding payment confirmation or an unsuccessful transaction (expired card, declined card, insufficient data, etc.).

What is the best way to handle quarterly, bi-annually, and yearly payments?

We strongly recommend monthly payments because they will help you with the incidental fees of medications and labs. Typically we recommend that physicians bill monthly so that they can include the medications and labs in the monthly invoice. This is much simpler for them and much easier for you. In this way, we can automate a lot of the tasks of invoice creation like sending payment capture, notification for successful and unsuccessful payments etc.

Features, features, features

The following features are typically included in the monthly membership fee, although you have the final say on what you choose to offer.

  • Unlimited access to your doctor. Literally. After hours, weekends, holidays- there’s no bad time to receive excellent medical care.
  • Extended, relaxed visits. You won’t feel rushed through an appointment, and there’s never a question you won’t have time to ask. Part of the relationship you’ll build with your doctor is based on your understanding of your care. Now that’s what we call personal healthcare.
  • Same-day and next-day service scheduling. Because our physicians have reserved their time for a select few, there will be no “squeezing you in.” You’re a priority, and you’ll feel like one.
  • House calls. You can choose to come to our office, or the doctor will come to your house at no extra cost, of course. You set the terms based on your comfort level.
  • Full access via technology. You’ll be able to reach our team and get other medical information via webcam, email, text and more. The sky is the limit.
  • An annual physical. This exam will be fitted to your personal medical needs. It’s all about you and your specific goals for wellness.
  • Diagnostic and procedural benefits at no extra costs. EKG, Holter Monitor, DEXA Scan, Body Fat Analysis, Spirometry, Breathing Treatments, Cryotherapy, Lesion Removal, Laceration Repair, just to name a few.
  • Wholesale labs and medication costs. DPC passes benefits right on down to the patient.

Sure, we’ll share our prices with you!

Seriously, you can’t beat our prices on panels, tests, procedures and prescriptions. Well you could, but we wouldn’t advise it. Keep in mind that Atlas MD’s subscription model might vary from yours. In our case, we’re charging monthly for a principal service that includes 24/7 access to an exclusive doctor who sees no more than 500 patients. Phone calls, text messages, select procedures (abrasions, incision and draining and more) are all included.

From there we charge for prescriptions, tests and panels. But look at the difference between what you’ll pay in a traditional model. Even with insurance, these items get insanely expensive. Take for instance a B-12 and folate test. We can charge $12.00 a test and still make money. Meanwhile, the market is charging $138.50 at retail. And that’s fine, we guess, if patients have met their deductible and have premium coverage. But if they’re still meeting their deductible, that’s a ton of cash to drop for one test. That might dissuade people from having the test performed at all.

And a final thought: most panels need to be done yearly, and some only in special cases like a pre-existing condition. Patients can subscribe to our model and have every panel and test done once, and add in a couple of prescriptions with a pill a day and still pay less than just their premium on a PPO. Now if patients had a wrap-around insurance plan or HSA that covered emergencies. Yes, it would include a high deductible, unfortunately, which is similar to your car insurance where you have to pay the first $500-$1,000 even if the accident is someone else’s fault. You might find that these low costs negate even having the high-cost insurance plan, to begin with.

But what if patients are getting insurance coverage through an employer? Then that gets interesting. Concierge medicine is here. And we’re affordable. Wouldn’t it make sense for employers to start sending employees to us? They’re businesses after all. They’re trying as hard as everyone else to cut unnecessary expenses. And there are cases popping up where this is happening. But we believe it will take more doctors making the leap of faith and increasing the supply of the concierge service to tip the scales in our favor.

And yes, we made a big claim up at the top. But we’re proud to be transparent. Here’s a complete cost breakdown of our services, along with a retail comparison.

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What's next?

Now that you have an idea of what to charge for your services and how to make your business model work for you, let’s talk about something else that will bring in revenue and save your patients money. Running your own in-house pharmacy! Running your own in-house pharmacy can be much simpler than it sounds, and just think how much your patients will enjoy skipping the long pharmacy lines! You can send them home from their appointment with their medication in hand. Find out how in the next section of the Direct Care Curriculum.