FAQ's
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Membership
The membership fee allows us to provide the vast majority of a person's primary care in an innovative way for a simple, fixed price. Much like Netflix or a gym membership, it allows members to better budget their healthcare finances without worrying about extra costs, co-pays, and deductibles for routine care.
We do not think of our services as “extra” but rather an independent, alternative, and better way to do your primary care. Most of our members save money when combining ORFM with a high-deductible health insurance or medical cost sharing plan (vs. standard low-deductible/"copay" insurance plans).
No. To keep things simple and consistent for all of our patients, we do not provide visits or care outside of our standard membership system. If you’d like to come check out our clinic and meet with one of our providers before joining as a member, we’d be happy to show you around and answer any questions.
We do not require members to sign any contracts that commit them to a certain period of membership. Memberships are ongoing and open, but must be paid ongoing in order to maintain service with us. A minimum of the first month of membership and a registration fee is paid upfront and is non-refundable. If you decide to cancel, we require written authorization. You will be required to pay the current balance for the current month, and cancellation will be effective immediately. You will be charged the remaining outstanding balance on the day your written authorization is received.
Yes, we do allow for one-time re-enrollment after cancellation, but members will be charged a re-enrollment fee of $100 per member/family before service can be restarted.
A little, but without the high price tag . . . or valet parking! We provide a concierge level of service to all members, but try to make things affordable for people of all incomes, with or without insurance.
Yes. Our memberships (eligibility or fees) are not based upon any existing medical issues or conditions.
No, we do NOT have any income or health guidelines to become a member. Our fees are the same regardless of income, insurance arrangement, level of health, or utilization of our services.
That is great! *HIGH FIVE!* Our primary focus is to keep members well and avoiding lots of "medical" care. As such, we can dedicate more time to prevention and lifestyle issues to continue to keep you away from the expensive, cumbersome health care system. However, when you do need care, we are available 24/7 to help get you back on track and avoid trips to the ER or urgent care.
If a member establishes care (and has a visit) in-person, we can provide remote monitoring of issues over phone and internet for some period of time. Ultimately, some care (sick visits, etc.) must be provided in-person, and therefore we do not encourage people to join our practice unless they can reasonably visit us in person should we request.
Fees
Nope. We are transparent. We provide most care to members without any extra fees at all! If we do charge for non-covered services, we always list prices upfront. If we recommend outside services, we try very hard to find you an upfront, reasonable price if you are paying cash.
All members have access to many basic labs and diagnostic testing at significantly discounted wholesale prices - 50 to 90% less than insurance-based prices.
For any fees for non-covered services, we expect full payment at time of service for most services, including medications, labs, procedures, etc.
Contact us for any questions regarding specific requests
We do not charge "per visit". New members must pay a registration fee and a minimum of one month of membership fees upfront. To get started, members will usually pay a minimum of around $130. If any non-covered services are required (labs, procedures, etc.), then the first visit cost may be slightly more.
All wellness visits (including routine labs and pap smears) are provided at wholesale costs to all members.
Visits
Currently our regular clinic hours are 9:00 AM - 4:00 PM Monday-Friday. However, all members have access to their doctor after-hours by phone and after-hours visits if required.
While we can always offer same or next-day to our members (even newbies), we do recommend scheduling an appointment at our office in Wittmann, AZ for all visits.
Taking into consideration the number and complexity of medical issues, most of our clinic visits are scheduled for 30 - 60 minutes.
We can order or refer just like any insurance-based doctor can do. For some outside services, we can help find reasonable "cash" prices if you are paying out-of-pocket - especially radiology and labs. We can provide many urgent care and minor emergency services during regular or after-hours (stitches, simple fractures, etc.) that can help people avoid a trip to the ER. However, we do recommend having health insurance in the case of an unexpected, expensive event such as surgery, ER visit, or hospitalization.
While there are times when house calls are necessary, we'd prefer having access to all our resources in our office to best care for you. Give us a call if you think a home visit is necessary and we can discuss further.
We think of "virtual visits" as a supplement to good primary care - not a replacement for in-person care. Generally if the issue does NOT require a physical exam, a virtual visit is fine. Many chronic issues (ex. diabetes, hypertension, etc.) can be largely managed by email and virtual visits. However, any issue requiring a physical exam (ex. cough, sinus infection, ear infection, new pain, etc.) will be required to be seen at a traditional clinic visit.
Insurance and Health Plans
No, it is not. At ORFM, we do not bill any insurance for our monthly membership, but if you have insurance you can always use it for labs, x-rays, specialists, etc. It is also very important to have insurance in case of an unexpected hospitalisation, surgery, or serious illness.
Keep in mind that sometimes insurance plans have deductibles and co-pays that may end up costing you as much or more than being a member at ORFM.
For example, if your individual deductible is $1500 per year, then your insurance doesn't pay until you meet that. You pay $65-$85/month ($780-$1020/year) for unlimited access to ORFM, which might be less than your deductible!
Clearly, this is just food for thought. You have to make the right decision that is best for your family and your financial situation.
No. ORFM is a great way to receive high quality primary health care, but we do believe insurance is needed for unexpected and expensive events.
No. ORFM does NOT contract with any private or public insurance plans.
We do not contract with any Medicaid plans and cannot bill them for our services.
We cannot currently contract with Medicare beneficiaries to provide stellar primary care services. Our charges cannot be billed to Medicare by us or the patient and the beneficiary must sign a Private Contract prior to joining that acknowledges this fact. As Medicare is an open network, patients may continue to use their Medicare benefit elsewhere with accepting providers as usual.
In most cases, yes. Your insurance plans will continue to operate “as usual” at other doctors' office, hospitals and pharmacies. PPO-style plans do not require a designated “gatekeeper” doctor for referrals, medications, tests, etc.
Our providers can order or refer just as another doctor would.
HMO-style plans do require an in-network designated primary doctor for access to other services, so they do not pair as well with ORFM.
We think of "virtual visits" as a supplement to good primary care - not a replacement for in-person care. Generally if the issue does NOT require a physical exam, a virtual visit is fine. Many chronic issues (ex. diabetes, hypertension, etc.) can be largely managed by email and virtual visits. However, any issue requiring a physical exam (ex. cough, sinus infection, ear infection, new pain, etc.) will be required to be seen at a traditional clinic visit.
For the time being, insurance companies do NOT recognize our membership fees as a reimbursable expense. For non-covered service fees (meds, labs, x-rays, etc.), we can provide a receipt of payment so you can process with your insurance plan if you wish. However, most of our members have not found it worth the time and effort to do so.
We are not financial or health insurance advisors and recommend you speak with a professional in that industry if you have questions. However, our members with high-deductible (or catastrophic) insurance plans are very pleased with their arrangements when combined with our services. ORFM can provide day-to-day services, and a high-deductible plan can help limit the enormous expenses of a major event.
No, health insurance is not legally required for all Arizona residents. The federal mandate that required health insurance was repealed in 2017.
The Affordable Care Act (ACA) required most Americans to have health insurance or pay a penalty. However, the Tax Cuts and Jobs Act eliminated the individual mandate in 2019.
Arizona's constitution protects the freedom of Arizonans to provide for their health care. This means that no law or rule can force people, employers, or health care providers to participate in a health care system.
However, Arizona does require employers with 50 or more full-time employees to offer health insurance.
Medical Services
We think of our business model as an alternative to managed care medicine, but our provider is a board-certified family physician (American Board of Family Physicians) and practice very traditional medicine. However, our provider is generally very conservative with ordering of tests and medications and would much prefer to prescribe a book, an iPhone app, or lifestyle changes to solve health problems.
Yes. We can provide standard women’s and gynecologic services at our office in Wittmann, AZ, including pelvic exams, pap smears, birth control, IUD insertion/removal, Nexplanon insertion/removal, and menopause management. We currently do not offer colonoscopy.
Absolutely! We love little tikes of all sizes, from newborns to teenagers. We can provide all standard childhood health care services including yearly well child checks, sports physicals, acute care (sore throats), and chronic disease management (asthma, allergies, etc.). We are NOT currently giving childhood vaccinations, but can review records and send you elsewhere for completion of vaccines.
Medications
At ORFM we believe vaccines provide an important tool in preventing or minimizing the impact disease on our patients. We do not currently offer vaccines in office due to cost.
We do not provide chronic pain medications or perform interventional pain management procedures such as spinal injections.
Our provider is comfortable providing primary care for most any mental health problem, including associated medications. We generally have a conservative and careful approach when using medications (particularly benzodiazepines, such as Xanax or Valium) in this area and strongly promote the use of non-medicine therapies and lifestyle changes.