FAQs

Frequently Asked Questions About Our Endocrinology Clinic

  • What are the membership fees, and do they go toward my deductible?

    The annual membership fee is $240. This fee does not guarantee it will count toward your deductible, as the practice does not bill insurance, including Medicare or Medicaid.

  • What is covered under the $279 per-visit fee?

    The per-visit fee includes consultations and lab work done at designated LabCorp locations. Any lab work done outside these specified labs will result in additional charges for which you are responsible.

  • Are there additional fees for new patients?

    Yes, new patients must attend two initial visits. The first visit incurs the $279 fee and the membership fee, while the second visit incurs an additional one-time fee of $150.

  • Can I choose my own lab for testing?

    Yes, but if you choose a lab outside the specified LabCorp facilities, you will be billed separately for the lab work, and the $279 per visit fee will still apply.

  • Will the practice submit claims to my insurance?

    No, the practice operates on a direct-pay basis and does not submit claims to insurance or provide documentation for insurance reimbursement. Payments may not count towards your deductible or be reimbursable through insurance.

  • How do I get my medical records?

    You can request medical records be sent to another doctor for free. However, a fee will be charged if you request them for personal use.

  • Will I be charged for phone consultations or telehealth visits?

    Yes, all medical advice, including phone and telehealth consultations, will be billed at the regular $279 per visit rate. Free phone consultations are available only for prescription refills.

  • What should I do in case of an emergency?

    The practice does not provide emergency services. In case of an emergency, you should call 911 or visit the nearest emergency room.

  • Can I use the membership fee toward specialist services or hospitalizations?

    No, the membership fee only covers consultations with Dr. Stesin. Specialist services, hospitalizations, and imaging are not covered and will incur separate costs.

  • How are prescription refills handled for non-participating members?

    Non-participating members will have their prescriptions refilled until March 2025, providing five months to find a new provider.

  • How are prescription refills handled for participating members?

    Members with active memberships will not experience changes in their prescription refill policies. However, it is important to establish your membership before March 31, 2025, if you will require a refill before your follow-up appointment later in the year. After March 31, 2025, prescription refills will only be available to current members.

  • What is the practice's cancellation policy for appointments?

    Cancellations made less than 24 hours before an appointment may incur a fee. Repeated cancellations may lead to suspension of services.

  • Does the practice offer after-hours or same-day appointments?

    No, all appointments must be scheduled in advance and are subject to availability. Membership does not guarantee access to immediate appointments.

  • How can I terminate the membership?

    You may terminate the membership by providing 30 days' written notice, but the membership fee is non-refundable.

FAQ: Stesin Info Session

  • What changes are being made to Dr. Stesin's practice?

    Dr. Stesin is transitioning to a cash-payment model. This means the practice will no longer work with insurance companies, and patients will pay an annual membership fee plus a fee for each visit.

  • Is this a concierge practice?

    No, this is not a concierge practice. Patients will not pay large upfront fees for unlimited services. Instead, there will be an annual membership fee and a per-visit charge.

  • Why is the practice moving away from insurance?

    Over the years, the healthcare system has changed, and insurance companies have increasingly controlled medical decisions. The administrative burden and reduced reimbursements from insurance have made it unsustainable for the practice to continue under the traditional insurance model.

  • What is included in the annual membership fee?

    The annual membership fee helps cover overhead costs such as staff salaries, office space, and other administrative expenses. It allows the practice to offer a personalized, patient-focused experience.

  • How do I sign up?

    You can sign up on the practice's website, in person at the clinic, or by using the sign-up sheet available tonight. The membership year will start on February 1, 2025, for those who sign up before that day or on the day of your registration if you sign up later.

  • Can I use my HSA (Health Savings Account) for payments?

    You may be able to use your HSA to cover both the membership and visit fees. However, you must confirm this with your HSA provider, as each plan varies.

  • What happens if I need lab tests?

    If you use a LabCorp facility with which the practice has partnered, the cost of labs will be included in your visit fee. For other labs, including those at non-partner facilities, you will be billed separately, and your insurance may cover these costs depending on your plan.

  • Will Dr. Stesin still write prescriptions and order insulin pump supplies?

    Dr. Stesin will continue writing prescriptions for members only after March 31,2025.

  • What if I need help with insurance reimbursement?

    The practice will no longer submit claims to insurance companies, but you will receive a receipt at each visit that you can submit to your insurance provider for reimbursement. It is up to you to check with your insurer about what will be covered.

  • Can I still get care if I am a Medicare patient?

    While the practice will not bill Medicare, Medicare patients will need to complete a special form to receive care from the practice. Please check with the clinic for details. You must commit to not submitting or attempting to bill Medicare for these visits.

  • Will telehealth appointments be available?

    Yes, telehealth appointments will be available for the same fee as in-person visits.

  • What are the clinic hours under the new model?

    The clinic will be open three full days a week, tentatively Monday, Tuesday, and Thursday. This may be subject to change, and any adjustments will be communicated to patients.

  • Can I still sign up after February 1st?

    Yes, patients can sign up anytime after February 1, 2025, and their membership will last for one year from the date of registration.

  • How does the fee-for-service model work for prescriptions and medical care?

    There will be no changes in the quality or range of medical care provided by Dr. Stesin. The primary change is in how the practice operates financially, moving away from insurance-based billing to a direct-pay system.

  • Will the practice still communicate with my primary care physician?

    Yes, communication with your primary care physician will remain the same. Dr. Stesin will continue to provide reports and updates as needed for continuity of care.

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