These are questions frequently asked by people considering our practice,
but if you have any additional questions, please feel free to contact us here.
Do I still need health insurance if I become a member of your practice?
Yes. Membership benefits are only for insurance non-covered services. You will be responsible for any co-payment or co-insurance amount. I will attempt to refer you to in-network physicians for any necessary consultations and to in-network facilities for diagnostic tests and hospitalizations as medically indicated. All procedures and services not performed in my office will be billed by the performing entity. Those services will then be covered according to your particular insurance plan.
Will insurance still be billed for my office and hospital visit?
As a courtesy, we will submit my office and hospital visit charges directly to your insurance carrier. These charges are not included in your annual fee.
Will my private insurance reimburse my annual fee?
It is unlikely that the annual fee amount will be reimbursable. It may be possible to utilize funds from a Flexible Spending Account (FSA) or Health Savings Account (HSA) toward the annual fee. You should consult your human resources representative, FSA or HSA plan manager or your tax advisor.
Will you still be a participating provider for Medicare?
Yes. I will continue to bill Medicare and your supplemental insurer on your behalf as required by law. You will be still be responsible to pay any co-payment or co-insurance amount as required by Medicare.
Do you bill Medicare for my annual fee?
No. The annual fee only includes services and benefits that are not covered by Medicare (or any other payer) and will not be paid for or reimbursed by Medicare. I will continue to submit claims to Medicare and to your supplemental insurance on your behalf for Medicare covered services.
What are my annual fee payment options?
Your annual fee may be paid in full by check annually or the annual fee may be paid by credit card annually or semi-annually. If you opt for a semi-annual payment option, the second half of your fee will automatically be charged to the credit card you indicated on your initial sign-up.
What additional fees can I expect outside of my yearly membership fee?
Insurance co-payment and co-insurance amounts are still your responsibility. Membership benefits are only for insurance non-covered services as stated in the Membership Benefits.
Is the annual fee tax deductible?
The fee is a medical-related expense and may be deductible. You are advised to consult with your tax advisor to clarify qualifications in your particular instance.
What about lab, x-ray, specialists’ fees and hospitalization?
Your annual fee covers membership in David R Buyer, MD SC and for other amenities listed on the Member Benefits page. All procedures and services not performed in my office will be billed by the performing entity.
What if I have an emergency?
If you have a life threatening emergency, call 911 immediately. I will assist in the coordination of your emergency care thereafter. I ask that you contact me before going to an urgent care facility at any time of the day or night. I will attempt to address the urgent after-hours problems directly.
At which hospital are you on staff?
I am affiliated with Rush University Medical Center.
What if I am hospitalized?
If you are admitted to Rush University Medical center I will see you in the hospital and continue to advocate on your behalf. Rush has mandated hospitalists for all admissions as other medical centers have done years ago.
Who will cover for you when you are not available?
My goal is to be available 24 hours a day, 7 days a week via cell phone and electronic messaging. There may be infrequent occasions when I am out of town or otherwise unavailable. In these situations a trusted colleague will serve as my covering physician.
What if I become ill while traveling or away on an extended vacation?
Call 911 if you have a life-threatening emergency. Call me first if the problem is minor. If you seek care at an emergency room or urgent care center out of our area, please have the doctor seeing you call me for coordination. If you should require hospitalization while away, I will, at your request, attempt to establish phone communication with you and your attending physician(s) to ensure continuity of care.
What if I need to see a specialist or a surgeon?
As always, my patients are free to see any specialist they wish. I am available to help you decide which specialists to see and to coordinate such consultations. In this way, the most appropriate resource is used, the earliest appropriate arrangements are made, and your applicable medical information is sent in advance of your specialist visit.
Will I be required to pay my annual fee even if I do not use your services?
Yes. Paying your annual fee allows you to be a member of the practice whether you are sick or well. You are encouraged to use the benefits and amenities offered, regardless of your state of health.
What happens if I move out of the area after I enroll?
If you move and wish to secure a new primary care physician, the annual fee will be refunded on a pro-rated basis. If the relationship is otherwise terminated, the annual fee may be pro-rated or forfeited, to be determined on a case-by-case basis by the practice. A copy of your records will be sent to your new physician upon receipt of a signed release. This release of records is required by law.
Is there a limit on the number of patients enrolled?
Yes. Every effort will be made to accommodate interested patients, but the enrollment limit must be honored in order to continue to provide the highest standard of personalized care and service to all of my patients.