Do I have to sign up for annual membership or can you do a one time home visit?

We offer two types of services. Concierge and Traditional Palliative Focused Primary Care

Traditional: We offer virtual consultations/care for the home limited and a complimentary home/facility visit to see you in person once a year. Since our services focus on those who have difficulty leaving home independently, office visits are not offered. Traditional patients do not pay the concierge membership fee.

Concierge: has a membership fee for conveniences not covered by insurance and appointments are billed to insurance.

We offer a 3 month concierge trial membership option if you are not yet ready to sign up for the annual membership. Even with a one time visit, there is typically a follow up of either result review, referrals, coordination of care, form completion for placement etc that takes more than just one appointment. That is why we only offer a 3 month trail or annual membership options.

Does the concierge fee cover all your services?

A home visit, telephone visit or a video visit is billed just like an office visit. Your usual co-pays and deductibles still apply. The Concierge Membership fee you pay is an out-of-pocket expense not covered by insurance. See our member benefits page to review some of the services we offer that are conveniences that are not reimbursed or covered by insurance or Medicare. For example, our yearly fee covers the convenience of:

• Complimentary Virtual Meet & Greet with the physician(s)
• Home/facility visits based on medical necessity
• Non-rushed, quick access (usually same or next day) appointments
• Priority and direct access to your doctor & team
• Secure texting for follow up questions
• High touch, personalized and Individualized care

Will you accept my insurance? 

Yes, to the extent we are in-network with health insurance plans, we will continue to take your insurance for regular visits or insurance-covered physical/routine visits. Our yearly fee covers only the wellness services and conveniences outside of plan coverage.

Do you take Medicare?

Yes, we will continue to take Medicare and hope to add more services for our Medicare population. And we believe that our Medicare patients will particularly benefit from our new services, which are outside of Medicare coverage (please do not submit any of our private fees to Medicare for reimbursement—those fees are not covered by Medicare, and the services provided via those fees are not covered by Medicare).

Do I still have to pay copayments and deductibles?

If we deliver plan-covered services, yes, because we continue to accept insurance. We are mandated to collect copayments and deductibles to the extent required by plans. But our additional wellness subscription services will not trigger copayments or deductibles as those services are private fee and outside plan coverage.

How does my health insurance apply to your doctors and services?

Please call your health insurance company to ask about coverage. To check if we are in network with your insurance provider. We will do a courtesy check to see if we accept your plan. However, it is the patient’s/ your responsibility to confirm your network and coverage.  To find out what your insurance coverage you would need to contact your insurance directly.

Do you make emergency house-calls?

Our Home Based Medicine program is not an Emergency Room replacement and we do not treat patients experiencing chest pain, shortness of breath, head trauma, loss of consciousness, or other life-threatening emergencies, as these conditions may require immediate hospitalization. If you are having a medical emergency, please go directly to the nearest Emergency Room or dial 911 immediately.

Do you offer virtual care?

Yes, we. offer convenient remote/virtual care appointments to our members. If there is a concern we are aren’t able to fully assess remotely, by phone or video, we will schedule an in-person home visit appointment.

Do you refer to other specialists or fill out forms?

Yes, we will assist you with appropriate form completion as needed as well as refer you to select specialists we typically work with in the Bay Area. When we refer you to home health, or other specialists such as Cardiologist, Pulmonologist, Psychiatrist etc, as your Primary Care Physicians, we remain involved in your care as your primary care physicians.

How much do I save using the Home Based Medicine program?

Time and monetary savings are significant when you consider the number of hours it takes to coordinate an office visit for an individual who cannot easily leave their home without assistance or planning. Besides the office wait time, individuals typically encounter barriers such as transportation, need to have a care giver accompany the person to assist with transfers, transportation and getting to the appointment.

Paying Bills

Direct billing questions to our billing department at 650-360-9309. Bills are due within two weeks of posting (in the patient portal). Pay on your Athena portal to easily take care of your bills. You can also pay us via check. We do not accept cash.  Unpaid bills are automatically sent to collections if unpaid within two months of service. An additional 50% charge is applied if the bill is sent to collections.   

How can I reach my doctor?

Message your doctor through Athena Health Portal for non-urgent issues any time and we will get back to you within 48 business hours.  You can also Text (650) 360-9309 during business hours to make same-day appointments or change appointment times. Call (650) 360-9309 our office or reach us through our answering service in the evenings/weekend. Part of our additional services is subscription to this platform to better enable our communications.

After Hours

For issues that cannot wait for regular office hours, After Hours (evenings, weekends, and holidays), phone calls to our office are directed to our triage center or on-call clinician/physician.  

Can I access my medical information online?

Yes, the benefits of Athena Health Portal include:

• Viewing your test and lab results
• Accessing your medical records, medications, immunizations, and more
• Scheduling appointments
• Requesting prescription refills
• Sending secure messages to your doctor’s office

If you need a medication refill

1. Request a refill as you typically would through the pharmacy. Provide pharmacy with your new doctor’s name and practice location to update their system.
2. You can send us a message through the Athena Health Portal to refill a medication and be sure to specify which pharmacy the medication prescription should be sent to.
3. Request refills at least 2-5 days before you run out.
4. Please give us 5 days to complete your request.

What should I do if your office is closed and I need medical care?

If you are experiencing what you believe is a medical emergency, please call 9-1-1 or go to the closest hospital. If it is a non urgent issue please call the office and select option 1 and you will be directed to the On-Call Service where a nurse can give you medical advice.

What are your billing requirements?

Patients must pay any co-payments at the time of their visit. Patients are responsible to pay any amounts, such as deductibles, co-payments and co-insurance that their insurance company designates is their responsibility.

Why am I being billed for Physical Exam?

The physical exam is preventative care to prevent illness or disease, and it may include counseling on diet, exercise, sleep, stress, vaccines, medications, and medication reconciliation. 

It does not cover diagnostic care or acute or chronic care. For example, if we address a medical concern during your physical exam, an additional visit code is added and submitted to your insurance along with the documentation.   By law, we cannot alter the billing diagnosis/codes or write off any balance upon patient request. Therefore, we cannot adjust the bill or the amount due.  

Will my insurance pay for a physical?

A physical exam is a preventive health maintenance exam during which your physician takes your relevant medical and family history, asks pertinent screening questions, and performs or orders appropriate screening tests to evaluate your overall health. An office visit is a problem-related visit that addresses a specific health problem through discussion, examination, diagnosis and/or testing. Treatment is prescribed as necessary.

Sleep Study Questions

A sleep study is a diagnostic test and is billed accordingly. The code used for this test is 95800 and 95806. You may be responsible for the bill if you have a high-deductible plan. Please check with your insurance how much it will cost you. We do not determine the cost; it is not covered as part of a physical exam or visit. Check with your insurance if prior authorization is required, and we can assist in getting the approval. 

Why is my bill higher than last year?

Our insurance contracts determine the fee schedule. You might see this reflected on the bill. Contact your insurance to clarify the cost of the visit.