FAQ

What services are provided as a part of our annual fee?

Routine annual comprehensive diagnostic physical exams, supported by follow-up routine exams and communication services aimed at helping patients achieve their routine exam health goals. By detaching from dependence on healthcare insurance plan reimbursement, and focusing on a smaller number of patients investing in extraordinary care, interactions are unhurried and convenient.

Are you on the medical staff of a hospital?

Yes. Dr. Mohan is on the medical staff of HonorHealth Thompson Peak. If you require hospitalization, she will try to coordinate your inpatient care by working with physicians who are based at the hospital.

Some of her patients go to Mayo Clinic’s hospital in Phoenix, and she is able to log into the Mayo Clinic portal to check their charts regularly.

Do I still need insurance if I enroll with you?

Yes. Membership-based cash medical practices are beyond plan coverages, but, do not take the place of general health insurance coverage. Our practice is a primary care medical practice, not a health insurance program. You are advised to continue your PPO, Medicare, or other insurance program.

Will my insurance still be billed for my office visits?

If our practice is in-network with your insurance plan, we will also provide plan-covered healthcare services that may be submitted to your insurance plan for reimbursement, with copayments and deductibles potentially applicable.

Is there a copayment?

Yes, only if we are in-network with your plan.

Are you a participating provider for Medicare?

Yes. We can provide as-requested or needed Medicare-covered services to our Medicare-eligible patients without triggering additional fees or costs (other than potential co-payments or deductibles). Separate from our private fee services, which are designed to be outside Medicare coverage, we can also provide Medicare-covered services to Medicare-eligible, such as virtual check-ins, Annual Wellness Visits, the Welcome To Medicare physical, chronic care management (CCM), care coordination, and telehealth services. Additionally, with Medicare-eligible, Medicare will continue to pay for services (i.e. lab work, x-rays, etc.) that are ordered by us but provided by a different facility.

Do you bill Medicare or other insurance plans for the annual membership fee?

No! Our membership fee services are designed to be outside Medicare coverage and therefore lawfully delivered for private fees, so your membership fees paid to our practice should NEVER be submitted to Medicare for reimbursement. At this time, we are in-network on many commercial health insurance plans but do not participate with Medicaid/AHCCCs reimbursement.

Will my private insurance reimburse my annual membership fee?

No! Please do not submit the membership fees to your health insurance plan.

I have a HSA account attached to my PPO health insurance plan, or I have a FSA or HRA or MSA healthcare expense reimbursement plan with my employer (or as a self-employed person). Can I use HSA, FSA, HRA or MSA funds to pay some or all of your private fees?

Generally speaking, yes! By framing our cash services as a combination of routine diagnostic exams supported by a “medical information plan” of empowered electronic communication services designed to support those routine exams, we have designed our services to conform to IRS Publication 502–that publication identifies healthcare services that are “qualified medical services” suitable for HSA, FSA, HRA or MSA funding.That said, we are not tax experts and we do not give tax advice or guidance. You should check with your tax expert on HSA funds use, and, with your FSA or HRA or MSA plan administrator regarding those plans funding our cash fees.

Are annual private membership fees tax deductible?

The IRS has complex rules on when Americans can deduct their medical expenses. Because the test for this is in part based on the patient’s annual gross taxable income relative to the level of medical expenses incurred, deductibility is rare and typically only applicable toward the end of life (when medical expenses may reach the necessary threshold as a percentage of gross income). Again, patients are advised to consult with their tax expert to clarify qualification in their particular circumstance.

What about lab, x-ray, specialists’ fees, and hospitalization?

Your annual fee pays for the specified routine exam services and related communication services. Either your healthcare insurance plan may reimburse or cover certain diagnostic fees, or it may need to come out-of-pocket when the diagnostic services exceed what plans will cover.

What do I do if I become ill while traveling or away on an extended vacation?

You would call 911 if you have a life-threatening emergency, then call us. Call us first if the problem is minor. With the exception of a few controlled substances, most prescriptions can be ordered anywhere in the country. If you seek care at an emergency room or urgent care center out of our area, we will be readily available for phone consultation with you and/or other healthcare personnel. If you should require hospitalization while away, at your request, we will 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?

Of course, our patients are free to see any specialist they wish. We are available to help you decide what specialists to see and to coordinate such consultations. In this way, the most appropriate resource is used, the earliest arrangements are made, and your applicable medical information is sent in advance of your specialist visit.

What about the cost of prescription medications?

The costs of prescription medications are the patients’ responsibility and, in most cases, should be covered by their insurance plans. We have expertise in assisting patients in purchasing medications in the most cost effective manner.

Will I be required to pay my annual membership fee even if I do not use your services?

Yes. The private fees you pay are in exchange for our practice making available an array of routine exam services and related communication services. In theory, our cash services actually help you reduce your healthcare needs (not a promise or a guarantee, but a healthcare goal). The aim is not to connect fees to services as delivered, but instead to aim for the availability of substantial ongoing routine exam and communication services to provide you improved health and peace of mind. We strongly encourage patients to fully avail themselves to all private fee services each year but if you feel well, we believe we’ve done our job and remain available to you as/when necessary.

FAQ

FAQ