FAQ’s
FREQUENTLY ASKED QUESTIONS
What does a retainer based practice mean?
A retainer based practice is one in which an individual “retains” a personal physician by paying an annual fee in order to have medical attention when needed. A personal physician on retainer is available 24/7/365 for individuals who desire to have their own doctor who knows them and their medical history and who can coordinate and facilitate all their care from acute illness to hospitalization.
By retaining a personal physician, your health care is not left to “chance.” You don’t have to chance seeing a different doctor each time you need one or having to speak to a doctor that’s on call after hours that knows nothing about you. You don’t have to chance not being seen in a timely fashion or having to wait in a busy office full of ill patients. The retainer allows you to have enough time with your own physician to have all your questions and concerns addressed in a non-rushed atmosphere. At Destination Health, the retainer also provides the opportunity to receive a house call if needed.
(A typical family practice physician is contracted with many managed care plans and therefore must see thousands of patients to cover their costs due to reduced reimbursement. This makes it difficult for patients to get an appointment when they want it for the amount of time needed to address all their concerns.)
What is the maximum number of patients that Dr. Hall will accept?
Dr. Hall will only serve as a personal physician for 200 patients each year. This allows her to be readily available when needed. No more long waits or having to provide a full recap of your medical history at each appointment or on the phone.
What age group does Destination Health accept?
Medical services are provided to individuals 15 years of age and older.
Will I be able to use my insurance at Destination Health?
Destination Health will electronically file your insurance for you for any services rendered. You will then be reimbursed by your insurance company according to your specific plan guidelines. As with any healthcare service from any provider, your insurance plan will determine the reimbursement amount. The amount is determined by deductibles, the percentage of out-of-network coverage and whether or not preventive care is part of your benefit plan.
Dr. Hall has chosen to opt out of Medicare. That means that Dr. Hall nor a patient on Medicare can submit claims to Medicare for reimbursement. Individuals 65 years of age and older can be patients of Destination Health, but will not receive insurance reimbursement. However, Medicare benefits can be used for any services outside Destination Health such as hospitalization, specialist visits, etc.
If you are covered by a managed care plan and are in need of specialist care, we will refer you to an innetwork physician when possible so that you can take full advantage of your insurance benefits. You will also utilize your insurance if hospitalization or out-patient testing is needed at a facility other than Destination Health.
Will Dr. Hall be considered my PCP if I am on a my managed care plan?
If you are in a Preferred Provider Organization Plan (PPO), Dr. Hall can be your primary care physician (PCP) because a PPO does not routinely require you to indicate a PCP, but she will be considered “out-of-network” for reimbursement purposes.
Most Point of Service Plans (POS) do not require you to indicate a PCP. Others such as Blue Cross Blue Shield/Health Select do require you to choose an in-network physician in order for you to be eligible to receive reimbursement for services. Please check with your insurance company regarding this if you are in a POS plan. A Health Maintenance Organization (HMO) does require that you indicate a PCP to be eligible to receive benefits.
Will I be able to use my insurance at Destination Health™ for visits and services within the scope of my annual membership dues?
Destination Health™ will file with your insurance plan for any services and treatments covered by your annual membership dues for direct reimbursement to you. As with any healthcare service from any provider, your insurance plan will determine the reimbursement amount according to your specific plan guidelines.
Will I be able to use my insurance for visits and services outside the scope of my Destination
Health™ Patient Program Agreement annual membership dues?
Services outside the scope of the Patient Program Agreement are due and payable at the time of service. We accept payment by cash, check, VISA, MasterCard, American Express and Discover. Destination Health™ will file with your insurance plan for these services for direct reimbursement to you. As with any healthcare service from any provider, your insurance plan will determine the reimbursement amount according to your specific plan guidelines.
How does Destination Health™ work with a Preferred Provider Organization?
If you are on a Preferred Provider Organization Plan (PPO), Dr. Hall can be your primary care physician (PCP) because a PPO does not require you to indicate a PCP, but she will be considered out of network. This is also true for most Point of Service Plans (POS) with the exception of Blue Cross Blue Shield/Health Select. Please check on this if you are in a POS plan.
How does Destination Health™ work with reimbursement accounts offered by employers?
Many employers offer Health Savings Accounts (HSA), Health Reimbursement Accounts (HRA) or Flexible Spending Accounts (FSA) and will allow you to pay for services not covered by your insurance plan with pre-tax dollars. This is an option which offers additional savings for the services you obtain from Destination Health™. The same procedures and rules which apply to any other healthcare provider apply to Dr. Hall’s services. Most reimbursement plans automatically provide payment from your HSA, HRA or FSA for services not paid by your insurance plan; others require you to submit separately after you receive your explanation of benefits. Consult with your plan administrator to determine how to best utilize this benefit. Destination Health™ will provide an itemized statement for your use in obtaining reimbursement under these plans.
Are prescriptions covered?
As with any service provider, prescriptions written by Dr. Hall may be covered at various reimbursement levels depending on how your insurance plan covers prescription drugs. We suggest you contact your plan’s service department regarding your specific plan guidelines. Prescriptions written by Dr. Hall are not covered by your Patient Program Agreement annual membership fee.
Does Dr. Hall contract or is she a member of any insurance plans?
At this time Destination Health™ and Dr. Hall do not contract with insurance plans. However, as we have explained above, Dr. Hall’s services are generally eligible for reimbursement under most healthcare plans; although if your plan distinguishes between “network” and “out of network” providers, her services will likely be reimbursed on an out of network basis. Further review is underway as to the possibility of her future participation with a select group of plans and should Dr. Hall become a participant updated information will be provided to Destination Health™ members.
At Destination Health™, we electronically file claims for you. Most insurance plans will refund a patient faster for services if the doctor files the claim directly.
Office Visits And Other Services, Payment Examples
For each example below, assume the Destination Health™ visit or service is $100, and the Member’s insurance plan reimburses 80% for covered services after the Member has satisfied a 20% co-pay and any deductibles, and the Member has a reimbursement account (HSA, HRA, or FSA).
Services covered by your DH Patient Program Agreement Retainer:
- DH service is $100, Member pays DH nothing;
- DH files with Member’s insurance plan;
- Insurance directly pays Member $64 ($100-20% co-pay, x 80%);
- Insurance or Member files $36 claim with HSA, HRA, or FSA;
- Reimbursement account pays Member $36 tax free dollars
Services not covered by your DH Patient Program Agreement Retainer:
- DH service is $100, Member pays DH $100;
- DH files with Member’s insurance plan;
- Insurance directly pays Member $64 ($100 – 20% co-pay, x 80%);
- Insurance or Member files $36 claim with HSA, HRA or FSA;
- Reimbursement account pays Member $36 tax free dollars.
What services other than medical care is available at Destination Health?
Cosmetic procedures and products are available on site including:
- Revision Skin Care line
- Colorescience Makeup
- Botox
- Juvederm
- Lipoplasty (non-invasive fat and cellulite reduction)
Other services available:
- Dietary Consultations: Jean Kelley, registered dietician and certified diabetic educator.
- Private and Group Yoga Classes: Sherry Thompson of InnerWisdom Yoga.
(One complimentary class available to members) - Executive / personal coaching: Jayne Gardner, PhD, The Gardner Institute.
(One complimentary visit available to members)
How do I become a patient at Destination Health?
Simply call us at (817) 310-6050 to schedule a personal tour of our facility and meet Dr. Hall at a time that is convenient for you. We will answer any questions you may have during this complimentary, no-obligation visit. Once you sign the Patient Program Agreement and provide us with a check or credit card for the retainer, you are all set. We accept cash, checks, American Express, Discover, MasterCard, Visa and debit cards.
