Absolute Concierge Health Care

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Kenneth Volk, PA-C

PATIENT HANDBOOK

Welcome to Absolute Concierge Health Care!

We are excited to begin this journey toward a better healthcare experience with you! This handbook sets out the current benefits of participating in the ACHC Access and Preventative Medicine Program. After reviewing this, should any portion be unclear or should you have any unanswered questions, please do not hesitate to ask the Provider or staff member of ACHC for clarification.

Concierge Health Care is not an insurance policy. It is a private contract between ACHC and you.

Section 1
Summary of Benefits

The Absolute Concierge Health Care fee covers a comprehensive annual physical exam including the services listed below once every twelve months. These services will be performed without billing your insurance provider or Medicare and are intended to be a private contract between you and your Provider. Any results from these tests are private and not to be shared with your insurance company unless approved by the patient.

Other benefits exclusively available to participants in the Absolute Concierge Health Care Program include:

• Annual Exam
• Comprehensive Blood Work including CBC, CMP, Lipid, PSA, CEA if indicated.
• EKG
• Same-day or Acute Care Visits as available, seven days a week
• Electronic communications via e-mail directly to your Provider
• Extended appointments for counseling, education and evaluation of more complex concerns
• 24-hour access to your personal Provider.
• 24/7 access to local Pharmacy (Kilion's Pharmacy, Waskom, TX)
• Easy Scheduling of MRI's and Ultrasounds at Open Imaging

As Absolute Concierge Health Care is a patient-centered practice, we will always be open to your suggestions regarding other services we may offer.

Section 2
Frequently Asked Questions

• Why should I join the Absolute Concierge Health Care? ACHC offers you something you won't find anywhere else in our area. First and foremost, you will have unparalled access to your own private personal primary care provider. Not only is Kenneth available to you for routine questions by email, he is available to you 24/7 for any problems you may be experiencing.  Kenneth will make arrangements for you to be seen before or after work, or even on weekends if necessary. But joining ACHC isn't just about the amazing accessibility of your private provider; it also means you will receive a more thorough preventative exam than you may receive in a primary care office.
• What are the benefits of participation in the ACHC Program? Our primary focus when ACHC was founded was on the increased access to and attention from your own private provider. That focus remains today. In the second phase of our Program, we have added emphasis on disease prevention by including a comprehensive panel of annual screening tests for diseases such as heart attack, stroke, and lung disease.
• What are all of these tests for? Kenneth  invites you to schedule a visit with him to learn more.
• I have a doctor, and I'm nervous about changing. We understand what a big decision it is to change providers. We also understand that this type of practice seems too good to be true. Kenneth encourages you to schedule a visit in the office to get acquainted with him and the staff, as well as to get a feel for the practice environment before making this commitment to improve your health.
• What are the fees? The cost to participate in the Absolute Concierge Health Care is $150 per month, $1800 if paid annually. This fee covers the services listed in Section 1 and is not billed to your insurance or Medicare.
• Why aren't you billing my insurance for these tests? The goal of this program is to perform a thorough and comprehensive screening evaluation of several diseases for you. Unfortunately, most insurance companies only approve tests once you have symptoms of disease, when it is too late for 'prevention.' In fact, despite evidence that the tests we use can identify diseases at a much earlier stage, and can save healthcare dollars in the long run, many insurance companies flat out refuse to pay for them at all. You are entering into a private contract with ACHC to perform these screening tests in order for us to guide you to a healthier and happier life. We do not share the results with insurance companies, who might try to use them against you in the form of rate hikes or denial of pre-existing conditions.
• What if these tests identify a previously unknown problem? Kenneth will review your results with you personally and come up with a plan to address any abnormal results.
• How do I pay? You may pay annually or monthly. We highly recommend the annual payment option so that all of your preventative examinations can be performed at time of enrollment. For patients who choose the monthly option, the included preventative services listed in Section 1 will be spread out over a twelve month period. If you decide monthly payments are best for you, we will arrange for automatic deductions from your debit or credit card or checking account. You may change to an annual payment plan at any time, but previous monthly payments will not be applied towards the annual payment. Fees may be paid by cash, check, money order, debit card, or credit card.
• Is there an enrollment fee? There is no initial enrollment fee to join ACHC the Program. However, if you choose the monthly payment option, you are required to pay for the first three months at time of enrollment. If you end your membership with ACHC and wish to rejoin later, a re-enrollment fee may be applied.
• What if I can't pay? If you are a current patient of ACHC and you are experiencing financial difficulties that affect your ability to pay your membership fee, please contact us for assistance in working out a payment plan.
• Why don’t you bill Medicare for the Program Fee? The fee is for Medicare "non-covered services" and, as such, cannot be paid for or reimbursed by Medicare.
• Health Savings Account or Flex Spending Account insurance plans may allow the cost of ACHC benefits to be covered as a pre-tax health benefit.
• Do I need insurance? We do not require insurance. We do, however, strongly encourage all of our members to have and maintain insurance coverage for services that are not provided by your ACHC provider.
• Are lab tests, x-ray, hospital care or services provided by other physicians or specialists covered? No. Other than the labs included with the Annual Preventative Exam, all other healthcare services would be billed by those separate entities. ACHC may be able to negotiate significantly reduced rates with independent lab facilities and radiology services for you.
• Should I consider this a form of insurance? NO. The ACHC program covers only the services listed in Section 1 and throughout this Handbook. We will not pay other parties for care or services outside our practice. This is not considered a traditional form of insurance.
• What types of insurance are best suited for this type of practice? We do not endorse a specific insurance company, but encourage patients to consider Health Savings Account plans which will allow you to pay for the program with pre-tax dollars. These are complex and often confusing issues and we encourage you to speak with your accountant, or employer if you do not understand your health plan fully.
• What about the cost of prescription medicines? We work with patients to keep their costs down whenever possible, including generic medications assisting patients with Patient Assistance Programs. However, ultimately the cost of prescription medicines is the patient's responsibility.
• Can my fee be paid out of pre-tax medical accounts such as my FLEX, HRA or HSA account? Each employer's policy for their FLEX and HRA plans is different and we encourage you to speak with them about coverage for our Program fee and benefits. Health Savings Accounts ("HSA") may be used to pay for the program. 
• How do I reach my provider? The best way to reach us at all times, 24 hours a day is through our office phone at 903 687 2500 office phone or 903 265 2091 cell phone In the event of a life-threatening emergency, we strongly recommend you dial 911 then call your provider. You may also communicate directly with your provider via email. However, we ask that you use your best judgment and not send urgent or emergent questions via email. Kenneth’s email address is achc@eastex.net
• How many providers have a Concierge Practice? Nationwide, Concierge Practices are becoming increasingly common as patients and physicians grow more dissatisfied with our current medical system. The latest estimate is over 5,000 Concierge Practices exist in the U.S. including ACHC.
• What if I have an emergency? If you have a life threatening emergency, call 911 immediately. After you call 911, please call your ACHC provider and we will attempt to assist with your emergency care. Patients are asked to contact your ACHC provider before going to any urgent care facility and at any time of the day or night if real need exists. Urgent after-hours problems will be handled directly.
• What happens when my Provider is out of town or otherwise unavailable? Your provider will take a certain amount of time out of the office to attend conferences, maintain continuing medical education requirements, and for family time. When your provider is out of the office, arrangements will be made with another provider to provide coverage to ensure that your access to medical care is uninterrupted.
• What do I do if I become ill while traveling or away on an extended vacation? Call 911 if you have a life threatening emergency, and then call your ACHC provider. For minor illnesses, with the exception of a few controlled substances, most prescriptions can be called in anywhere in the country. Can I really see my provider whenever or wherever? While most primary care providers are unable to be available to see you at all hours or locations, your personal ACHC provider is in the unique position to work with you directly to arrange or provide care 24 hours a day, 7 days a week.
• What if I no longer wish to be a member? You may cancel your membership in our practice at any time. Membership is always voluntary. Please note that your membership fee for the first 90 days is non-refundable. If you are canceling membership because of financial hardship, please speak with us first.
• What happens if there are changes to this Handbook or the Fee Schedule? All changes to this handbook and fee schedule will be mailed to our members in a written notification, either via email or U.S. Postal Service. Please be sure to read notices from ACHC so you know how to continue to access benefits in our program.

By Section 3
Policies and Customs

I. Covered and Non-covered Benefits of Participation

This handbook expressly mentions those services included in the ACHC program. Any items not specifically mentioned here should be considered non-covered. Results from tests performed as part of the Program may suggest additional testing is necessary. The additional recommended tests are not included as part of the Program, but may be covered by your healthcare insurance. Each patient is responsible for knowing and understanding the benefits of their insurance plan. We at Absolute Concierge Health Care strongly recommend that everyone carry catastophic insurance coverage.

II. Office Policies and Customs

Office Hours are by appointment only, but we are generally in the office from 8:00-12:00 and 1:00-5:30 Monday through Friday and 9:00 -1­2:00 on Saturday. Please call in advance for an appointment since your physician may be out of the office.

Office Visits will be scheduled at standard 30-minute minimums to 120-minute maximums depending on the circumstances. Your ACHC program is based on the medical necessity of your problem may alter the length of an appointment. In order to allow sufficient time for scheduled patients, you should contact our office in advance and avoid "walk-in" visits. An adequate time to address each member's concern will be appropriately scheduled. In most cases, an appointment later that day or a next-day appointment can be arranged.

Contacting your Physician: By calling 903-687-2500 or 903 265 2091 cell phone.  Calls are typically returned within 60 minutes, voice-mail within 12 hours, and e-mails within 24 hours. Occasionally it may take longer due to unusual circumstances.

Healthcare insurance or other coverage is not a requirement for enrollment in ACHC. However, ACHC strongly encourages its patients to have and maintain such coverage if available. ACHC cannot guarantee that insurance companies will reimburse any costs incurred by its patients.

Pain management is an important aspect of healthcare and at ACHC we do believe in adequate treatment of pain. Patients must understand, however, that very specific and sometimes restrictive laws govern the use and administration of narcotic medications. Participation in our practice does not exempt the patient or provider from these laws. Community practice standards and all laws will be adhered to. Should a patient using chronic narcotic pain medications be unable to continue participation in the program, every effort will be made to place them with a physician with a similar pain management philosophy. Treatment of pain is not contingent upon payment of dues. Similarly, payment of Program fees does not guarantee prescription of narcotic pain medication thought to be detrimental or excessive by your provider. All narcotic prescription will be limited to a 2 week supply and certain narcotics are not written by ACHC providers.

Quality Assurance will be the keystone of success for our practice here at ACHC. Community and professional practice standards will be followed for the treatment of all illnesses to ensure the acceptable quality care for you and your family. To confirm that we are meeting those standards, ACHC will confidentially screen randomly selected patient charts by our supervising physician Dr. Steven Crayton M.D.

III. Membership

Membership in ACHC is voluntary. ACHC does not discriminate based on general health, age, sex, race or creed and there is no consideration of healthcare insurance status. Each member must indicate their understanding and agreement with the policies and customs of ACHC as outlined within the Agreement Contract and Patient Handbook in writing.
The total number of patients will be limited to 600 in order for your ACHC provider to meet the needs of their membership panel in a timely and effective fashion. Membership enrollment will be closed once this number is reached. Awaiting list on a "first come, first serve" basis will be generated and maintained. Any individual may place their name and contact information on this list without financial commitment.

IV. Fees/Refunds:

A Fee Schedule is attached which sets forth the costs and fees of membership. Patients choosing the monthly option will receive the core benefits of the program spread out over a 12 month period.

If any active member of the practice believes they can no longer afford the costs of membership, we strongly encourage them to contact their ACHC provider to review all options before terminating membership.

Payment options for your convenience include: Monthly or Annually. Annual payments may be made by cash, money order, check, credit card or checking account bank withdrawal. For those paying monthly, ACHC requires that an automatic payment plan via credit debit card or bank withdrawal be arranged at the time of enrollment.

Withdrawal from membership may occur at any time. A 30 day written notice is required. Any member that closes or ends their automatic payment agreement without written pre-notification will be treated as having terminated their membership. Your ACHC provider may also terminate the provider-patient relationship with 30 days written notice should interactions by the patient be seen to compromise the therapeutic nature of said relationship.

Delinquent accounts will be assessed a $25 fee if payment is more than 5 business days past due, and an additional $25 will be assessed for every additional five business days until the account is paid up to date. Membership accounts more than 30 days delinquent will be considered inactive. Membership may be reinstated at the discretion of ACHC as long as openings in the practice are available, and may assess a non-refundable re-enrollment fee of $200.

NON-SUFFICIENT FUNDS: Any check returned for non-sufficient funds (NSF) will be subject to a $35.00 NSF fee.

Refunds will be provided to each individual patient or family within 30 days following the last month of membership. Refunds can be in the form of: credits to your bank account via automatic clearing house, credits to your credit/debit card, check sent via US Postal Service or may be available for pick up if pre-arrangements are made and the party presents appropriate identification. Refunds will include an itemized statement of fees and balances. Refunds will include the balance of any monies paid in advance minus the months used and the enrollment fee.

Appeals regarding any policy addressed herein may be made in writing. The relevant officer of ACHC will review the circumstances and a written response will be given within 30 days.