FAQs

Traditional practices are volume based. Physicians are normally compensated on the number of patients they can see per day due to the increased focus on insurance billing. A typical full time physician will care for an average of 3,500 patients in his or her practice and will see an average of 25-35 patients per day. This volume is necessary in order to have a financially viable practice. As insurance companies decrease reimbursements, physicians are forced to increase their volume to maintain their practice. At Personalcare Physicians of Newport Beach we charge a yearly access fee that allows us the financial ability to see fewer patients, no more than 350 per physician, usually no more than 5-6 per day. This allows us to dedicate quality time to every patient and to offer superior, world-class treatment options to each of our patients individually.

It is our experience that Personalcare Physician’s patients are healthier and have fewer medical complications. Our primary goal is to diagnose and treat medical conditions in the early stages when they are potentially curable and before they advance. This leads to fewer sick and hospital days, fewer days lost at work, and fewer medical complications, which will allow people to live longer and healthier lives. Additionally, we work with our patients to proactively manage their health to maximize their health and vitality. More than treating illness, we are creating health.

The access fee allows our physicians to limit their practice size. The benefit for patients is that they have enhanced access to their physician. All patients have the ability to call their physician on his or her cell phone 24 hours a day, 7 days a week, including email and text messaging. Same day or next business day appointments and emergency house calls can be arranged. Physicians will provide dedicated time to all medical needs including specialist tracking, review, and collaboration.

1. You will be responsible for a yearly Access Fee to Personalcare Physicians. This Access Fee is for non-medical services and is not covered by insurance, although it may be reimbursable if you have an individual healthcare or flexible spending account. Please consult your employer or tax advisor.

2. Your Personalcare Physician will be your primary physician who you will see for most medical needs. You will enjoy, in most cases, same-day appointments and exceptional coordination of care should you require a specialist.

3. To get you started we will schedule you for a comprehensive, extensive yearly physical. You will have extensive time with your new physician during this visit, as well as we will introduce you to a Healthfit 4 Life fitness and nutrition specialist to begin the development of your overall care plan.

4. Coordination of Care — Should you need hospital or specialty care, your Personalcare Physician will work closely with these providers as your advocate to ensure quality of care.

5. Personalcare Physicians will bill your PPO insurance for office visits and procedures, just as your traditional healthcare provider currently does.

6. You will continue to be responsible for your co-pays, deductibles and non-reimbursable fees as specified by your PPO insurance.

7. You will need to continue to carry PPO health insurance coverage which allows you to self-refer without the permission of a primary care physician within the insurer’s network or an indemnity plan. Because of the self-referral limitations of HMOs, we are unable to accept this type of insurance

8. Personalcare Physicians does not participate in Medicare. By law, all of our patients are required to enter into a private contract with Personalcare Physicians. Due to the fact that we deliver private medical care on a fee-for-service basis, services delivered under this model are not reimbursable by Medicare. We do accommodate Medicare clients by providing a “pay for service” model. Please contact us for more information.

Your annual physical will be approximately a 2 hour appointment and the folloowing services will be provided:

• Past surgical history review
• Medication review
• Immunization review
• Social history review
• Exercise history review
  
• Comprehensive physical exam
  
• Weight & height
  
• Temperature
  
• Heart rate
  
• Blood pressure
  
• Body composition analysis
• Impedance index
• Body mass index
  
• Vision test
• Hearing screening (audiogram)
  
• Pulmonary function (spirometry)
• Resting EKG
  
• Fasting lipid pane
  
• Coronary heart disease risk index
  
• Dermatology exam (full body skin check)
  
• Functional movement screen
  
• Male prostate exam
  
• Urinalysis
  
• Biologic health age assessment
  
• Female halo breast pap
  
• Female breast & gynecologic exam (including pap smear)
• Wellness and lifestyle consultation

At Personalcare Physicians of Newport Beach over 20% of our existing practice is with children or dependents of our adult clients. We offer a reduced rate for all clients under the age of 22 as the yearly comprehensive physical is normally not needed.

You will be responsible for a yearly Access Fee to Personalcare Physicians. This Access Fee is for non-medical services and is not covered by insurance, although it may be reimbursable if you have an individual healthcare or flexible spending account. Please consult your employer or tax advisor.

Traditional fee-for-service plans such as preferred provider organizations (PPO) or indemnity plans will allow us to best coordinate patient care. In general, these are the only plans that will allow clients to make appointments with specialists without the need for a referral or approval and do not require that a client’s primary care physician be in a specific network. Because of program limitations and resulting servicing constraints, we are not able to provide services under HMO insurance plans. Our physicians participate in most PPO plans; please contact us for further verification.

As clients are treated for medical appointments and services, their insurance will be billed for the same normal office visits, procedures, labs, and prescriptions that would normally incur in any medical situation. Personalcare Physicians will bill your PPO insurance for office visits and procedures, just as your traditional healthcare provider currently does. You will continue to be responsible for your co-pays, deductibles and non-reimbursable fees as specified by your PPO insurance.

Personalcare Physicians does not participate in Medicare. By law, all of our patients are required to enter into a private contract with Personalcare Physicians. Due to the fact that we deliver private medical care on a fee-for-service basis, services delivered under this model are not reimbursable by Medicare. We do accommodate Medicare clients by providing a “pay for service” model. Please contact us for more information.

Our physicians will be available for phone consultation 24 hours a day, 7 days a week. However, there may be times when we will recommend utilizing the expert staff at Hoag Hospital’s Emergency Department, an affiliated Hoag urgent care, or an alternative medical facility if you are out of Orange County. We will always help to assure that you are well taken care of.

At Personalcare Physicians of Newport Beach, we are proud to be affiliated with Hoag Memorial Hospital in Newport Beach, rated one of the best hospitals in Orange County and among the top 100 hospitals nationwide for its high quality patient care and extensive specialty services. We use the services of Hoag Hospital’s exclusive 24 hour Hospitalist Group to manage your care while hospitalized. We work closely with these world-class physicians to assure all your in-patient and discharge-planning needs are met.

In the event you or your family must be hospitalized in another hospital, we would then help to coordinate care with a hospitalist or the specialist that was managing the care. We will do whatever we can to assure that our clients are getting the best care possible.

Yes. All of our physicians are well-trained and experienced in routine medical practices. However, we recognize that you may prefer to continue to see a specialist that you have developed a relationship with such as an OB/GYN. We will facilitate communications with these specialists in an effort to support your full medical profile.

No, but we strongly encourage each of our patients to see us on a regular basis. Preventative care is the best foundation for an excellent quality of life. Your annual fee covers both the annual exam and our availability for complete medical supervision of your medical care. If you choose not to participate in the annual physical exam, you will still pay the full annual fee.

We have patients who live all over the world, but if you must move and transfer care, we will assist you with finding a new physician. Your medical records will be sent promptly upon your signed release of information.