A list of common questions associated with Dr. Huzicka’s practice and concierge medicine

How does First Internal Medicine work?

First Internal Medicine operates using a concierge medicine model where patients need to pay an annual fee in order to receive medical care. The annual fee covers all services provided in the office, including preventive care, urgent care, management of chronic diseases etc. We do not accept health insurance payments. However, since the annual fee covers medically necessary services that are not covered by health insurance, it is a tax-deductible item, a valid HSA (Health Savings Account) expense or it is eligible for FSA (Flexible Spending Arrangement) reimbursement.
Service PERSONAL VIP CARE This is what other, insurance-based, primary care practices typically provide
Appointment length (time with provider, problems discussed) 45-60 minutes or longer; 90 minute initial visit Any number of problems. 15 minutes, 1-2 problems discussed
Appointment scheduling Guaranteed same day appointment. Earliest appointment often not available sooner than in 1-2 weeks.
Management of minor acute problems (cold, flu, bronchitis, UTI, back pain) without office visit 24/7 direct access to Dr Huzicka via phone and email. Unlimited number of phone consultations.  Most insurance carriers do not cover this service. If providers offer the service, they charge $50-$100 per encounter.
Online medical services charge $50-75 per encounter.
Provider access after hours, during weekends and holidays Direct access to Dr Huzicka’s cell phone 24/7
for personal phone call (preferred) or text messaging.
Call back frequently provided by a call center RN rather than an on-call physician. 
Review of test results Full discussion of all results will be done personally by Dr Huzicka by phone or email. Follow-up testing ordered without an office visit. Patients notified by office staff.
Unexpected abnormalities typically require office visit to discuss.
Email with provider Email response by Dr Huzicka within 24 hours. Please DO NOT USE e-mail or text (SMS) for any new or urgent symptoms – CALL Dr Huzicka’s cell phone instead. Not covered by insurance.
Providers vary in availability of this service. Providers typically require office visit to address new symptoms or unexpected results.
Telemedicine - text messaging, chat, videoconferencing Dr Huzicka is available 24/7.
Current capabilities include FaceTime, Skype, Tango; photo, audio, and video file sharing via email or cloud.
Not covered by insurance. Most non-concierge providers do not offer this service.
Specialized online services (e.g. AmWell) charge $50-75 per encounter.
Preventive exam & testing Comprehensive preventive visit lasting 90 minutes which includes full physical exam. Additional testing included in the preventive exam:  - EKG and lung function test  - Advanced cardiovascular testing (comprehensive lipid panel, Coronary calcium score, carotid artery scan; aorta enlargement scan) - Thyroid, vitamin D, PSA, testosterone or estrogen test. According to Patient Protection and Affordable Care Act (Obamacare) only services given grade A or B recommendation by USPSTF are covered free of charge (details www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/ ). Actual physical exam is not a requirement and therefore it may not be performed during ‘physical’.  
Personal health coaching Concierge patients benefit from limited number of patients in the practice as this will allow longer and more frequent appointments. Dr Huzicka can spend enough time with each patient to evaluate and manage complicated health problems in-house rather than referring everything to specialists. Also, Dr Huzicka personally advises each patient regarding best utilization of their insurance (testing cost etc.). Dr Huzicka communicates directly with specialist(s) to facilitate referral and care coordination. Many practices pursue the idea of ‘Patient-centered Medical Home’. However, in order to accommodate the growing number of patients, the physician becomes a manager of mid-level providers, nursing case managers and medical assistants without being personally involved in the patient care.    

Office based testing
All included in the membership.
Currently, we offer EKG, lung function testing, urinalysis, Strep/influenza /urine pregnancy tests.
Billed to insurance. Deductible often applies.
Basic laboratory testing: 
Blood count, metabolic panel, cholesterol, thyroid (TSH), urinalysis, hemoglobin A1c, INR
Included in membership (retesting based on medical appropriateness is also included). Blood draw in the office. Billed to insurance by service provider. Many patients pay full price due to high deductible. Many offices do not offer on-site blood draw.
Advanced laboratory testing Personal VIP members will receive 30% discount for cash-only tests. Typically not offered as such testing is considered “experimental” and not covered by health insurance.
Diagnostic imaging – X-rays, ultrasound, CT, MRI Cardiology testing (Echo, stress test)  Billed to insurance by service provider. Personal phone call by Dr Huzicka to insurance company to get prior authorization as quickly
as possible.
Counseling provided to patient regarding most cost-effective alternatives (including cash prices).
Billed to insurance by service provider. Providers associated with hospital systems (HealthOne, Centura) often refer patients to ‘their’ hospitals for testing. This is associated with up to 85% higher cost which, if the patient has a deductible, is passed on to the patient.
(see http://articles.mercola.com/sites/articles /archive/2012/01/21/mri-could-save-thousands.aspx)
Vaccines Standard adult vaccines
(influenza, Tdap, shingles, “pneumonia”) included
in the membership
 if not covered by insurance.
Practices should follow ACIP (Advisory Committee on Immunization Practices, www.cdc.gov/vaccines/acip/ ) recommendations.
Travel vaccines Typhoid (every 3 years) and hepatitis A (if not immune)
is included in the membership. Please note: we are not a certified Yellow Fever vaccine provider and cannot issue International Certificate of Vaccination (yellow card).
Often cash pay. Many practices do not provide health counseling before foreign travel and refer patients to travel clinics.  Those charge $50-100 per consultation in addition to vaccine and administration costs.
Medical certificates, form completion Included in the membership. Many offices charge fees for form completion, typically $25-$35 per form.
Copy of medical records to life insurance, social security, for legal purposes Included in the membership. Charges per Colorado Department of Health apply
Cost $3,000 per year for one person;
$5,000 per year for two persons;
$6,000 for a family up to 4 persons.
unless requested by the member.
“No additional cost.” However, copays and deductibles are so high these days that many patients pay full price for their outpatient care. Only preventive services mandated by Obamacare are truly fully covered by insurance.
Membership cost is eligible for payment from HSA Yes N/A
Membership cost is tax deductible Yes N/A

How do I become a client?

New patients are accepted on a first-come, first-served basis. To become a client, please contact us and we will walk you through our customized process and discuss options for new client availability.

Will my insurance support concierge coverage?

Concierge medicine is outside the coverage provided by the majority of insurance providers. In general, your insurance provider will not cover expenses incurred.

What happens if my doctor is unavailable?

Dr. Huzicka offers 24/7 on-call availability to all participating patients. If the doctor is unavailable, an assistant or approved physician will be in touch ASAP. In case of emergency, please contact 911 or travel to the nearest ER.

Does Dr. Huzicka charge an annual or monthly fee?

First Internal Medicine operates on an annual subscription basis.

Are there payment plans available for the annual fee?

We do not currently offer payment plans to cover our annual subscription fee.

Am I still responsible for my insurance deductible and copayments?

In general, most major insurance providers do not cover concierge medicine services. You are responsible for all copayments and insurance deductibles when seeing a doctor outside of our network, or in an emergency room setting.

What if I have an emergency?

In the event of an emergency, please call 911 or travel to the nearest ER, before contacting Dr. Huzicka.

Is Dr. Huzicka accepting new patients?

In the interest of providing exceptional care to our members, we limit the number of accepted patients, and enroll new members on a first-come, first-served basis. Please contact us to find out if we are currently taking new members.

What if I need to see a specialist or surgeon?

We can recommend surgeons and specialists within our approved network of providers to address all medical conditions.

What happens if I become ill while traveling for work or vacation?

We are connected to a network of approved concierge healthcare providers spanning the globe. If you become ill or injured while travelling, we can assist in finding an approved provider to treat you or can utilize telehealth services.

Learn more about Concierge Medicine and Dr. Huzicka’s practice. The doctor is in.