Coronavirus Update 13: Annual Exams, Chronic Disease Management, Addressing High Demands, COVID-19 Testing, Flu Season

Dear Patient,

I hope this letter finds you healthy and safe. Much has occurred since our last update, so I wanted to try to catch everyone up on where things are for us as a practice. The priority of Buckhead Medicine continues to be the health and well-being of our existing patients. We know that many of you have been dealing with COVID-19 infection with yourself or your family members. We continue to strive to ensure that we are able to provide appropriate and timely medical care for you during the current pandemic. We continue to urge everyone to frequently wash your hands, follow social distancing recommendations, wear masks, and avoid groups of greater than 8 to 10 people.

ADDRESSING THE HIGH DEMAND
As a practice, over the last 2 months, we have experienced unprecedented demands from our patients, particularly those who have been affected by this virus. We have been working continuously to improve our processes and protocols and have hired additional staff to support our established patients. We appreciate your patience through this transition. We have added a new automated receptionist system for high call volumes and have added an overflow support system with a live on-call answering service to assist us. To ensure your call is handled expeditiously, when calling our office, please identify yourself as a concierge patient, as we are currently receiving excessive calls from new or non-established patients and have hired new staff to support our practice and they may not be familiar with all the names of our concierge patients.

I do want to remind you that if you are having any difficulty in reaching me or our staff, please know that for urgent medical matters, that need to be handled immediately, you can always reach me by cell phone or text message at 404-XXX-XXXX. If I am not able to respond to the call or text immediately, I will forward the message to our nurse practitioner or our nursing staff. You can also reach me by email at XX@buckheadmedicine.com. In order to appropriately manage call volumes, however, please always initially reach out to our office main number at 404-257-5585 or use the OHMD application.

ROUTINE LABS PROCESSING AND REPORTING
We are experiencing issues with the reliability of processing and reporting from our long standing commercial lab providers. We believe this is due to high volumes which they are currently experiencing. We are working closely with our lab partners to reduce these occurrences. In certain situations however, we may have to repeat blood draws, as some labs are not being processed as ordered. We apologize for this inconvenient and expect this to improve as our lab partners adjust to the high volume demands.

CHRONIC DISEASE MANAGEMENT AND ANNUAL EXAMS
We are continuing to actively reach out to each one of you to ensure that from a preventive medicine, as well as chronic disease management status, we are addressing your needs and keeping up with appropriate monitoring and treatment. We also are keenly aware that for our elderly or frail patients, annual exams may not be indicated given the current pandemic. For those at greatest risk for contraction of COVID-19, we are deferring a face to face visit unless absolutely necessary. If you have not received a call from us yet, and feel you require more expedited evaluation for an annual exam or for chronic disease management, please reach out to our office.

For annual exams we have successfully implemented a protocol where we initially set up a ZOOM call to go over prior medical history, family history, upcoming screening requirements and any medical concerns or medical complaints you may have. This is followed, usually within a week’s time, by a face-to-face encounter in the clinic, for the physical exam, vital sign measurement, and EKG if needed. During this portion of the encounter we perform blood work and urine collection. We will subsequently set up a phone call to review these labs once resulted. I know these are additional steps for the annual exam, but we believe that by following this protocol, we are able to spend more time in reviewing pertinent history and requiring less face-to-face time in the clinic, thereby decreasing unnecessary exposure.

COVID-19 Testing
As far as COVID-19 testing goes, we are working to enhance our testing capacity and increase available options for testing within the practice. We currently have the following COVID-19 testing available:

• COVID-19 Nasal PCR by Quest Diagnostic laboratories, billed to insurance when appropriate, insurance does not always cover this test, turnaround time 10-14 days
• COVID-19 Nasal PCR by Life hope labs, not billed to insurance, expedited turnaround time 2-3 days.
• COVID-19 Serum IgG antibody testing by Quest diagnostic laboratories, billed to insurance when appropriate, turnaround time 2-3 days.

Beginning September 1st, 2020 we will be adding an in-house COVID-19 rapid test:

• COVID 19 in-house rapid testing (ID Now), billed to insurance when appropriate, insurance does not always cover this test, turnaround time 15-20 minutes. This test is not as sensitive as the above Nasal PCR tests, but this test does offer the benefit of rapid results.

INFLUENZA SEASON AND VACCINATION
The Flu season is fast approaching. We believe the presence of both the influenza virus and COVID-19 during this upcoming fall and winter season will likely complicate the clinic presentation and response to treatment for both infections. We continue to strongly encourage that everyone receive the influenza vaccine to protect themselves from Influenza. My recommendation is for vaccination sometime between Mid-September to late October. We will have the Flu vaccine available for administration in our office during this period.

We will get through this together,

Dr. Edward Espinosa
Buckhead Medicine
91 W. Wieuca Road NE
Atlanta, GA 30342
404-257-5585

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FAQ

What services are provided as a part of my annual fee?
  • Same-day or next business day appointments
  • Direct access to Dr. Espinosa via his personal cell phone after hours, weekends, and holidays
  • Minimal office wait times
  • Longer, more comprehensive appointments
  • House Calls (requires additional trip fee)
  • A strong focus on preventive medicine, long-term health and wellness
  • A personal professional relationship with your physician
What is the mission of Buckhead Medicine?

We strive to provide the highest quality medical care, emphasizing a comprehensive approach to prevention and disease management. We want patients to be completely satisfied with every aspect of their care.

Where is your office and are you on the medical staff of a local hospital?

Yes, Dr. Espinosa’s office is in Buckhead, a suburb of Atlanta. He is on the medical staff of Piedmont Hospital in Atlanta, Georgia and Northside Hospital in Atlanta, Georgia. If you require hospitalization, Dr. Espinosa will coordinate your patient care by working with the hospital based physicians. He will also make periodic hospital visits during your hospitalization.

Who will cover for you when you are not available?

On infrequent occasions when Dr. Espinosa is out of town or otherwise unavailable, he will have another qualified physician cover for him. Even while out of town, Dr. Espinosa will generally be available by phone to his patients and to his covering physicians. For practical reasons, we reserve the right to designate another qualified physician to perform any and all services should the need arise.

Do you accept insurance?

Commercial Insurance and Medicare:
Buckhead Medicine is an In-Network provider for Blue Cross Blue Shield PPO, Aetna, Coventry, Humana, Cigna, Tricare and United Healthcare. Our practice fully participates in the Medicare program. Buckhead Medicine accepts all other insurance as an Out-of-Network provider. We, however, do not participate in the Medicaid program. Regardless of your plan, we will bill your insurance for all covered services. It is our intention that no insurance-covered medical services are included in your annual fee.

HMO and Medicare HMO:
We do not participate in HMO programs. As such, HMO patients will not be able to join the practice until they transition to either a PPO or traditional Medicare plan.

Do I still need insurance if I enroll with you?

Yes. Personalized medical practices do not take the place of general health insurance coverage. Buckhead Medicine is a primary care medical practice, not a health insurance program. You are advised to continue your PPO, Medicare or other insurance program. If you are an uninsured individual and desire to enroll in the practice, we will provide you with a discounted fee schedule for office visits, tests and procedures.

What if I don't have health insurance?

For uninsured patients, Buckhead Medicine offers an uninsured patient plan. Although this plan is not insurance, it does cover for all clinic visits and any labs or tests that are performed in our office. In many cases this plan provides for significant cost savings to uninsured individuals. Please contact our office for additional details on this plan.

Will my insurance still be billed for my office visits?

Yes, we will bill your insurance company directly. The annual fee does not cover costs for regular exams or testing conducted inside or outside of the clinic. These costs are billed to your insurance provider in the same manner that traditional practices bill insurers.

Is there a co-payment?

If you have commercial insurance, we will collect the co-payment at the time of service. Medicare patients usually do not require a co-payment.

Do you bill Medicare for the annual fee?

No. The annual fee is not covered by Medicare. The fee only includes services that are not covered by Medicare and, as such, cannot be paid for or reimbursed by Medicare. We will bill Medicare for your sick visits and for any additional services performed at this practice that are covered by Medicare.

Will my commercial insurance reimburse my annual fee?

No, commercial insurance does not typically reimburse for the annual fee. However, some Flexible Spending Account and Health Savings Account plans may pay for all or part of the annual fee. In addition, some insurance plans allow the concierge fee to apply towards the annual deductible. Members are advised to consult their human resources representative at their place of employment.

Is the annual fee tax deductible?

In many cases the annual fee is a tax deductible healthcare expense. Patients are advised to consult with their tax consultant to clarify qualification in their particular circumstance.

Does the annual fee cover lab, x-ray, specialist fees and hospitalization?

Services such as labs, x-ray, specialty visits or hospitalizations are covered based on coverage determined by your insurance plan.

Are there age limits?

Dr. Espinosa is an Internal Medicine physician. His specialty is Adult medicine. Dr. Espinosa is trained to manage acute and chronic medical illnesses among adults. As such, the practice is limited to patients 17 years of age and older.

What if I have an emergency?

If you have a life threatening emergency, call 911 immediately. After you call 911, please call Dr. Espinosa. He will contact the hospital and notify the emergency room of your tentative arrival. In addition, Dr. Espinosa will provide the emergency room with pertinent medical history information

How far in advance do I need to book an appointment?

Dr. Espinosa is committed to providing his patients with easy access to care. All urgent visits will be accommodated either same day or next day, placing the greatest priority on the sickest patients. Annual physical exams will be booked 1 to 2 weeks in advance.

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. Then call Dr. Espinosa. Call Dr. Espinosa first if the problem is minor. With the exception of a few controlled substances, most prescriptions can be ordered anywhere in the country. If necessary, it may be possible for Dr. Espinosa to find you a resource in your area. If you seek care at an emergency room or urgent care center out of our area, we request that you have the doctor seeing you call Dr. Espinosa for coordination. Dr. Espinosa will be readily available by phone for consultation with you and/or other health care personnel. If you should require hospitalization while away, at your request, Dr. Espinosa will establish phone communication with you and your attending physician(s) to ensure continuity of care.

Do you make house calls?

House calls will be available to Buckhead Medicine members, within a limited radius from the clinic. These will be done as deemed appropriate by Dr. Espinosa on a case-by-case basis. Home visits will be billed to your insurance provider similar to an office visit. A separate trip fee is required for house calls.

What if I need to see a specialist or a surgeon?

Of course, Buckhead Medicine 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. Patients may frequently request for “doctors in my area”, and we can accommodate this. We will ensure that the most appropriate resources are 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 cost of prescription medications are the patient’s 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 fee even if I do not use your services?

Yes. Paying your annual fee allows you to be a member of the practice whether you are sick or well. We encourage our patients to utilize the amenities offered such as wellness consultations and emails for appropriate non-urgent health related questions, regardless of your state of health.

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