What is direct care or concierge medicine?

It is a modern healthcare model in which insurance is removed from the patient-provider relationship, and allows for patients to have direct access to their health care provider. Typically, the patient panel size is limited so that the provider has more time and energy to take care of the people on their panel. In an insurance based model, panel sizes can be as large as 1500-5000 patients.  In DPC, panel sizes are typically 200-600.  CCWW is even smaller. Patients typically have direct access to their provider between visits, and eliminates the need for you to come in to be seen for minor health concerns or questions.

Do you do telehealth?

Yes, for anyone in North Carolina.

Why do you require patients to pay a monthly fee?

Health and wellness is a long term effort, and I am interested in aligning with individuals who are invested in their health for the long haul.

What is included in the membership?

Annual physical exam, wellness consultations, chronic disease management, acute care.  Access and communication to your provider between visits.  Visits on the weekends/after hours can be arranged for a mutually agreed upon time. Text/email support with your provider.  All/any paperwork that is required for medication authorization, employment, jury duty, or other miscellaneous paperwork as it comes up. 

What is not included in the membership?

Any visits to urgent care or emergency department or hospital.

Labs or imaging, with the exception of point of care testing in the office (urinalysis, microscopy, hemoglobin A1C, and COVID/flu when in season.

What about labs and imaging?

If you have insurance, you are encouraged to use your insurance for labs and imaging. The way that the lab or imaging facility contracts with your insurance does not regard whether or not the ordering clinician is an in or out of network provider.  However, sometimes these costs are still high and for that reason CCWW offers cash pricing with Quest Diagnostics for frequently ordered labs.  For example, a TSH is $10, a CBC is $10, and a testosterone is $40.  You must indicate prior to the lab draw if you prefer your labs are cash pay.  In that case, you will pay CCWW for your labs prior to them being drawn.  CCWW also has an account with LabCorp, but does not have cash pricing with them.  Therefore, Quest Diagnostics is CCWW preferred lab.

There are other functional testing that is not typically covered by insurance and this includes specialized hormone testing, urine neurotransmitter testing, functional gut testing in which case these tests will be pre-paid prior to ordering.  

There are some imaging modalities that are not covered by insurance such as coronary calcium artery score and abbreviated breast MRI.  If indicated and ordered, pricing will be discussed.

All lab and imaging bills are patient responsibility.

I am not sure which is best for me to book - a consult or go ahead for the comprehensive membership?

For most individuals, the membership makes sense because it is not going to take 1 visit to figure out the best course of action for most people.  Perimenopause, in particular, is like trying to treat a moving target.  Sometimes we pick the right course of action, sometimes we don't! The membership allows for ease of care in between visits, so that we don't have to book several subsequent visits, costing you more money in the long run.  If you are still uncertain, we recommend just book an initial consultation and you can decide to join the membership for your follow ups (registration fee waived).

But what if I am healthy and don't need to see you often?

There is no long term commitment.  You can cancel when/if you feel your healthcare needs are met.  However, we can't anticipate our health care needs.  The goal of direct care is to establish a meaningful relationship with your provider so that when a health need arises, it can be addressed in a timely, appropriate, and compassionate manner.

Is this like insurance? 

No membership based medicine is not like insurance.  I highly recommend you have an insurance plan for specialty visits, emergency, and surgical procedures.  However, I cannot advise on which insurance plan or carrier might be right for you?

Can I use my insurance for labs or imaging?

Sure! The way your insurance contracts with imaging centers, pharmacies, and labs is between your insurance and these entities.  Sometimes labs are less expensive if you do not go through your insurance, but I will leave that up to the patient as it is impossible for me to know what your benefits are.

I have direct cash lab pricing through Quest, which is my preferred lab. I also have an account with LabCorp, but do not offer cash pricing for LabCorp.

I can order imaging wherever your insurance prefers.  If you do not have insurance or prefer not to use it, I have cash pricing for an outpatient imaging center.

Based on clinical scenario I also offer functional medicine testing including urine neurotransmitter testing (ZRT), saliva hormone testing (ZRT), food sensitivity testing (Genova), and pharmacogenic testing for psychotropic medications (Genesight).  These labs may or may not be covered by insurance.

Can I get a superbill?

Insurance does not cover membership fees, and there is no ICD10 or CPT code attached to membership billing.  Both of these codes are required for insurance reimbursement.  For this reason, there is not a way to produce a superbill for membership fees.  It is up to you to look to see if your HSA/FSA will cover the membership fees.  I can still produce a superbill for those who choose to be non-members and their visits fall under fee-for-service.  You can download a superbill by going to your Hint account.

What if I want to see you but don't want to sign up for a membership?

I believe everyone should have access to menopause and sexual medicine care, and they may not want to sign up for recurring membership.  If you anticipate you do not need frequent communication between visits, and plan to only be seen 2-3 times per year, a fee for service model makes sense for you.  Please visit the fees tab to learn more.

Can I talk to Christina Saldanha, PA-C before signing up?

Due to the busy nature of our clinic, Christina will not be able to discuss your case with you on the phone prior to a consultation.