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frequently asked questions

questions

How is GetzWell Pediatrics different from other pediatric practices?

GetzWell Pediatrics is an integrative practice offering a qualitative approach to the delivery of medical care. Our integrative approach combines the best of conventional and complementary medicine, addressing not only physical symptoms but also psychological, social, environmental, and spiritual aspects of health and illness. We believe in stimulating the innate human capacity for healing, while teaming with parents to provide safe and effective choices for your child’s care.

At GetzWell, our highly trained staff is unhurried, listens to you, and focuses on your child’s unique needs. We offer longer visits, guaranteed availability, counseling for healthy lifestyles, a state of the art paperless office and other customized services including nutritional counseling and lactation expertise for nursing mothers. This contrasts with most other pediatric and family practices that don’t provide such support services and where each doctor routinely sees over 25 patients per day. In such quantitatively oriented practices, the average office visit with a physician lasts about 12 minutes.
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Why do you offer prenatal nutrition counseling in your pediatric office?

At GetzWell Pediatrics we believe whole kid care begins before your child is born. The environment in the womb is just as important as the family and world your child enters at birth. We want to help optimize your child’s health by providing nutritional support before and during your pregnancy. We are experienced in helping women to achieve the highest level of nutritional health and well being and are available to educate, guide, and motivate mothers, children, and the entire family.
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Do you take insurance?

We are a fee for service practice which means we don’t take insurance. We accept payment at the time of the visit in the form of check, Visa, Mastercard, cash, and debit cards. However, prior to leaving our office we will provide you with insurance specific paper work so that you may seek reimbursement directly from your insurer.
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Will my PPO insurer reimburse me for the cost of my child’s office visits?

In most cases, yes. While we cannot guarantee a specific reimbursement rate, many of our patients with PPOs report their health insurer reimburses 60-80% of the amounts we charge for our services (after any applicable deductibles have been met). Most insurers classify us as an “out of network” provider. HMO insurance will not typically cover our services, which is why most of our patients have or obtain PPO health insurance. (See Why do I need health insurance? for more information about PPOs.)
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What is the procedure for getting reimbursed by my insurer?

We try to make it as easy as possible for you by generating an insurance specific claim form which you submit along with our billing receipt to your insurer. Many of our patients report that they are often reimbursed (once deductibles are met) within 4 weeks of submitting such paperwork.
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Why do I need health insurance?

GetzWell Pediatrics is not a substitute for your health insurance. However, by choosing to bring your child to us, your health insurance needs will change and you may find it advantageous to alter your current plan. Three suggestions are listed below. In the long run, your aggregate medical/insurance costs could decline if you adopt one of these options. Your situation is unique and the decisions you make should always be guided by your personal financial and tax advisors as well as a qualified insurance agent.

a. Increasing your health insurance deductible

Many healthy families have a Preferred Provider Organization (PPO) health plan, with a relatively low ($500-1000) deductible. However, the premiums for such a plan can be quite high. By increasing your deductible, monthly premiums may be greatly reduced, resulting in significant annual savings.

b. Using a Health Care Reimbursement Account (HCRA) to pay for services at GetzWell Pediatrics

As an employee, you may have access to a Health Care Reimbursement Account as part of your benefits package. An HCRA lets you set aside a predetermined annual pre-tax amount, to use for qualified medical expenses. Individuals may generally direct a maximum of $5000 per year to such an account; if their spouse is also an employee, then together they may contribute up to $10,000. Note, however, that you must carefully track your health expenses, as the IRS requires that you forfeit any unused HCRA money after the closing date of the plan year.

c. Using a Health Savings Account (HSA) to pay for services at GetzWell Pediatrics

Health Savings Accounts provide tax advantaged opportunities for the self-employed.   An HSA combines a tax favored savings account and a qualified high deductible health insurance policy (HDHP). Based on 2009 figures, Health Savings Accounts allow you to deposit up to $3,000 for individuals or $5,950 for families into your HSA.   Whatever you deposit into your account up to April 15 each year is an "above the line" tax deduction for your annual taxes, meaning you get a federal income tax deduction for money you put in even if you take the standard deduction and don’t itemize. To qualify, you must have an approved high deductible insurance plan with at least a $1,150 deductible for an individual or $2,300 deductible for your family. The annual out-of-pocket expenses for a qualified HDHP including deductibles, co-pays and co-insurance cannot exceed $5,800 for an individual or $11,600 for a family. Your contributions to a HSA accrue interest on a tax exempt basis. Unused amounts roll over to the succeeding year and aren’t taxed if used for qualified medical expenses!

The above suggestions are not intended as specific tax or insurance advice and may become outdated without notice. Your situation and insurance decisions should be discussed with your financial and tax advisors and a qualified insurance agent.
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Won’t you get too busy and wind up being difficult to reach like most other doctors?

No. Note that the average solo pediatrician has over 2000 patients and sees more than 120 patients per week. We have made a conscious decision to limit our practice size because our primary goal is to offer the highest quality medical care to our patients. One of the ways we do this is by charging an annual open access membership fee. We will place a limit on new patients joining the practice before we allow the quality of care we provide to decline.
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What is an open access membership fee?

Each new pediatric patient is assessed an annual open access membership fee upon joining our practice. Our current annual fee is $240 for a single child and $390 for families with 2 or more children. This allows us to keep the practice small and offer open access to our members under most circumstances, which means we will be able to see you (even for non-urgent matters) either on the day of your request or within three business days. Additionally, the membership provides 24/7 direct access to a GetzWell professional, priority appointments over non-members, no charge for prescriptions called in, answers to brief non-urgent email questions at no additional cost, a 10% discount on all in-stock supplements, among other benefits. Non-members pay a surcharge for all medical services, etc.

If you are an existing patient, you may arrange an appointment by emailing info@getzwell.com or by telephone at (415) 826-1701. During our regular weekday business hours, we allocate a portion of appointments each day for our established patients to visit us within hours or a few days of their request, depending on their needs. This eliminates having to plan weeks in advance or to reschedule because of unanticipated conflicts. If you would like to become a new patient, please call us during business hours.
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Are lab tests covered?

In general, your PPO covers the cost of lab tests and other studies as if they had been ordered by an “in network” physician. We suggest that you check with your insurer or your employer’s HR department, as each plan varies.
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What if my child needs hospitalization or specialist care?

GetzWell Pediatrics works with many of the Bay Area’s finest hospitals. If your child needs hospitalization, at your request, we will co-manage hospital care and/or maintain contact with your hospital team. Upon discharge, we provide seamless follow up.

The providers at GetzWell Pediatrics will arrange for pediatric specialty care if it is needed. We have relationships with pediatric specialists at all the major hospitals in the area: UCSF, CPMC, Children’s Hospital Oakland and Lucile Packard Children’s Hospital at Stanford.
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What happens if my child is sick outside of regular business hours?

For members only, we provide an after hours phone number which will connect you directly with the on call pediatrician, typically Dr. Getzelman. This eliminates phone trees, answering services, and impersonal nurse triage systems.
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