frequently asked questions
questions
- What is integrative medicine?
- Why do you offer prenatal nutrition counseling in a pediatric office?
- What insurance do you take?
- Does this replace my child’s health insurance?
- Won’t you get too busy and wind up difficult to reach like our regular doctor?
- What is an open access fee?
- Does the open access fee mean you are a “boutique” practice?
- Are lab tests covered?
- What if specialist care is needed?
- How do I request a prescription refill?
- What happens if my child needs to be hospitalized?
What is integrative medicine?
Integrative medicine combines the best of conventional and
complementary medical approaches, addressing not only physical
symptoms but also psychological, social, environmental and
spiritual aspects of health and illness. It believes in stimulating
the innate human capacity for healing, empowering patients
in their own care, while providing them with choices in healthcare
that are proven to be safe and effective.
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Why do you offer prenatal nutrition counseling in a 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 after
birth. We want to help optimize your child’s health
by providing nutritional support before and during your pregnancy.
Our certified nutrition counselor is experienced in helping
women to achieve the highest level of nutritional health
and well-being, and she is available to educate, guide, and
motivate mothers and families.
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What insurance do you take?
GetzWell Pediatrics offers a qualitative approach to the delivery of medical care. This contrasts with other practices where doctors routinely squeeze in over 25 patients per doctor each day. We believe that individuals and families should be free to select pediatric health care on the basis of an acceptable tradeoff between quality and cost. We want to spend unhurried time with you, focusing on you and your child’s needs, and we are able to do this by eliminating the burdensome bureaucracy associated with the insurance industry.
We are a fee-for-service practice. We don’t accept insurance; however, we offer longer visits, guaranteed availability, counseling for healthy lifestyles, a state-of-the-art paperless office and other customized services in exchange for payment at the time of the medical visit. In turn, prior to leaving our office, we will provide you with a claim form for your insurance company so that you may be reimbursed directly, in accordance with the terms of your plan. We are an out of network provider.
We accept payment in the form of credit card, personal check,
or cash. Our charges are based on the amount of time spent
with you and any materials or equipment we use during the
visit. As a principles-based office, all aspects of our practice,
including our professional fees, reflect our ethical and
rational approach to medical care.
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Does this replace my child’s 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, if you were to adopt one of these choices, your aggregate medical/insurance costs could decrease. Your situation is unique and the decisions you make should be guided by your financial or tax advisor and a qualified insurance agent/broker.
1. Increasing your health insurance deductible
Many healthy families have a Preferred Provider Organization (PPO) health plan, with a relatively low ($500-1000) deductible. The premiums for such a service can, however, be quite high.
By increasing your deductible, monthly premiums may be reduced by almost half, resulting in significant annual savings to you.
2. 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. Such a program lets you set aside a predetermined amount, pre-tax, for use for qualified medical expenses. Individuals may generally direct a maximum of $5000 per year to such an account, but if their spouse is also an employee, then together they may contribute $10,000. Note, however, that you must carefully track your health expenses as the IRS requires that you forfeit any unclaimed money in your HCRA account after the closing date of the plan year.
3. Using a Health Savings Account (HSA) to pay for services at GetzWell Pediatrics
New in 2004, and providing opportunity for the self-employed, the Health Savings Account is a combination of tax favored savings account and a qualified high deductible health insurance policy. To qualify you must have an approved plan with at least a $1000 deductible for an individual or $2000 deductible for your family. Each year you and/or your employer can contribute enough to cover 100% of your deductible (up to a maximum of $4000 for an individual or $8000 for a family). As with a Health Care Reimbursement Account, the money goes in before taxes (or is tax deductible), but unlike an HCRA, accrues interest tax free, rolls over to the next year, and is never taxed if used for qualified medical expenses!
As always, your situation and subsequent decisions should
be discussed with your financial or tax advisor and a qualified
insurance agent/broker.
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Won’t you get too busy and wind up difficult to reach like our regular doctor?
No. Note that the average pediatrician has over 2000 patients
and sees more than 120 patients per week. Our primary goal
in limiting our practice size is to be available to you offering
the highest quality medical care.
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What is an open access fee?
Each new pediatric patient is assessed an annual $200 open access registration fee when joining our practice (but never more than $350 for 2 or more children). This allows us to keep the practice small and offer open access under most circumstances. We will be able to see you, even for routine matters, either on the day of your request or within three business days. If you are an existing patient, you may arrange an appointment by emailing reception@getzwell.com or by telephone (415) 826-1701. If you are a new patient, please call us during business hours.
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. This eliminates the need to plan weeks in advance or to reschedule because of unanticipated conflicts.
For expectant mothers who purchase one of our nutrition consultation
packages during their pregnancies, we discount by 50% the
open access registration fee for newborns joining our practice
at birth.
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Does the open access fee mean you are a “boutique” practice?
No, we are not a boutique practice. While boutique practices
are springing up in the Bay Area, Los Angeles and New York
City, among other places, they are generally adult only clinics
run by internists or specialists who charge membership fees
which average $3000 per year (and as much as $10,000). These
doctors often also charge for office visits and other consultations,
which makes these practices prohibitively expensive for most
adults.
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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 the HR department
of your employer, as each plan varies.
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What if specialist care is needed?
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, Lucile Packard
Children’s Hospital at Stanford.
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How do I request a prescription refill?
You may request a medication refill by emailing us or by phone. We
cannot
supply medications for those who have not been examined by
one of our providers; it violates California State Law.
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What happens if my child needs to be hospitalized?
GetzWell Pediatrics works with many of the Bay Area’s finest
hospitals. If your child needs hospitalization, upon request,
we will manage in-house hospital care and/or maintain contact
with your hospital team. Without such oversight, if your
child is hospitalized, up to 3 different in-house pediatricians
(known as hospitalists) per 24-hours will manage your child’s
care. This lack of continuity raises the risk of errors.
These risks are ameliorated if GetzWell Pediatrics is engaged
to provide oversight and coordination during hospitalization.
Upon discharge, we provide seamless follow-up.
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