What’s this no insurance thing? How does that work?
January 5, 2025
States Dr. Fraser is Licensed in:
Alabama, Arizona, California, Florida, Kentucky, Tennessee, and Washington State
Our goal is to provide a premium service, the type you cannot get at corporate managed practices, or practices that rely on insurance. Part of us keeping things cost effective, is to not have the massive overhead of staff who spend hours trying to get your insurance to agree to pay for things they don't want to.
We don’t perform medication refills, in general (as we prescribe enough to get you to your next visit when we will refill the medications).
We don’t routinely complete medication pre-authorizations, however if desired, we will bill the time it takes to get through the paperwork, records and their online form. We however cannot guarantee that it will be approved.
It is important to read the section on labs/imaging below to avoid getting surprise billing for labs your insurance denies. We have more cost effective strategies.
We also don’t spend 7-8 minutes on average with you, after you commute, wait in a waiting room, etc. All the booked time is spent with you, allowing substantive things to be addressed at a visit. That is the value proposition, but insurance isn’t really part of it. If you aren’t on Medicare, we do give you a superbill, which you can submit to your insurance. Additionally, our focus on precision primary care with longevity is a service difficult to obtain in a comprehensive manner - we provide this expertise.
What does it cost:
We have opted for a flat hourly rate. This will be adjusted by inflation every year in January, but it is $420/hr [please note the average functional medicine doctor (as chiropractors, naturopaths, etc can step into this space as can NP's and PA's) bills over >$1,000/hr according to an article on Rupa, whereas all practitioners in this space average $460/hr]. However, for your first 2 months, while you get established and get to a stable 3 monthly follow-up, we discount this by 25%. A minimal intake visit is 60 minutes, complicated patients require 90 minutes. The booked time is spent one on one with Dr. Fraser, via telemedicine. During intake, Dr. Fraser takes substantial time, which is not billed, to review prior medical history, and order any needed labs and medications. If there is an extensive amount of material, we will request to bill you for that review and integration into our chart.
Our average patient, after initial intake and subsequent visits, sees us for a 30-minute quarterly visit, to address medication refills, labs, and any ongoing concerns. This at full price presently is $210 per quarter.
Prescriptions are generated to take you to your next physician visit. If there are refills needed, this means you’re beyond the expected follow-up date, and we need to meet. The good news is that we have appointments available every week within no more than a few days waiting.
How do labs/imaging work:
We order labs through LabCorp, Quest, or your laboratory of choice. We can order radiology testing through any local facility and provide a requisition for use anywhere. Our functional medicine labs for all the “interesting stuff” is through Rupa. It is important for healthcare consumers to understand that medical tests are paid for by your insurance at negotiated rates. However, IF your insurance doesn’t cover the test, you are billed a rate typically 10-15 times what your insurance would usually pay for this test.
If you have a high deductible health plan .. Just pay cash and have Dr. Fraser set it up cost effectively. If not, or you are likely to exceed your deductible, then when you go to the lab or radiography center, have them confirm what will and won’t be covered. DO NOT have the lab perform any test done that your insurance won’t cover (you can cross it off the requisition, and just get the tests done that are covered). Let Dr. Fraser know the things that you cancelled, and he will arrange for that to be done cost effectively.
For the functional medicine “interesting stuff” – this will be cash pay – but Dr. Fraser has you pay direct, and doesn’t add any costs to this.
For imaging not covered by insurance, we have cost effective self pay options. Even when paying with insurance, if you are being asked to pay significantly, contact us as we often have better options. For example, one of my patients on Medicare was going to be out of pocket $1400 for a Lung CT - we got that done for $150 cash pay instead.
How do Rx Medications work:
Most of what we recommend will be standard Rx medications covered by insurance, and if you are on a high deductible plan, available cost effectively.
For compounded medications and drugs which might not be covered by insurance we have ways to make these cost effective. For example, patients who need compounded hormones, costs are usually $35-40/month, and for Semaglutide (Ozempic) or Tirzepatide (Mounjaro) it is typically $100-150/month depending on dose.
Medications that we pay for (e.g. Bill Clinic send to Patient) from compounders such as Empower, Central or University Compounding reduce costs to you over direct pay by 33%. Due to the processing and other work associated with this, we do charge a 15% surcharge to cover our processing costs and administrative time.
How do Supplements work:
Most functional, anti-aging or longevity medicine practices will have proprietary supplements they sell you at a premium, or unbeknownst to you, are making profit on your purchase. We have a FullScript business account, accessible on the button "Products" in the upper right on the Home Page. You get a 15% discount, and the practice does get a small percent back. FullScript limits its products to high quality supplements, and are generally a good source for everything. We will come up with a supplement plan for you and send the plan to your from FullScript if desired.
Many supplements are simply available on Amazon, but we take care to only recommend items that have third party testing. Additionally, we provide expert advice on what to take and why. Supplements can be harmful, and certain combinations are not sensible - we can advise.
Can we replace your Primary Care Physician?
Yes we can, and for about 50% of our patients we serve this role. We often replace multiple specialists allowing you to get everything done in one visit and with everything consolidated. Exceptions are when we need to refer you for a procedure. Our focus on managing chronic health conditions, and importantly, your aging and longevity is what we do, generally at a level of detail that is different from typical care.
The areas we have high level competence in include:
Hypertension
Hyperlipidemia
Neurocognitive decline prevention, especially Alzheimer's and Parkinson Disease
Longevity therapies such as Rapamycin, SGLT2-I, PDE5-I, Dasatinib, and others
Long Covid
If I need a lifestyle coach consult how does this work?
Yvette bills at $100/hr, but also extends the first 2 months at a 25% discount. She is an expert in providing advice on how to modify lifestyle to promote longevity. This is often a more powerful factor than pharmaceutical management. It requires effort; but having an expert walk you through the mechanics of small changes sequentially making big differences is powerful, and empowering. Individuals have so much ability to affect their outcomes with the correct information, a plan, and some motivation.
Summary:
You’ll get 100% of the time you book with the doctor!
Yvette is an incredible resource – and inexpensive for what she can offer.
A 60-minute appointment moves things forward in a meaningful way – this is never going to happen in current corporate medicine practice.
The drive to and from our practice will be perfect, takes 0 minutes.
Your time is valuable – spend it effectively. In order to enact change, good luck if heading through the usual workflow of current medical practice! Come see us, we can help with meaningful change.
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