Timarron Family Medicine, Esthetics, Regenerative Medicine

Tiered Access Health Plan (TAHP) FAQS

1. Can I keep my current insurance and still see you?
Yes.  Your signing up for a TAHP has no bearing on your current insurance or Medicare policies.

2. Will my insurance still be billed if I pay an annual TAHP access?  
Yes.  The TAHP fee only covers the items listed in the plan.  These items and benefits are not covered by insurance or Medicare so billing for other services rendered are billed just as before.

3. Do I still pay a copay or have to pay coinsurance until I meet my deductible?
Yes. The membership TAHP fees and the non-member administrative fees (up to $75 per calendar year) do not cover the usual medical services rendered, so the billing process does not change.  See question #2 above. 

4. What if I cannot afford a TAHP access fee?
We understand that not everyone can afford an access fee.  We designed three plans so you can choose a plan to best suit your needs and create a value equal to your needs. If you choose not to become a TAHP member, each office visit will include a $25 administration fee but only for the first three visits in a calendar year.  So the administrative fee would max out at $75 for any individual in a calendar year. 

5. As a TAHP member, whom will I see if Dr. Christopher King, MD is out of the office?
Should an acute care need arise when Dr. Christopher King, MD is out of the office, you will see Dr. Lori King, MD if she is available or one of our physician extenders in our office.  If we cannot accommodate your acute care needs in a timely enough manner, you may have to visit your local acute care facility (such as Care Now or Urgent Care).  We have discovered from you, our patients, that you already do this on a fairly regular basis after hours.  We estimate this situation during my absence from the clinic may occur on average less than once per year per TAHP member patient.  We will still have staff in the office during usual clinic hours to answer calls and take care of the more routine needs.

6. Do I pay the TAHP access fee up front?
Yes. You can pay the entire annual fee up front or we will collect 6 months of the annual fee up front and bill for the second 6 months when appropriate. A $35 administration fee will be added to fees paid at 6 month intervals instead of paid annually.  Fees not paid in a timely manner could cost you your membership and the membership spot will be offered to others waiting to become a member.

7. How do I renew my TAHP membership?
You will be given first right to renew your membership 60 days before your membership expires.  If you choose not to renew or do not pay before 14 days after your renewal date, you will forfeit your membership. 

8. How long is my membership commitment? 
Your membership is an annual, renewable agreement.

9. What if I choose to leave or have to leave the practice, do I get a TAHP fee refund?
If 90 days or more after your plan start date you leave the practice, you will get a prorated refund minus $175 fee.  So if your prorated refund is less than $175, you will owe money. If you leave in the first 90 days, there is no refund.   

10. If I don’t sign up now for a TAHP membership, can I sign up later? 
There are a limited number of patients who will be cared for under the TAHP plans.  Once the maximum number has been met, the plans are closed to new membership.  If a member leaves the practice or forfeits membership, the available membership plan will be offered to patients who requested to be placed on a waiting list for future TAHP membership. The offer will be made to patients in the order they were placed on the waiting list.
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11. Do the phone and email consultations mean I don’t have to come to the clinic to receive medical care?   
No.  The consultations will be screened for appropriateness.  If it is appropriate to handle the consult over the phone or via email, it will be done so, saving you the time, cost, and inconvenience of coming into the office.  We will take care of issues this way as much as possible, but it is up to the doctor to determine whether a clinic visit is best for your healthcare and thus required.  Face-to-face consultations ALWAYS facilitate the best care.

12. What is meant by improved coordination of care?
Caring for fewer patients will allow me more time to communicate directly with your other doctors and this communication will improve the quality and efficiency of your care.  Better communication between providers should lead to better outcomes both for hospitalizations and specialty consultations. In addition, we will have more time to make follow-up phone calls to you to check on your progress.

13. If I sign up for Plan-I membership and have the doctor’s phone number, can I call it any time for any reason?
No.  The benefit of having my cell phone number is to more easily and more directly coordinate after hours care.  It is anticipated that a mutual respect would limit these after-clinic-hours calls to only necessary urgencies and emergencies, not for routine care.  The very best medical care is ALWAYS face-to-face consultation and most non-emergent issues can safely wait until clinic hours.  Any gross abuse of this service will result in termination of your TAHP membership with no refund.   

14. What is a Portable Personal Health Record (PPHR)?
In a Plan-I membership, I will personally create a summary of your most pertinent conditions, treatments and history.  You can take the PPHR with you to other doctor visits and keep it with you and give it to your family members who may need to provide this information for you in case of emergencies.  I will put the record in a portable electronic format on a flash drive that would work on any provider’s computer.  I will update your record accordingly as things change and you can update the PPHR as well.  I will use a Word Document format that will be easily edited.  You control the use of your PPHR and are responsible for keeping it secure.

15. Under family plans, what constitutes a family?
A family would include a married couple and their children or a single parent and his/her children.  Adult children over 24 years old could not be included in a family plan.  An adult 25 years old or older could sign up as an individual.
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16. What is the difference between acute and routine care visits?
An acute care visit addresses a condition that is new and of sudden onset like the flu, a fever, or an injury and likely needs treatment in the next 24-48 hours.  A routine visit addresses chronic conditions like high blood pressure or diabetes and can be scheduled well in advance because there is no urgency in treatment.  

17. What is the $25 fee for if I am seen as a non-TAHP member?
It is simply an administrative fee to help cover the increasing costs of doing business in today’s healthcare environment.  So even if your deductible has been met for the year, you will still have a $25 fee paid at the time of the visit if it is one of your first three visits to our office in any one calendar year. Any visits after your third visit will NOT include a $25 fee. 
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