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Frequently Asked Questions

When should I consider using your services?

  • When you need PHYSICIAN-DIRECTED MEDICAL care management & coordination for older adults (over 75) who are having trouble getting to a doctor and need guidance or coordination regarding:

    • Management of chronic complex medical illnesses, multiple medications, multiple specialists or doctors, declines at home, frequent hospitalizations/nursing home stays, falls/safety concerns at home

      • Coordinate or co-manage with primary care providers & specialists

      • Connect with community resources & support 

    • Clarifying goals & priorities of care

      • Help completing POLST forms

      • Guidance on completing advance care directives, end-of-life care

      • Education & guidance regarding code status, CPR, DNR/DNI

    • Palliative Care ​

    • Evaluating options available for care at home or elsewhere

      • Explore options for home care- what it would take to continue living in your home

      • What is assisted living, skilled nursing, hospice, continuing care

      • Help with completing forms necessary for admission to a skilled nursing facility, assisted living facility or other site

    • Memory problems that may be impacting functioning at home.  

    • Families who may have older adults visiting for a few months & need geriatrics care/follow-up for that time period.

  • You are an attorney, geriatrics care manager, or health care navigator who needs a medical geriatrics assessment for your clients or patients.

How can we schedule an evaluation?

  • Please contact me to schedule a 15-20 minute phone call (no fee) to determine how I can help.

 

Can you be my/our primary care provider?

  • Currently, I am accepting a select panel of patients for primary care.

    • Please call for more details and to see if this could be a appropriate fit for you or your loved one. ​

    • This may be an option when/if a patient becomes much more homebound or is transitioning to an end-of-life care situation/hospice.  

  • The advantage of my services is having a medical/health navigator & advocate on your side- one who understands geriatrics and all aspects of the health care system.​

    • Available by phone as needed to review questions, coordinate conversations with medical team(s), get medical updates, make recommendations to specialists/PCP, reach out to hospital teams (if needed), make referrals to home-based services & help communicate/translate things into language you can understand.

    • Can also help research and recommend providers if a current one is not working out. 

    • In-person visits/re-evaluations either regularly or "as needed."

    • Urgent visits can be accommodated with the understanding that I would have to charge a bit more.

    • Other follow-up visits can include:

      • Transitional care visits- after a discharge from hospital or rehabiliation to home

      • Navigating goals of care conversations.   

      • Follow-up on certain conditions help you to monitor and manage them.  

        • Dementia​

        • Frequent falls/gait disorders

        • Polypharmacy (too many medications) 

        • Urinary incontinence

        • Insomnia (No prescriptions for scheduled medications.)

        • Frailty/deconditioning

  • Help you make sense of confusing medical records.  

  • Help communicate with your primary care provider and specialists to coordinate your care.

  • Just as you see a cardiologist for your cardiac issues or an orthopedist for your bone/joint issues, I can follow you to help organize your chronic medical problems, manage dementia, plan out your goals for care, & assess/manage common geriatric syndromes (e.g. frequent falls, urinary incontinence, frailty/deconditioning, multiple medications, sleep issues, etc.).  Unlike the other specialists though, my approach is holistic & focuses on making sense of complexity in multiple domains- medical, functional, cognitive, social, psychological- basically, putting the pieces of a puzzle together.  ​​

 

Are you available for emergent or urgent appointments or calls?

  • There may be times when an urgent appointment or phone call can be arranged, depending on availability.

Do you do house calls?

  • One of the advantages of my practice is that all of my visits are house-calls.  You do not have to travel anywhere!  

  • This allows you the convenience of having a doctor come to your home and also gives us the time necessary for a more thorough & comfortable evaluation.

 

How much do the visits cost?  

  • I charge a flat fee for all visits, phone calls, & consultations

  • As some visits may entail traveling, I do charge a $100.00 flat fee for each visit that is > 1 hour from my office location.

How much time does a visit entail?

  • Initial visits will usually be 2-3 hours, depending on each individual case's needs.​​

  • Follow-up visits tend to be 1-2 hours each

  • However, with my practice, this is a general time frame and if a case needs more time, that is included in the flat fee.

  • Aside from the actual visit itself, please know that I will also be spending time reviewing your records, communicating with your involved caregivers and providers, coordinating care, and completing any forms necessary.  This time is also included in the flat fee.

Where are you seeing patients?

  • Currently, I am doing house-calls in all of New Jersey & suburban Philadelphia, PA.

  • At the current time, I am not seeing patients who are residents of skilled nursing facilities (nursing homes), but can see residents of Assisted Living Facilities and Adult Independent Living Communities.  

What can I expect after the initial consultation visit?

  • The 1st home visit will serve to gather information and do a comprehensive assessment, physical exam, etc. 

  • For one-time consults, I will be available for 4 weeks after this initial visit to answer questions via email/phone & coordinate care/communication with your providers

  • For the subscription option, we will schedule follow-up visits as needed, and I am available to help for the duration necessary.  

  • All of my notes/documentation & most communications can be managed via HealthHive, our patient portal (see Contact & Forms page for link & details).  This allows you & your appointed caregivers centralized access to your records along with a host of resources to coordinate your care plans, communications, medications, lab/imaging results, etc.  Other providers at practices/health systems affiliated with HealthHive can also access these records when you see them.  

 

Do you accept Medicare or other health insurance?

  • No - please be aware that this is a direct-pay practice and I have opted-out of Medicare.  This means that I cannot submit any claims or billing to Medicare or other insurances nor receive payments from them.  

  • Also, you cannot submit a bill/claim for my visit and services to Medicare/Medicaid.

  • However, medication prescriptions, lab/testing orders, prescriptions for therapy (PT/OT/Speech) or DME (durable medical equipment- e.g. walkers) written or ordered by me can be processed through the usual Medicare/insurance routes & be covered.

Why should I choose your service when I already have Medicare/insurance and a primary care provider?

  • How many doctors can offer you time, expertise, and a unique personalized service- in your home?

  • From the comfort of your home, we will have the time to review your history and concerns thoroughly, prioritize your areas of need, do a home-based comprehensive geriatrics assessment, coordinate care with your providers and caregivers, and provide you guidance/concrete ideas for moving forward on a path that makes sense to you.  

  • Office-based primary care visits often do not address these complex issues nor do they allow for the comprehensive assessments and discussions needed, especially when discussing goals of care and disposition needs.

  • Medicare is an important service for older adults and I believe it should continue, but its current structure doesn't  allow for the flexibility and time needed to review multiple complex interconnected issues and find solutions that matter to you- all from the comfort of your home. 

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