Drs. English and Ahmed are committed to your wellness. They work together closely to create the best possible experience for you. Our goal as a medical practice is to provide the best possible patient care in a personalized way. We are the starting place for any of your health concerns, focusing on prevention, treatment of the whole person, and coordination of care with specialists if needed. However, the many changes in the healthcare landscape have created a challenging environment, where the physicians and their staff are required to spend increasing time on tasks that are not paid for by insurance such as phone calls, insurance authorizations, emails, portal messaging, prescription refills, form completions, and coordination of care with specialists.
In order to focus on patient care and allow our doctors to stay independent, we now charge an annual fee to cover these non-reimbursable administrative tasks and services. This is above and beyond your customary insurance payment for services rendered. Unfortunately, your insurance will NOT pay these fees. However, if you have a Flexible Spending Account, it may be covered.
When you come to our office you will only be seen and treated by a board-certified Medical Doctor as we do not utilize physician extenders such as physician assistants and nurse practitioners. After hours emergency calls to us are directly answered by one of the physicians. The doctors are also available by direct portal messaging. We have a number of urgent care appointments available each day and strive to see each patient who calls in for a sick visit within 24-48 hours. Keeping our patients healthy is our upmost goal, and we strive to have your experience with us be as compassionate, kind, and stress free as possible.
Please contact Shana Sweeney, our Office Manager with any questions you might have.
Individual Patients under 25
$10 monthly $100 annually
Individual Patients over 25
$25 monthly $250 annually
Parent with one dependent under 25
$30 monthly $300 annually
$40 monthly $400 annually
Family (3-5 people – dependents under 25)
$50 monthly $500 annually
$60 monthly $600 annually
You may choose to pay monthly by credit card. The fee will automatically be charged to your credit card on the first day of the month to cover the upcoming month. You may call the office to set up the monthly payments starting in January. If this is not set up in January, payment will be due at your first visit in entirety up to the date of your first visit, and then will continue monthly. This is not prorated for established patients dependent on month of first visit – it is a yearly fee due in entirety. If you are a new patient joining after the first quarter of the year your fee will be pro-rated.
The annual rate shown is already discounted from the monthly rate as shown. This fee covers you for a calendar year. If you are a new patient joining after the first quarter of the year your fee will be pro-rated. You may call the office to pay with a credit card, or you may mail us a check with the patient(s) your check will cover at the rates listed above to: 801 E Park Ave. Long Beach, NY 11561. Annual fees should be paid in January or will be collected in full at your first visit of the year. This is not prorated for established patients.
There will be several scholarships available for patients who have been in the practice and for whom these fees will be prohibitive of care. We empathize and only seek to provide the best care possible, not to make health care unattainable. Please call us and speak with Shana if you would like to be considered for one of these scholarships. If you would like to donate a scholarship for another individual anonymously you may also speak with Shana.
If you are a Medicare patient AND on a fixed income, please call Shana so that we can determine if you qualify to have the Administrative Services Fee waived. This is only for those on a fixed, limited income, not for all Medicare patients.
ADMINISTRATIVE SERVICES FEE POLICY
MEDICAL PRACTICES OF Dr. Jacquelyn English, D.O. & Dr. Saniya Ahmed, M.D.
Effective January 1st 2022
Our practice has implemented an annual Administrative Services Fee to be paid by all its patients to cover the significant amount of time we have to spend on providing these administrative services which are not covered by any federal, state or private health insurance coverage. These third-party insurance payors cover professional medical services and certain other included professional activities. There is no change in our current policy regarding co-payments, deductibles, etc. The office continues to operate as it has in the past simply with the addition of the required annual Administrative Services Fee. To be clear, this is not to be considered concierge medicine – the office will continue to operate in the way that it has, continuing to utilize your insurance.
This has not been an easy decision. Please know it has become necessary to implement this new policy due to the continuing deterioration of the economics of managing an office-based primary care medical practice. You may or may not know that third-party payors, including Medicare, have not significantly increased the fees paid to us in well over a decade. Medicare, in particular, has raised what it pays primary care physician slightly, but not significantly, and these fees are set to decrease by 10% in 2022, with private payors expected to follow. During that same decade, the office overhead of typical primary care physicians has risen over 100%.
We have explored our options including sale of the practice to a hospital system, or to increase our patient visits per day to combat the reduction in fees paid per visit, which would in turn decrease the amount of time we spend with our patients. If we were to join a hospital system, we were informed the visits would definitely get shorter, staffing would not be under our control, and we could possibly be moved out of Long Beach. Neither of these options reflect who we are fundamentally and the care we strive to provide to our patients.
Our desire and goal is to preserve our small medical practice structure and culture, maintain independence, and keep our daily visits at a manageable level. This will enable us to protect and defend what has been important to us since we opened, which is our policy of longer appointment times to address the concerns of our patient community.
The annual Administrative Services Fee you pay will allow us to increase the number of staff and/or staff hours needed to complete prescription refills, phone third-party payors to obtain a variety of required pre-authorizations, coordinate referrals to specialists, make follow-up calls, and review and complete paperwork such as insurance forms, disclosures, and other government and employer forms. Administrative needs have increased significantly since the onset of the COVID-19 pandemic and are putting a significant strain on our system. Ongoing we wish to ensure we can adequately staff our office to effectively handle the ebb and flow of future COVID-19 surges like we have experienced and continue to experience. To be realistic, we may find it necessary to increase these administrative services and the fees in the future depending upon circumstances.
If you are a new patient receiving a copy of our policy, we will not require you to pay the fee prior to your first appointment. Once you have completed your New Patient Visit, you can decide at that time if you wish to become an ongoing patient of our practice, at which time the fee will be due.
As mentioned above, this fee is charged to all patients of our practice. If you pay the fee monthly and decide to leave our practice, your fee will be discontinued upon 30-days’ notice to us of your intent to leave the practice. If you pay annually, you are receiving a discount and the fee is not refundable except in special circumstances.
If it is demonstrated that your particular healthcare coverage includes separate payment for these administrative services, then we will make an adjustment to the fee as needed.
We intend to continue our communication with our patients through the use of email and other digital communications, such as the EMR portal. The emails that you send and our responses, and vice versa, will likely become part of your medical record. We intend to fully comply with all applicable state and federal patient privacy and confidentiality laws (e.g., HIPAA), but cannot guarantee your email communications will remain secure, as we will not be taking extraordinary measures, which is why we always request your permission first. The portal remains a HIPAA secure form of communication.
If you have any questions regarding our new Administrative Services Fee policy, please let us know.