August 10, 2019

 What is concierge therapy?

In the healthcare industry, as we know of and is experiencing now, major changes made its turn 1st quarter of 2010 with Affordable Care Act. However, there are alternative healthcare practice models that came to surface in order to compensate for the surge of demand for high quality care. One such example is the concierge medicine, which could either be a subscription based or a package deal offer. This is gradually inching its way in the vicinity of therapy- concierge therapy.

Subscription based is an adopted model with which a client pays a monthly or annual fee for an unlimited healthcare provider’s (therapist, in this case) services . As such, may include consultation for exacerbation of a chronic condition to injury evaluation, maintenance, prevention and wellness program. Immediate care may be readily available, which means there is no need to wait days or weeks to access a provider through a physician (grateful for the benefit of direct access law) and for insurances’ pre-authorization. Next, a package deal is an offer of specific number to a service. For instance, 10 sessions/visits for a specific price that is believed to be appropriate and/or has medical necessity for the condition noted e.g. post op surgery, which is of fair market value. A client may personally submit the claims to his insurance in some cases through his provider’s invoice and documentation.  While this may hold true with those who have private insurances, the situation with Medicare beneficiaries is quite more complex because of more legal considerations regarding the provider’s relationship as to whether provider is enrolled as participating/nonparticipating and/ or non-enrolled. This will be a whole new discussion to come.