Terms
Comprehensive Geriatric Care is a direct-pay practice. Dr Zeleznik is a Medicare "Opt-Out" physician. This means services are provided under a private contract and not charged to insurance. There are strict requirements for a contract between an "Opt-Out" physician and a Medicare beneficiary including that the contract cannot be initiated at the time of an emergency health circumstance. Please read the documents carefully. The possibilities to be reimbursed include private primary health insurance, long-term care insurance or a Medicaid pooled income trust for medical expenses. Medi-Gap plans and secondary insurance do not cover these services. Visits to homebound elders are made in Manhattan and Riverdale. Special arrangements can be made for other parts of the Bronx, Brooklyn and lower Westchester County.
Billed Services
Face to face home visits with the patient. The initial visit is usually 60-90 minutes. Follow up visits for scheduled health exams are anticipated to be 15-20 minutes unless new issues are presented. Request for a visit for a new health problem are often 20-40 minutes.
Clinical phone, text and email communication
Clinical coordination of care with visiting nurses, physicians, radiology service providers, laboratory service providers, obtaining and review of medical records
Medication refills which occur at times other than the home visit. Prescription of controlled substances requires on-line verification procedures set by New York State Department of Health and a face-to-face visit no less frequent than every 4 weeks. Management of warfarin (Coumadin) requires a face-to-face visit every two months for the first year.
Completion of documents such as certification of home care orders, jury duty letters for caregivers, M11q, and Medicaid 486T forms.
No Charge Services
Phone calls which result in a home visit
Calls received from other licensed health care providers about a new health issue
An annual influenza vaccine and one time pneumococcal vaccine unless already received
Services that are necessary after death, such as speaking to police and funeral homes and completion of a death certificate
Printing and mailing test results to the patient or representative
Fees
$350 per hour prorated to 12th hour minimum which is $29 per five minutes of time for face to face home visits, phone management, answering email, coordination of services to other providers including phone calls from the physician to visiting nurses or from the physician to care managers, reviewing additional health records, renewal of prescription medications at times other than the time of a visit, and completing forms requiring a doctor's certification. For travel up to 30 minutes beyond Manhattan there is a flat charge of $50 per visit in addition to any fees for trains. For travel from 30 to 60 minutes beyond Manhattan there is a flat charge of $75 per visit in addition to any fees for trains.
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