How does Integrative Medicine Insights work? 
Like thousands of other practices across the country we have gone to a cash only monthly subscription fee. We do not accept or bill insurances. We do not collect co-pays, coinsurances or deductibles. The monthly subscription fee covers most services, procedures, and labs we perform in the office. This type of practice is also called a membership practice or direct primary care practice. Since we provide holistic as well as allopathic care we are called a direct integrative care practice. Outside of the office your insurance continues to function as always. Dr Barley can still order labs and x-rays, prescribe medications and coordinate referrals to other providers and hospitals.
Why would I pay extra for additional health services when I already have health insurance?
Health insurance is not health care, and it reimburses for health care based on certain requirements. All of us are conditioned to think that having health insurance means getting health care. This is no longer true. With high deductible insurance plans, health care costs often come directly out-of-pocket because people never meet their yearly deductible. Our goal is to help you avoid or minimize severe or chronic conditions that trigger high out-of-pocket costs. Improved access to your own personal physician, enabled by your investment in subscription primary care that delivers services well beyond what insurance covers, can lead to better health outcomes. Many patients have discovered that being in a subscription model practice and changing to a less expensive health insurance plan may actually save them money.
What is a Subscription Model Practice?
A subscription model practice establishes a direct relationship between the patient and the physician. The physician works only for the patient. Affordable monthly membership fees cover the vast majority of services. Easy physician access, relaxed visits and small practice size allow for a more personalized healthcare experience. Insurances are not billed for services in the office. And subscription allows for an ongoing relationship, rather than services being delivered based on a reimbursement menu that can restrict the time and service we can deliver until more significant illness arrives—we want to spend more time before illness, and we want to work hard to avoid that if possible.
Is a Subscription Model Practice the same as Concierge Medicine?
Yes and no. Yes, to the extent that the concierge model delivers added care features for additional patient fees. But no in the sense that, unlike many concierge practices that also bill plans for plan-covered services, our model entirely avoids insurance requirements and we believe that allows us to more efficiently and effectively deliver added care features.
Can I be part of the practice if I live outside the area?
Yes. By law I am required to see you in the office to establish care. After that I can provide care electronically via email, portal and phone visits.
What services are included in my subscription?
*Allopathic Medicine Services:
**Medical care for acute illness
**Medical care for chronic illnesses
**Preventative medicine/Healthcare maintenance
**Immunization recommendations
**Screening tests
**Medication reconciliation/medication management
**Coordination of care (home care, outpatient therapies, specialist care, hospitalization/hospice)
**Office labs including EKG, spirometry, nebulizer treatments, oximetry testing, lipid panel testing, glucose testing, hemoglobin A1c, urine micro albumin, urinalysis, urine drug test, rapid strep test, audiology testing, and vision testing
*Holistic Medicine Services
**Annual Functional Medicine physical exam, focusing on personalized lifestyle medicine (nutrition, hydration, sleep, exercise, stress, relationships), clinical imbalances (gastrointestinal health, immune health, hormone health, structural integrity, vascular health, detoxification, and mitochondrial health) and genetics.
**Basic and advanced nutrition testing and counseling
**Body composition analysis
**Resting metabolic rate testing
**Weight management therapies
**Personalized gastrointestinal recovery program,
**Elimination diets,
**Bioidentical hormone replacement, and low testosterone treatments,
**Individualized thyroid restoration and adrenal gland balancing
**Natural sleep hygiene protocols
**Natural mood therapies
**Natural approaches to atherosclerosis/hypertension/cholesterol
**Natural approaches to prediabetes and diabetes
**Autoimmune protocols
**Chronic infection protocols
**Detox programs
**Natural migraine therapies
**Energy/mitochondrial testing
**Comprehensive microbiology-gastrointestinal testing/recovery programs
**Food allergy/Food sensitivity testing/Intestinal permeability testing
What other benefits are included in my subscription?
**Easier physician access
**Unhurried and longer appointments (average appointment is 30-45minutes)
**Same day or next day appointment with Dr. Barley
**Electronic connectivity (“We Care with E-care”) with phone appointments, e-mail, portal
**Medical chart maintained in Athena EMR
**Option to keep diagnosis and prescriptions confidential from third parties
**Possible use of health savings account,
**Expedited availability to communicate with specialists, pharmacists and hospitalists helping to navigate complex health care system while implementing your optimal health plan
***Please note: our patient agreement will outline in more detail the services we will provide. We are not providing unlimited services for a flat monthly fee. We offer a significant array of services for that monthly fee, but, it is possible that there may be additional charges for more significant services (examples: there may be out-of-pocket costs for certain labs, tests, or medical supplies), In other words, we are not offering a version of insurance, but we are offering significant and valuable finite services for a monthly fee.
How long will I have to wait if I come in for an appointment?
Our goal is no waiting when you come in for your appointment.
How long do office visits typically last?
Visits last from 30 minutes to over an hour. They can also be quick if you are in a hurry.
Can I be seen by the doctor without appointment?
We prefer that you call us to schedule an appointment to make sure you have all the time you need to address your concerns.
What if I need to see a specialist?
We will coordinate your specialist referral and advocate on your behalf as we have always done.
What if I need to go to the emergency room or hospital?
While Dr. Barley is available on a daily basis to you by phone and e-mail there may be medical situations that require more advanced care that cannot be provided in the office. In these cases you will be advised to be seen in the emergency room. In the event of a medical emergency, you are advised to call 911 prior to calling our office.
What happens when Dr. Barley is out of town?
When Dr. Barley goes on vacation or is out of the office, he is usually available to answer phone calls, messages and help coordinate your health care needs. Our nurse practitioner and office staff will also be available to help coordinate you care.
What does it cost?
Subscription fees are based on age
- Age 19-34 -please call office
- Age >35 -please call office
How do I pay the subscription fees?
We accept fees paid monthly by either debit or credit card.
Are their co-pays, co insurances or deductible payments?
No, because we are 100% out of network with all insurance, there are no insurance co-payments or deductibles we need to collect for insurance plans.
What about medications, tests and services not provided in the office by Dr. Barley?
Medications, vaccines, tests and services provided outside of our office are not included in the subscription fee. You will need to use your insurance as you have done in the past.
Do I still need insurance if I join the practice?
Yes, this is strongly recommended. Subscription fee practices combined with health insurance provides better access and services for all of your health care needs including serious illnesses and emergencies. And, none of your subscription fees can be submitted to plans for reimbursement. The subscription fees represent your additional personal investment in improved health services.
Will you bill my insurance plan for office visits?
No, we do not contract with any private or government health insurance plans.
Will my insurance plan reimburse my subscription fee? Is it tax deductible?
Insurance reimbursement and tax laws change and evolve over time. We encourage you to consult with your insurance broker and with your tax or financial advisor to secure competent advice on these issues.
Can I use my insurance elsewhere if I join your practice?
Yes. Your insurance continues to operate as usual outside of our office for specialists, hospitals, pharmacies, labs and imaging centers.
If I have Medicare can I still join the practice?
Yes. Dr. Barley has opted out of Medicare so you must sign a contract declaring that neither you nor Dr. Barley will directly bill Medicare for any services. Medicare continues to operate as usual outside our office for specialists, hospitals, pharmacies, labs and imaging centers.
Is the practice considered health insurance? Does it satisfy the requirements for “insurance” under the Affordable Care Act?
No, we are not an insurance plan.
Can I just visit the office without having a subscription to the practice?
No, our small practice size allows for better access and efficient services to our subscribed members.
Do I have to sign a long-term contract? What if I move or want to cancel my subscription?
We do not require you to sign a long-term contract. Subscriptions are ongoing and open and must be paid in order to maintain services. You may cancel your subscription at any time. Call the office for specific details.
How do I subscribe and join the practice?
It is easy, simply come by our office and pick up a registration packet (Patient Agreement, Schedule A and Schedule B ). Once this is completed, signed, dated and returned you will be a part of the practice.