Top Questions

1

Q: Why would I want to see a family physician who uses the SENTIRE™ system?

A: SENTIRE™ has created solutions for the two most common complaints patients have when they see their family physicians under the existing insurance company coding system:  1) I have needs that could be handled over the phone (or text or email exchange), but my doctor tells me I have to come to the office to be seen, and 2) When I’m at the office, my doctor always seems rushed and I don’t feel he or she really listened to me. SENTIRE™ solves these problems.

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Q: How does SENTIRE™ work?

A: SENTIRE™ has created transparent fees that do not use existing insurance company codes. Your doctor signs up with the SENTIRE™ system first, then you sign up and designate your doctor at sentirecare.com. After that, all of your doctor bills will be generated through the SENTIRE™ system website. Contact me any time day or night, and I will get back to you as soon as possible.

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Q: How much does SENTIRE™ cost?

A: You pay $50 per year to your family physician to stay registered with him or her for that year, which triggers an annual review of your preventive care needs and access to communicate with your family physician at any time. For office visits, each concern you’d like addressed will usually cost $21 to $45 each, depending on how much time is required for your doctor to discuss them with you. Phone visits are charged at $15 plus $7 per minute of conversation time (many single issues can be managed in a few minutes, which means your bill will commonly be $30 to $50). Click here for the full fee schedule.

4

Q: Will my insurance company pay for SENTIRE™ services?

A: Because SENTIRE™ is a disruptive innovation in primary care targeted to people with high-deductible health insurance plans, the expectation is that you will pay your doctor directly after each service is delivered, just as you would any other service professional, just the way it used to be before insurance companies got between the doctor and patient. SENTIRE™ has developed software to safely handle payment from the patient to the doctor for both office visits and non-office visits (phone visits, eg). You are free to send in a copy of your bill to your insurance company for reimbursement, but SENTIRE™ does not guarantee that the insurance company will reimburse you. SENTIRE has obtained legal opinion that patient bills generated under this system are allowable to be compensated through self-directed Health Savings Accounts.

1

Q: Why would a family physician want to use the SENTIRE™, LLC system?

SENTIRE™, LLC has created solutions for the most common complaints physicians have when they see their family physicians under the existing insurance company coding system:

  1. They have needs that could be managed over the phone (or text or email exchange), but you could have addressed the concern without asking them to travel to your office. You’re currently paid nothing to provide this service.
  2. You feel like a hamster on a wheel, running from patient to patient, to form to be filled out, to prior authorization stuck on the phone taking time that you’re not paid for. You currently don’t have time to listen to your patients and be thorough in your care, because under the existing CPT code and CMS and insurance company payment rules, you’re not paid to.
  3. You continue to be burdened by meaningless CMS documentation requirements and button clicking. SENTIRE™ solves these problems.
2

Q: How does SENTIRE™ work?

SENTIRE™ could be considered an alternative form of direct primary care in that it is founded on the assumption that the American Medical Association CPT codes and the CMS E&M documentation rules are the fundamental problems that have repressed family physicians from thoroughly caring for their patients. It is different from common DPC models in that it does not use a monthly fee model, but instead is a fee-for-thinking system: few patient concerns yield a small bill, many patient needs yield a larger bill. read more…

SENTIRE™ has created transparent fees that do not use CPT codes. You have to sign up to use the SENTIRE™ system first, it costs you nothing to sign up, then your patient sign ups and designates you to be their personal family physician at www.sentirecare.com. They pay you $50 to register with you, and a $50 annual renewal. After that, all of your bills/fees for just the patients you care for under the SENTIRE™ system will be generated through the website.
When your patient sees you in the office, the SENTIRE™ bill will look like your patient went to a big department store (See Sample Bill). If they want one issue addressed, the bill has 1 item; 8 issues, 8 billable items (See Generating Office Bills). In return, your patient will have nearly 24/7 access to you and/or your partners. The SENTIRE™ difference is that each time you address a patient’s need, you generate a bill and are paid the next business day. All of this is managed through the SENTIRE™ system payment platform and optional apps. SENTIRE™ will not micro-manage how you provide this access. SENTIRE™ only expects that when a patient calls your designated number (or email address or text message service) that a family physician will answer the phone and address the concerns. As soon as the exchange is completed and the concern addressed, you may then generate the non-office bill that is sent to the patient immediately (See Generating Non-Office Bills).SENTIRE™ is scalable and compatible with any payer mix. You could use it once a week or 20 times a day; you could have 10 patients using the system or 2,000. SENTIRE™ is paid 1% of your total charges. This fee is paid directly and automatically by you to SENTIRE™ at the end of each month. Other usual credit card or bank charges apply. SENTIRE™ uses stripe.com to provide state-of-the-art encryption and bill processing services. see less…

Visit sentirecare.com to sign up today.

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Q: How much are you allowed to charge?

The SENTIRE™ fee schedule is fixed. You will receive $50 per year per patient to stay registered with you, which triggers an annual review of your patient’s preventive care needs and access to communicate with you and/or your partners at any time. For office visits, each concern you address will usually cost $21 to $45 each, depending on how much time is required for you to discuss the issues with your patient. Phone visits are charged at $15 plus $7 per minute of conversation time (many single issues can be managed in a few minutes,  which means bills will commonly be $30 to $50). For patients who have lots of questions or if you need substantial extra time to deal with a few issues, there are Extra Time codes that may be used to recognize and pay for your extra work. Click here for the full fee schedule.

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Q: Do you have to bill insurance companies for SENTIRE™ services?

Because SENTIRE™ is a disruptive innovation in primary care targeted to patients with high-deductible health insurance plans, the expectation is that your patient pays you directly after each service is delivered, just as he or she would to any other service professional (lawyers, accountants, and so on), just the way it used to be before insurance companies got between you and your patient. SENTIRE™ has developed software to safely handle payment from your patient to you for both office visits and non-office visits (phone visits, eg). Patients are free to send in a copy of their bill to their insurance company for reimbursement, but SENTIRE™ does not guarantee that every insurance company will reimburse them.

Happy and satisfied patients
Sentirecare doctors

Other Questions

Q: How do I pay my family physician for a phone, text, or email visit?

For added security, SENTIRE™ uses two-factor authorization of non-office payments from you to your family physician. As soon as the service has been completed, your doctor will send you an email or text message that includes the bill details and asks you to approve the bill. When you approve the bill, your doctor is paid the next business day.

Q: What if I need a procedure performed?

SENTIRE™ procedure charges are approximately equal the rates Medicare allows.

Q: Can my family physician charge more than the SENTIRE fees?

No. One of the principals the doctor agrees to when he or she signs up to use the SENTIRE™ system is that he or she will only use the SENTIRE™ fee schedule for eligible patients.

Q: Will my family physician’s medical decisions made on my behalf be influenced by SENTIRE™?

NO. SENTIRE is just a new way for family physicians to document, code, and bill for their work. All of the details of your care needs are decided between you and your family physician. Your family physician will still be held accountable for the quality of his or her care for you through existing professional codes of ethics and the relevant state medical boards.

Q: What is meant by a new way for family physicians to document their work?

One of the current administrative burdens for family physicians forced on them by Medicare, Medicaid, and most insurance companies is extensive documentation in medical records that is not important for high-quality patient care. SENTIRE™ disrupts the existing documentation rules in two major ways: 1) doctors are only asked match the fee they charge for each issue addressed to their documentation of the depth of the conversation you have about the issue (usually this is best applied to new symptoms), and 2) SENTIRE™ has a different system for documenting the status of chronic disease care. Other details of your care such as whether or not tests are ordered, or treatments started or changed, are at the complete discretion of your family physician and SENTIRE™ makes no claim or effort to influence those decisions in any way.

Q: Can I see a family physician under the SENTIRE™ system if I have Medicare or Medicaid?

No federal health program such as Medicare or Medicaid currently endorses or even recognizes the SENTIRE™ approach. Additionally, your doctor may be at risk of civil and even criminal prosecution by the federal government if he or she tries to bill you using the SENTIRE™ system outside of Medicare or Medicaid.

Q: How are you paid for a phone, text, or email visit?

You can bill the patient with procedure charges that approximately equals Medicare rates. POC tests are also set fees, priced to be on the lower end of common office charges.

Q: Can you charge more than the SENTIRE™ fees?

No. One of the principals you agree to when you sign up to use the SENTIRE™ system is that you will only use the SENTIRE™ fee schedule for registered patients.

Q: Will your medical decisions be influenced by SENTIRE™?

No. SENTIRE™ is just a new way for family physicians to document, code, and bill for their work. All of the details of your medical decision making are decided between you and your patient. You will still be held accountable for the quality of your care through existing professional codes of ethics and your state medical board.

Q: What is meant by a new way for family physicians to document their work?

SENTIRE™ disrupts the existing documentation rules in two major ways:

  1. SENTIRE™ only asks that you document your conversation (history) with your patient to match how much you bill for each issue you address (usually this is best applied to new symptoms or acute illnesses or injuries). Everything else is based on your own needs for the medical record to serve you as a reminder of what you were observing and thinking at the time, and your own interpretation of your state’s medical board documentation requirements. See Acute Care Documentation and Fees.
  2. SENTIRE™ has a different system for documenting the status of chronic disease care. Other details of your medical decision making such as whether or not tests are ordered, or treatments started or changed, are at the completely at your discretion and SENTIRE™ makes no claim or effort to influence those decisions in any way. See Chronic Disease Documentation and Fees.