Tell me about your concierge membership.
OC Sports and Wellness provides a straightforward membership model. Qualified patients pay our practice directly, bypassing the need to involve their insurance company. Concierge membership offers a comprehensive range of services for a fixed monthly fee.
Members gain access to a heightened level of care that goes beyond the conventional fee-for-service medicine approach. Benefits include telemedicine visits via phone or video, text messaging, extended consultation times, the convenience of same-day or next-day appointments for urgent concerns, and personalized attention from Dr. Sunshine.
What are the advantages of membership? At OC Sports and Wellness, we prioritize empowering you with knowledge and skills rather than relying solely on medication. You will have enhanced access to a doctor who genuinely cares about your well-being. Becoming a concierge member is akin to having a dedicated physician in your family. Dr. Sunshine will virtually be by your side, working with you to maintain optimal health.
Why is it a monthly membership?
Expecting to pay your doctor for each service we offer in your membership would be akin to paying Netflix for every single TV episode you watch. A pay-as-you-go approach is far from desirable as the cost would be significant.
Many businesses are turning to a subscription model in today’s landscape, and there’s a good reason. Subscriptions provide businesses, regardless of their type, with an effective means to consistently deliver high-quality service and support over an extended period. The alternative is a usage-based and itemized pricing system, which mirrors the traditional healthcare system, and we all know how that has panned out. Many physicians are overworked and over-scheduled due to their efforts to keep up with the demands and restrictions placed on them by insurance companies and bureaucratic agencies.
Time Spent During Office Visits
Number of Office Visits
Are there any additional expenses in addition to my monthly membership fee?
A significant portion of in-office procedures is already included in your membership fee! Members can also enjoy a generous discount on cash services, encompassing advanced lab testing, pellet therapy, injection therapies, VO2 max fitness testing, custom orthotics, and bracing.
We have established partnerships with local laboratories and radiology centers, allowing you to access extensive lab testing, pathology screens, X-rays, MRIs, and more at cost-effective cash prices. As a member of OC Sports and Wellness, you may have the opportunity to achieve significant savings on insurance by transitioning to a high-deductible plan.
When Outside Care is Necessary
What if I require care from specialists, diagnostic testing, the ER, or hospital services?
We can facilitate orders and referrals just like any doctor in an insurance-based system. In instances where you need to cover costs out-of-pocket, we can assist you in finding cost-effective “cash” prices, particularly for radiology and lab services. Additionally, we have established agreements with commonly recommended specialists, ensuring access to their services at significantly discounted cash rates.
Furthermore, our practice can provide various urgent care and minor emergency services during regular hours, helping individuals avoid unnecessary trips to the ER for non-critical issues. However, we strongly recommend maintaining health insurance to safeguard against unexpected, high-cost events such as surgery, ER visits, or hospitalization.
The Need for Insurance
Your concierge membership is not a substitute for health insurance; you will still require insurance coverage. Health insurance is crucial in safeguarding you from the financial burden of substantial healthcare expenses resulting from emergency department visits, surgical procedures, or hospitalizations.
If you do not receive health insurance through your employer, you can join a healthcare cost-sharing community such as Sedera. To gain further insights into this medical cost-sharing plan option, visit sedera.com or get in touch with our office, and we’d be happy to provide guidance and assistance.
Insurance reimbursement for paying out of pocket
Can my health insurance carrier reimburse me for paying out of pocket?
We are happy to help. While some of our services are not typically covered by health insurance, some exceptions exist. If applicable, we can supply you with a ‘superbill’ containing billing codes, which you can then submit to your health insurance provider for potential reimbursement.
Additionally, for many of these services, you may be able to utilize your Health Savings Account or Flexible Spending Account if you have access to these options. We advise our patients to contact their insurance member services before any procedures or consultations to understand the specifics of their plan, including rules and coverage. Contact us for the CPT codes needed to facilitate the insurance inquiry process.
Are non-members seen at your clinic?
Absolutely. Our office extends a warm welcome to non-members at highly affordable cash rates.
For further information, please reach out to our office. We are delighted to assist you!
Who Should Join
Is your membership plan worth considering if I’m already in good health?
Absolutely! We work with you proactively to keep you healthy.
It is hard to break out of the mindset of the insurance-based healthcare system. In the conventional healthcare system, everything is centered around treating illness. If you want to partner with a medical team that understands your needs regarding access, affordability, and consistency, sign up today. Regular access to your physician is unheard of in today’s healthcare landscape.
If you are bothered by having to wait weeks for an appointment, then wait for an hour in a waiting room only to be given 10-15 minutes of the doctor’s time while much attention goes to a computer, then this practice model will be a refreshing change.
We are most compatible with patients who have a proactive and health-conscious mindset. Our focus extends to individuals such as CEOs, entrepreneurs, and athletes. We specialize in regenerative injection therapies to address frustrating injuries, manage hormone deficiencies, aid in aging gracefully, address gut-related issues, and assess your fitness level.
How is concierge care different?
How does this practice differ from traditional healthcare?
Instead of adhering to a fee-for-service model, our patients opt for a monthly subscription fee, establishing a more robust patient-doctor relationship characterized by trust and transparency.
Under this membership model, a doctor’s income is no longer contingent on the frequency of patient office visits or the volume of patients seen daily, as is the case with the traditional “fee-for-service” approach. Instead, the doctor is compensated for their commitment to maintaining patients’ well-being. With fewer daily patient appointments, physicians have more availability and quality time to dedicate to each patient, encompassing office visits, phone calls, text messages, and email correspondence.
Furthermore, we embrace a functional medicine approach and offer conventional medical treatments like prescription medications and specialist referrals. We take the time to listen to your medical history and concerns. This approach allows us to explore potential underlying causes, triggers, and mediators contributing to your symptoms. Subsequently, we formulate a comprehensive treatment plan that often incorporates lifestyle adjustments, emphasizing modifiable factors rather than relying solely on prescription medications.
What is included
What does my membership encompass?
First and foremost, your membership ensures you receive prompt and personalized attention from your dedicated physician. Gone are the days of dealing with off-site nurses who may not be familiar with your medical history. You’ll have the privilege of quickly reaching, texting and speaking with your doctor for a reasonable monthly fee with no copay. This grants you expanded direct access to your physician via phone, video-chat, text, or email, and it also includes most in-office procedures. Additionally, you’ll benefit from extended consultation time with your doctor, advanced lab test result reviews, and exclusive discount pricing for in-office injection therapies, hormone pellet therapies, fitness testing, and more.
For more information on what’s included, please visit About Concierge Membership
Is yours a walk-in clinic?
Do I need an appointment?
How soon can I be seen?
We do not operate as a walk-in clinic; appointments are necessary. However, we provide the convenience of same or next-day visits for our members.
To ensure a smooth experience, we kindly request that all visits be scheduled in advance. A brief phone call or text to confirm our availability is typically needed. Our members also have the option to address their medical concerns through phone or video chat right from the comfort and privacy of their homes or offices.
Which types of appointments can be conducted through phone or webcam consultations?
Viewing virtual visits as a complement to comprehensive primary care rather than a complete substitute for in-person care is essential. Typically, a virtual visit is a suitable option if the concern doesn’t necessitate a physical examination. Many ongoing chronic issues, such as diabetes and hypertension, can be effectively managed through email and virtual consultations. Nevertheless, we suggest a traditional in-office clinic visit for any matter that demands a physical examination, such as coughs, sinus infections, ear infections, and new pain.
When therapy is not suitable
Can I receive a reimbursement if the therapy recommended during the consultation is unsuitable?
No, unfortunately, reimbursement is not available in such cases. The initial consultation aims to explore treatment options and compensate the doctor for his time with you. It’s crucial to recognize that the consultation does not ensure the performance of a specific procedure due to its suitability for your situation.
Obtaining a copy of your records
We are happy to help. Your records can be delivered via mail, securely faxed, or picked up at our office during regular business hours.
Before your records can be released, we require a completed and signed medical release form. There is a small charge of 60 cents per page for all copies. You are also responsible for postal costs. All fees must be paid in advance, and please understand that it may take up to 15 days to process your request and provide you with the records.
Sending records to another physician
How do I send a copy of my medical records to another healthcare provider?
We are happy to help. The most streamlined method to transfer your records to another physician’s office is to have them send a fax request to us. As a professional courtesy, we offer to send these records electronically at no cost.
While we aim to expedite the process, please be aware that medical records may take up to 15 days to be transmitted. It’s important to note that we maintain medical records for seven years in compliance with the regulations set forth by the California Medical Board.