Once you have scheduled an appointment you may be sent information via mail, text or link. Please complete these items as early as possible before your appointment. Some are requirements for the appointment to proceed and others will be related to your care. We will review these documents prior to your apopintment and sometimes well ahead of time. To give us the time we need please try to have them complete at least 24 hours in advance otherwise as soon as is feasible.

New Patients

You will be sent a consent for telehealth care delivery, a privacy and financial notice and HIPAA privacy notice. These documents are also available at the following links in case you are having difficulty obtaining them. You may also receive questionnaires related to the concern you cited for your visit. These are validated tools to assist us in identifying the most important information we way need for your care. As above, please complete these as soon as possible prior to your visit. (A new tab will open with each of the links below)

• Telehealth Consent
• Privacy and Financial Notice
• HIPAA Privacy Notice

Given the technological nature of our service we try to allow for a limited number of new visit in close proximity. We will allow extra time to ensure that we are able to establish a connection and perform the necessary concerns you have. Please reach out if you have specific concerns as far ahead of time as is possible.

Established Patients

Once you have established the basics and are fully registered in our system we encourage you to explore the other modalities for care we offer. In many instances they will save significant time and effort. Follow-up appointments are available without approval or additional concerns. We offer a variety of care models to assist your needs. We require a 20 minute minimum for standard follow-up appointments unless we specify otherwise. Our rate is billed regardless of the method used to provide care.

General Policies

Our rate is billed regardless of the method used to deliver care. We encourage all patients to utilize the tools we offer to improve the efficiency and effectiveness of the time spent. Spruce Visits, Intake questionnaires and following an appropriate follow-up schedule are all critical parts of maintaining efficient care. Our time is billed in 20 minute increments rounded to the nearest interval (e.g. a 33 minute appointment would be billed to the 40 minute schedule). We make every attempt to eliminate clerical time or technical challenges from this time. Home visits will be billed for the time at location. The travel is handled elsewhere.

We are a private and flexible micropractice designed to maximize care delivery and flexibility. The medical services we provide here are not intended to replace a health insurance policy. Due to the highly variable rate of reimbursement and frequent denial for services from many private insurers we are currently out of network for all private insurance plans. We are in the process of credentialing for medicare and medicaide.

In using a hybrid fee-for-service model we are able to maintain completely patient centered in our care delivery and can more predictably provide care to those without insurance or those the choose not to utilize their insurance. In short, everyone gets more choice and less complicated guesswork. Please note that many of the prescriptions, labwork and imaging studies we order can be covered under your insurance individually. We also offer all of these services on a cash or fee-for service basis. As a micropractice, we do not maintain the staff to handle these claims; however, we will provide you with the paperwork to receive reimbursement that may be offered by your plan. Please see our current services pricing.

While we are out of network, we will still provide you with a superbill for your appointment. This is the document plans use to decide on coverage and reimbursement. You may submit this bill to your insurance for consideration of partial reimbursement. Please see our Privacy and Financial Notice for other details.

Medicare

For Medicare patients interested in care, we are in the process of credentialing with CMS for medicare covered services billing. Current guidance from CMS is that they are allowing for retroactive billing for up to 30 days and have also indicated that they are working diligently to waive many of the technical barriers to credentialing. We have filed the initial application. Once that is accepted we will begin visits with Medicare beneficiaries. We have designed a care model that will provide many our or services with several very effective options for remote patient monitoring and virtual health. We are currently maintaining a list for Medicare patients interested in any of our services and our best estimate is that we will be able to begin offering appointments by August 1st.

HSA/FSA

We are a fully qualified, licensed and registered medical clinic. As such we are able to accept HSA and FSA accounts for payments for medical services. However, some of the fees for equipment supplies and premiums will not qualify as HSA expenses. The penalties for HSA or FSA misuse are sometimes vague and can be quite severe. Please check with your insurer and HSA organization for details to ensure that they consider our services as qualified expenses to avoid conflicts, issues suspensions or disqualifications.

When you schedule your appointment online you will automatically be enrolled in our HIPAA compliant communications service through Spruce Health. These systems are integrated and fall under the HIPAA privacy and use guidelines. You can enter a credit card number at the time of registration. Our credit card collections are completed by Stipe.com and they will allow for you to keep a card on file. No charges will be applied to your card unless you cancel an appointment without following our cancellation guidelines.

Payment for services will be due at the time of service unless otherwise specified. Home services will be billed at the end of the visit.

A complete price list of services is available within our Price Transparency List.

We accept many forms of payment, major credit cards, Apple Pay, HSA/FSA cards and PayPal. This list changes regularly based on what Stripe.com will process so please be prepared with alternates if your payment type is not present. We can also provide an invoice for more traditional means of payment, checks etc.

We make every attempt to be flexible and accommodating in the care we provide. If you have a concern and are unable to be present for your appointment please reach out to us if possible. Although we understand that this may not be possible.

As such telemedicine, virtual care or Spruce Visits will be billed for the time allotted in the schedule if 24 hours notice is not provided. This fee is non-refundable; however, we will provide a partial credit towards a rescheduled visit within 5 business days after the cancellation.

Repeated cancellation will require payment in advance for future services.

We use the following services and systems to provide the core service of your care.

• Elation EHR All of your patient data, visit information and orders are kept within the HIPAA compliant medical record system at Elation. You can follow the link in the name to access the patient portal.
• Portal Access Video
• Spruce Health: Our telemedicine, patient communication, HIPAA compliant text and messaging platform can be accessed by logging in to a computer for messaging or downloading their app to connect with us directly. Spruce is also integrated with Stripe, our payment processor. Payment requests will primarily be sent from our practice via Spruce.
• Spruce Health Intro Video
• Stripe:

Stripe is our primary payment processor. You will occasionally receive payment requests or payment receipts from Stripe.com. At the current time they are processing all of our non-check, non-cash payments.

• Making a Payment Video

Please note that routine text messages or emails are NOT a HIPAA compliant means for communicating healthcare related information. Communicating via those means would subject our practice to very significant penalties, fines, or worse. Please use our Elation EHR or Spruce Health Platforms to communicate any patient care related information. If private information is received through our general messaging channels, we will reply with links for the compliant channels and delete and remove that information. Elation and Spruce are integrated and anything communicated via Spruce in written or recorded form will be directly linked to your patient record in Elation. This maintains compliance and allows us to properly store and track your care. Please follow the following links to access those sites directly.

• Elation EHR
• Spruce Health

As a routine we do not video or audio record telemedicine visits. We do maintain a full health record of every visit. We can provide your records to anyone you see fit. Some of this can be done electronically, other times we will fax. Please complete the Release of Information and either attach it to a spruce message or Fax it to our HIPAA compliant fax number through spruce at (610) 320-2130.

Please note that medical concerns will only be addressed during scheduled or formal visits for registered patients. If you have several family members with concerns or questions please schedule each member accordingly. Medical questions, requests or refills should be done strictly via the Spruce and Elation Platforms above. We make every effort to address concerns as soon as possible but please allow us 2 business days respond to routine questions. More urgent concerns should be completed via a scheduled visit.

A HIPAA notice of privacy practices should have been sent with your registration and visit request. Please review this carefully, sign, and return through our HIPAA compliant channels outlined in the communications section.

We are required by law to:

• Maintain the privacy and security of your Protected Health Information or PHI
• Provide this notice to you outlining our legal duties and privacy practices in regards to PHI
• Notify you of any changes or additional uses related to the use or disclosure of your protected health information.

You may find a copy of this policy here: HIPAA Privacy Policy

We are committed to maintaining your privacy. Please note that in accordance with State statutes and current guidelines we do not video or audio record any of the visits we provide. The only enduring record will be that present in the electronic health record. We will communicate information only through the channels you have approved or requested.

Privacy and Security Elements

The Elation electronic health record system is a fully HIPAA compliant cloud-based electronic medical record that we access through secure internet channels. Access to this system and telemedicine visits are conducted though our telemedicine office. We maintain a dedicated business internet line for this communication and use only “hard-wired” ethernet connections for our equipment. Our network is protected by a next generation physical “hardware” firewall with cloud based analytics, active threat detection and monitoring with Zyxel’s SecuReporter. Our web services maintain a rigorous “extended validation” SSL certificate to ensure that all information and communication are completed with enterprise standard encryption and certificates. In addition to electronic security if paper documents are required for short term care or business needs they are kept in a secure location under physical lock and key with an active video and protective alarm system. Once those documents are no longer needed they are shredded on site and disposed of appropriately. All billing information is transmitted and maintained via PCI compliance standards

As noted in the insurance section above, we are a micropractice designed to maintain maximum flexibility in the services we offer. Our prices are reflective of what would be the typical reimbursement for services. Please see the Price Transparency List for updated base rates for services. Please note that these prices are subject to change at any time without notice. We will make every attempt to convey these fees to you ahead of time and, unless otherwise specified, we will follow the fee schedule. Please note that not all of the services listed are qualified health expenses according to HSA and FSA rules; if you plan to use HSA or FSA funds, please contact your provider for details.

Price Transparency List – Updated July 2020.

We also maintain a list of services that we do not provide directly but can arrange as a part of your care. We have set up these arrangements so that we may offer services that are not traditionally available under most insurance plans as well as allow for adequate planning for those without insurance. Please review the following lists for currently available services and fees. Please note that this is a rapidly changing list and we always strive to improve the prices and add to the offerings. Each link will also outline how each service is billed and/or collected.

Cash Based Services

• Radiology/Ultrasound/ECG
• Common Prescriptions
• Lab Testing

Virtual care is the practice of utilizing current technology to facilitate standard medical care from a remote location. Virtual care is becoming more and more commonplace throughout medical practice both within the hospitals and medical systems. For many reasons, unfortunately the implementation of this method of care has lagged in the outpatient setting. Virtual Care can range from everything from a phone conversation or text message refill request to a comprehensive real-time suite of patient evaluation, monitoring and examination technology. It has even been demonstrated to be capable of providing procedures, invasive evaluations and surgery.

In our practice, we are working diligently to bring as many of these technologies our of the care facilities to where they are currently needed the most, and will ultimately prove to be the most cost-effective — In-Home.

The onset of the pandemic identified many gaps and limitations to the widespread adoption and implementation of these technologies. We have been and will continue to work diligently to enhance the possibilies of virtual care.

At the current time we are able to integrate many traditional devices for blood pressure, blood sugar, spirometry, pulse oximetry, temperature and weight into our remote exams without much additional effort, planning or cost. We have extended this to identify devices currently on the market to allow for detailed, close up skin exams, ear exams to rule out infections, and close up throat exams. We have also been able to integrate digital stethoscope technology to allow for real-time evaluation and examination. At the current time these require the purchase of additional equipment as it is cost-prohibitive for our practice to provide these instruments directly. We are working on solutions to these barriers but as noted above secondary to FDA regulations and certifications it will be some time before we are able to fully fund this venture and offer these options at much better cost.

At the same time just placing a priority on the integration of the available technology does address a number of gaps in access to care that have emerged along with the social and medical challenges associated with management of the coronavirus pandemic. Because of this focus we are better able to serve healthcare customers that are homebound, have high-risk conditions for chronic health reasons, or even those that electively remain isolated as a personal health preservation reasons. By making these appropriate decisions whether it be for individual risk or population health concerns they effectively become “underserved” by the current health delivery systems and circumstance. We are also able to more predictably able to provide care to those that are uninsured or have lost their health insurance. We have worked diligently to identify medical services such as lab, prescriptions and x-rays that can be purchased on a cash basis. In doing so we are able to reduce or prevent expensive and consuming visits to the hospital and emergency departments.

Collectively based on my experience and judgement the more we are able to offer to appropriately address the short and long term health needs of anyone who is not seeking care for personal or underlying health reasons then we will have succeeded. For many reasons maintaining the standards necessary for social isolation are increasingly challenging. Having the option for in-home based and virtual care could empower those vulnerable individuals at increased risk for severe outcomes or families that might have needs that are not addressed otherwise. We hope to fill at least some of the gaps that would impact the long term health maintenance and needs that have not gone away despite the changes in access to medical care.

Fortunately in healthcare you have the freedom to choose whomever you would like to provide for your medical needs. We believe that we provide many significant benefits when compared to the nationwide or large system telemedicine services. Virtual care and telemedicine are often, by their very nature, less connected and impersonal. Being a small scale and flexible practice, we do not have to adhere to the specific cost measures or care strategies that larger systems require to offer their service. You will very quickly get to know us on an individual level and will encounter the same friendly faces with each visit. We will tailor our offerings to your specific needs. In addition to our flexibility, we provide a single personalized and trusted system to provide care that may range from text messaging all the way to face-to-face in-home care.

Spruce Visits are a type of asynchronous visit where you are sent a validated and adaptive set of medical questions through the Spruce App prior to your visit. The adaptive questionnaire takes you through the typical clinical scenario and presentation of common conditions and can significantly reduce the time needed to obtain a full evaluation from our providers. In many instances the full visits can be completed without the need for full face to face or real-time evaluation by the provider.

Here are links to the Spruce web FYI and a brief instructional video on how to utilize the Spruce Visit technology to improve the efficiency of your care.

• Spruce Intro Video
• Spruce Visits Provider Primer Website

At the current time, Spruce Visits are not automatically selected at the time you schedule your visit. If you request a Spruce Visit in addition to the reason for your visit, we will review those requests and send the appropriate link.

Coronavirus or COVID-19 Spruce Visits

The one exception at this time is for Coronavirus (COVID-19) testing. If you type “covidtest” in the reason for your visit, you will automatically be sent the Spruce Visit COVID-19 Screener. We will evaluate the results of the screening test and can speed up your evaluation and may order and coordinate appropriate testing prior to your visit.

Existing Conditions

Dr. Faith is board certified in Family Medicine and has been in clinical practice for over a decade. Over his career he has provided the full spectrum of clinical primary care in adults and children. In addition to primary care, Dr. Faith has over ten thousand hours of experience in hospital medicine and critical access emergency medical practice. This experience allows him to evaluate and in many instances treat both chronic medical conditions and provide evaluation of acute concerns.

Acute Concerns

If you think you may be experiencing a medical emergency or your symptoms are changing rapidly you should contact 911 or visit the closest emergency department. If you are considering visiting an urgent care or after hours clinic, we can likely be of assistance. Follow this link for a list that Dr. Faith has seen and evaluated through telemedicine and virtual care visits in recent months. Many acute concerns can be addressed through Spruce Visits and/or via telemedicine visits if you prefer. If you do not see your concern on this list and do not need immediate attention please reach out and we will help in any way necessary.

Chronic Moderate to Severe Conditions

In addition to the traditional primary preventive and primary care, we are excited to integrate strategies for remote patient monitoring for healthcare customers that have conditions that change frequently or typically require visits to the clinic or emergency department more than twice per year. We are excited to offer Remote Patient Monitoring (RPM). Remote patient monitoring takes regular measurements, such as vital signs, in-home and on your schedule and links them to a clinical database that monitors them over time. This data is then summarized and sent to us for review. If something changes in the pattern, it will alert our staff and providers to look in to them further. If you have high blood pressure, diabetes, Asthma, COPD or have been told you have congestive heart failure, this may be a very valuable asset to your health and wellness. We ar currently enrolling healthcare customers in an interest list for this service. Once we are able to meet the minimum requirements of enrollment we will roll out the service. Contact us for more details.

Yes, as a telemedicine-forward virtual care practice we cannot safely and effectively complete and document your care without the minimum resources of an Elation EHR record and a Spruce Health communications account. These resources are combined through an integrated API to work seamlessly to maintain your full health record and any communications. See the HIPAA Privacy Notice for more details. These platforms work on many devices and operating systems; however, if you run into problems give us a call and we will help.

• Elation EHR Patient Portal
• Spruce Health

If you are unable to utilize these resources or would like to explore alternatives we do make exceptions on occasion. These exceptions are very situation dependent and should certainly be discussed with us prior to scheduling an appointment. Do not hesitate to reach out by phone or use our general info email. Please be advised that our general email does not meet the minimum requirements for HIPAA privacy, so please keep questions general.

If you have questions, concerns or uncertain just reach out to us by phone at: (610) 890-8522 and leave a message or speak to the medical staff and we will gladly help you.

At the current time we do not have an office or specific exam location. Our business facilities are only for administration and operations.

We are committed to utilizing virtual care for as much as is reasonable. At the same time, we understand that some conditions are just not possible to evaluate and treat via virtual care. In this instance, we will provide in-home visits on a case-by-case basis. If the circumstances, timing, location and safety permit a home visit based on our assessment, then we will schedule this appropriately. If you need an in-person evaluation and we are unable to complete this for any reason, we will only bill the minimum consult fee and do our best to arrange for your further care.

We are working towards establishing a permanent location in the Upper Main Line region. It is too early to provide details at this time, however we will keep all of our healthcare customers informed of these developments.

Currently we are doing in-home visits on a case-by-case basis. In-home visits require a prior telemedicine or virtual care visit and will be approved individually. For logistical reasons we are typically only scheduling home visits within approximately 5 miles of east central Willistown Twp. Please see the attached area map. Exceptions are likely based on availability and request. We plan to expand this area as we are able, so do not hesitate to ask.

If you have had a service in a primary care clinic or urgent care in the past, we can likely provide a similar service at your home. We can also conduct visits for acute care concerns in addition to standard exams and visits. Acute care concerns may include evaluation of wound care or lacerations and stitches/repair, contusions, sprains, concussions and other concerns identified during virtual heath visits. We will also conduct home visits to demonstrate instruments or devices you would like to use for your ongoing care.

We can also arrange for services to be provided in-home in association with a virtual visit. X-Rays, Echocardiograms, non-urgent ECGs, Prescriptions Deliveries, and some lab draws can be ordered, coordinated and completed in home without the need for a provider visit. Once these studies are completed and the results returned, we will convey those results to you just as you have experienced in the past.

We are out of network for private insurance plans at this time. We will provide you with a superbill that you can submit to them for possible partial reimbursement of our medical visit, virtual visit and in-home services.

This may change in the future if reimbursement and coverage for virtual health services becomes more consistent and accepted; however, at this time the only insurance with whom we are credentialing is Medicare.

We are in the process of credentialing with Medicare. We are enrolling Medicare recipents to a wait-list while we await this credentialing process to complete. We do not currently have a specific time frame as to when this will be completed.

We are out of network for private insurance plans at this time. We will provide you with a superbill that you can submit to your insurance for possible partial reimbursement of our medical visit, virtual visit and in-home services.

Lab Testing

We currently can place orders for labs through Main Line Health Labs, Quest Diagnostics and LabCorp. Some insurers require that you have your testing done through a specific company, so please check with your insurer ahead of time. Once you identify your preference for lab testing, each of these agencies will collect your insurance information and bill appropriately. We will still receive and review those results and forward them to any place you choose.

Prescriptions

At this time we do not stock or sell prescription medications. We can order your prescriptions to any pharmacy you choose. We are working with a local pharmacy to provide a list of common medications that can be purchased directly from the pharmacy on a cash basis. Depending on your insurance coverage this may be a more cost-effective option. With all other prescriptions your pharmacy of choice will take your insurance information and process them as they always have in the past.

Imaging

Home-based imaging is typically not a covered item for most insurance companies unless you are medically home-bound or have a prior approval for advanced home care services. If you meet these criteria, the imaging companies can take your insurance information and bill for those services appropriately. If you choose to have your imaging done at one of the local outpatient imaging facilities, your insurer will very likely cover them as it would traditionally. If you would like to have the imaging done electively at home, we have made specific arrangements to allow for this to be completed on a cash basis. Because of this arrangement we are required to bill for these studies in advance. Please see our itemized list of imaging options in the Price Transparency section of policies as above. If for some reason the study cannot be completed and the imaging company does not bill us for the service then we will credit that money to you.

While we cannot speak for every clinical practice and provider, we will make every effort to work with your care team to improve your overall care and health. We encourage you to share any information, results or records we produce with anyone you see as valuable to maintaining and caring for your health. In some cases there will be overlap due to the different nature of our care delivery models, but we hope this has a net positive effect on your healthcare access and delivery.

Can you be my primary care doctor?

We can perform many on the services required to provide effective primary care for healthcare customers who live in the Upper Main Line region of Philadelphia. When we establish a permanent clinic location, this will be a core part of our service for healthcare customers in this region. Until that time arrives, we advocate that you maintain the critical relationships that you have established with your current regular care team.

Greater Philadelphia

This is one of the major advantages to everyone with our care model. It does not depend as much on you being located close by to receive care directly through our practice. We have customers that frequently travel throughout the state or to neighboring localities. In many instances, if you are using a portable computer such as a laptop, and also possibly instruments or devices to participate in our care, just take them along. As long as you have a reasonably fast internet connection you are as good as you are at home. There are some restrictions based on certain services. We will very likely be able to provide pharmacy and lab services through the nationwide networks that we participate with, and the imaging service provides service in a number of states beyond Pennsylvania.

As always, if you have homes in multiple places or plan to travel frequently, it is always best to check with us ahead of time. Even though travel has been somewhat limited recently, we want to extend all of the benefits of our care model to you wherever you may be.

Outside Philadelphia

We are also capable of providing service to a wide area outside of Greater Philadelphia. This will limit home visits but can provide for the needs of healthcare customers in rural underserved areas. If you think this applies to you, please reach out to us and we can discuss ways to work together to improve your access to care.

We are excited to roll out our medical practice and hope you are satisfied with the services we currently offer! That being said, we do hope to add several services to better provide for your care needs. The following are a few examples:

Mobile Clinic

In the very near future we are going to purchase a dedicated mobile clinic that we can use to more effectively and efficiently provide home-based services. There is currently a waiting list for the vehicles required due to the recent large expansion and growth of nationwide delivery services. Stay tuned: As soon as the appropriate equipment is available, we will add this exciting addition to our services.

Healthcare Marketplace (Farmers Market)

We hope to grow this care delivery model as rapidly as we can. One major area that we would like to incorporate is a healthcare marketplace. We are constantly looking for like-minded practitioners in any specialty or other facet of healthcare. From physical therapy, complementary and integrative health providers and nutrition. We want to make sure you as a healthcare customer have as many choices as you need to maintain your health and wellbeing.

Virtual Care Instrument Development

This may be a small footnote to this long and exhausting page of information that is presented above but this is a very exciting and interesting area of interest for our group. We have assembled a very talented team and have been able to develop tools that will make all of our care more readily available and accessible. We have outlined the process and have the key elements in place. Once we are able to secure proper funding and support, we will have some very exiting announcements to make in the coming months.