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Frequently Asked Questions

Below lists some of our more Frequently Asked Questions about Direct Primary Care with Dr. Heniser

 

What is Direct Patient Care (DPC)

Direct Patient Care is a rapidly growing philosophy of moving away from the traditional, current approach to healthcare.  Insurance companies increasingly are driving the way your healthcare is being provided, dictating documentation standards, reducing physician compensation, and increasing the burden placed on physicians and office staff.  This results in less face to face time with patients, decreased reimbursement, and decreased patient and physician satisfaction.  We at Lotus Medical and Aesthetics wish to return to the real reason we all went into service in medicine, namely to care for our patients, our neighbors, our friends, the way it used to be.

Does Lotus Medical accept insurance?

We do not contract directly with any insurance companies.  Instead, we contract directly with you, our patients for your health care.  Through a modest annual fee, we are able to provide the opportunity for unlimited visits with Dr. Heniser, coverage of needed procedures, and even no-cost home visits and phlebotmy services (date TBD).  In additon, you will have 24/7 access directly to Dr. Heniser for any after hour needs, and a commitment to see you same day or as soon as needed for acute/urgent issues.  Visits can be via telehealth, in-office vists, or as simple as a brief text question or email.  Regardless, when you need care, Dr. Heniser will be available to care for you.

Do I still need insurance?

The simple answer is YES.  There will always be the possibility of a need for a major surgery, a hospitalization, or even a full Emergency Room visit.  These levels of care can be very costly and it is important that everyone have the necessary insurance to protect yourself against these possibilities.  Our feeling at Lotus Medical and Aesthetics is that the best combination is a DPC relationship combined with a high deductible, low premium catastrophic coverage plan.  90% of the care you will likely require in your lifetime can/should be handled through Primary Care

Can I still submit to my insurance for reimbursement?

In most cases you can.  Unfortunately, every health plan is a little different and we encourage you to speak directly with a representative from your health plan for specific answers regarding your coverage.  In general, annual contract fees can not be reimbursed, however, we will work together with you to provide the necessary information for you to submit any visits, procedures, or other care that you receive for reimbursement.  Additionally, many of our patients also have access to HSA/HRA accounts which often can be used to offset costs associated with your care.

Are there any costs outside of my annual contract?

Depending on the plan you choose, you may incur a minimal fee if you require a procedure or intervention.  The Platinum package allows you to have ZERO additional costs for care received through Lotus Medical's Primary Care services.  Other packages require a nominal charge for procedures or interventions, and those prices can be found on our procedure list.  If you require outside lab, imaging, or testing, these services will be billed to your insurance and you would be liable for any copay or co-insurance costs.

Do I have to enter into a contract with Lotus to be seen by Dr. Heniser?

You are not required at this time to enter into a contract with Lotus to be seen by Dr. Heniser.  You can elect to be seen as needed for routine primary care, similar to a walk-in/urgent care facility.  You will not, however, be able to participate in the extra added features made available to patients who contract for their care.

Does Lotus Medical accept Walk-In/Urgent Care appointments

Yes we do!  We ask that you please call the office at 207-276-8120 if you can before arriving at the office to be certain someone is available to assist you.  If no one is in the office, we will arrange an appointment method with you based on your presenting complaint and arrange for a tele-helath visit or make arrangements to meet you at the office to care for you face to face.  
If you happen to arrive at the office and notice that our OPEN flag is out, this means we are in the office and ready to assist you.  If the flag is not flying, please call the office number and we will promptly return your call
We ask that all patient visits for Medical Aesthetic care please make an appointment for thier service

Do you see Children at Lotus Medical?

We sure do!  Pediatrics is a big part of our practice and it would be our honor to help maintain the health of your children.  Children typically don't need to be seen by the doctor as often as adults, thus the lower annual contract rate for their care.  They are still provided with the same accessibility to their doctor after hours and as needed throughout the year.  We are still working to see whether we can offer vaccines through Lotus at this time.

What other info should I know?

Working with Lotus Medical and Dr. Heniser means that you will have choice.  If labwork, imaging, diagnostic procedures, or other care will be required, we will happily send the necessary information to the providers/hospitals of your choice.  We are not employed or contracted with any facility, which allows us to help you find the best fit for your care outside of our office.  

We know that for many of you the annual fee might seem like a lot at one time.  We do offer no-interest payment plans that allow you break the amount down into manageable monthly payments.  You have the choice. 

We appreciate that you have options in where and with whom you chose to receive your health care.  Our promise to you is to be timely, focused and committed to you, our patient, and to the pursuit of your good health

 

(207) 276-8120

PO Box 382

Mount Desert, Maine 04660

Locations:

9 Kimball Rd Northeast Harbor

417 Wilson St Brewer
131 Main St Calais

41 Factory Rd East Machias

270 High St Ellsworth

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