Membership Information Packet

Membership Information PacketJuly 15, 2016

Questions? Contact us at:

Loudoun Holistic Health Partners, 209 Old Waterford Rd., Leesburg VA 20176Phone: (703) 779-2801 Email: [email protected]

mailto:[email protected]

Thank you for your interest in joining LHHP Concierge Medicine!

We look forward to returning to our original vision of a patient-centered practice where each of our patients will be assured of prompt access to high-quality holistic medical care and the compassionate and undivided attention they deserve from their doctor and healthcare team.

After reading the enclosed information about LHHP Concierge Medicine membership we hope you will join us so that we can help you experience peak health and enjoy life to the fullest.

Best wishes,

David Stewart, M.D. Anne Stewart, M.D.

Loudon Holistic Membership FeesMembership Type Payment Plan Fee * Payment Plan Discount

Individual Adult

Quarterly $657 ($219 / month) None

Semi-Annual $1,248 5%

Annual $2,365 10%

Children 12-17 Years



Annual $2,084 10%

Children < 12 Years


Semi-Annual $906 5%

Annual $1,717 10%

Adult Combo (Per adult when another adult

or child joins/ maintains membership)

> See Children’s Rates Above for additional fees per child



Annual $2,171 10%

Well Child Membership 11

See Details Next PageLimited to 25 Members

1st Child - Any Age $745 per year ($62 / month)

Additional Children - Any Age

$637 per year ($53 / month)

Ideal for children who have not required any ongoing medical care for long-term issues in several years.

Continued Next Page

Loudon Holistic Membership Fees (continued)Membership Type Payment Plan Fee * Payment Plan Discount

Remote MembershipLimited to 25 Members

Restrictions Apply


Semi-Annual $678 5%

Annual $1,285 10%

Remote Membership Combo

(Fee per additional family member)


Semi-Annual $618 5%

Annual $1,177 10%

Remote PLUSMembership

(Limited to 25 members.Restrictions apply.)


Semi-Annual $963 5%

Annual $1,825 10%

* Discounted fees are rounded to the nearest dollar.

Remote PLUS Membership Fee Includes:

• One Complimentary Wellness Exam per membership year ($1,800 value)• 60 minutes of TELEPHONE doctor visits per membership year. (Doctor visits included with the Remote PLUS plan may be scheduled as four

15-minute visits, two 30-minute visits, or one 60 minute visit during the one-year membership period.)• 30 minutes of in-office ACUTE CARE each membership year. (Acute care visits are billed at the discounted membership rate of $25 per 15-

minute visit.)• Member discounts for other on-site services. (See Discounts on LHHP Services Chart below.)

Well Child Membership Fee Includes:

• Annual Well-Child Check-Up (does not include all features of the Executive Wellness Exam).• Access to LHHP for further needs (60 minutes of acute care at member rates ($100 / hour); additional acute care at nonmember rates ($400 / hour); supplement discounts.)• Well Child plans are payable annually. Monthly/quarterly/semi-annual payment plans not available.

Well Child Membership Fee Does Not Include:

• House calls, complimentary member services, discounts for on-site services, mobile wellness coaching.

LOUDOUN HOLISTIC HEALTH PARTNERS MEMBERSHIP BENEFITS PACKAGE

SERVICE ANNUAL MEMBERSHIP BENEFIT

EXECUTIVE WELLNESS EXAM (1,5) 1 PER YEAR

Complete Physical Examination (1)

InBody™ Body Composition Analysis

Electrocardiogam with Interpretation

Dermoscopy Examination (1)

ABI Vascular Disease Screening

Spirometry (Lung disease screening)

24-hour Ambulatory Blood Pressure Monitor

Audiometry (Hearing Evaluation)

Vision Screening

Urinalysis

Fecal Occult Blood Test (Colon cancer screening)

Iodine Patch Test

Laboratory Testing (1)

TEXT, EMAIL & CALL YOUR DOCTOR ON YOUR SCHEDULE (3) UNLIMITED

SAME DAY APPOINTMENTS UNLIMITED

OFFICE VISITS WITH YOUR DOCTOR (15 MINUTES EACH) 4 PER YEAR

… CONTINUED

DISCOUNTS ON LHHP SERVICESSERVICE MEMBER FEE NON-MEMBER FEE

OFFICE VISITS WITH DOCTOR

15 minutes $25 $100

30 minutes $50 $200

45 minutes $75 $300

60 minutes $100 $400

NURSE VISIT $15 $30

INFRARED SAUNA $15 $30

IV INFUSION THERAPY

Meyer’s Cocktail $75 $150

Vitamin C $149 - $175 $200 - $300

Magnesium $35 $75

Glutathione $75 $125

Iron $100 $175

Chelation Therapy $100 $200

HALO PAP BREAST SCREEN $100 $150

ZYTO ELECTRODERMAL SCAN $35 $50

INBODY™ BODY COMPOSITION ANALYSIS $19 $39

… CONTINUED

LHHP MEMBERSHIP BENEFITS PACKAGE (continued)SERVICE ANNUAL MEMBERSHIP BENEFIT

NUTRITION COUNSELING WITH MY HOMEGROWN HEALTH (NORMALLY $150)

50% OFF

HOUSE CALLS (4) 2 PER YEAR

COMPLIMENTARY ENGAGEMENT WITH YOUR SPECIALISTS & INSURANCE COMPANY (7)

UNLIMITED

Insurance prior authorization and appeals

Forms completed, letters written

INTRAVENOUS VITAMIN INFUSION (MEYER’S COCKTAIL) 2 PER YEAR

INFRARED SAUNA SESSIONS (5) 5 PER YEAR

INBODY BODY COMPOSITION ANALYSIS (5) 6 PER YEAR

LHHP MOBILE WELLNESS COACHING UNLIMITED

Via Nudge™ App

ACCESS TO MEMBERS-ONLY SECTION OF LHHP WEBSITE UNLIMITED

Exclusive info, recipes and more

LHHP REWARDS PROGRAM (9) PER LHHP SERVICE USAGE

IN-OFFICE AND ONLINE SUPPLEMENT DISCOUNTS 10% OFF RETAIL PRICES


ECG $49 $100

URINALYSIS $13 $25

TETANUS SHOT $35 $85

INJECTION FEE $0 $25

RAPID STREP TEST $20 $35

FECAL OCCULT BLOOD TESTING $25 $50

CERUMEN REMOVAL (EAR IRRIGATION)

$25 $50

ABI VASCULAR HEALTH SCREEN $50 $150

URINE PREGNANCY TEST $20 $50

AUDIOMETRY $25 $50

SPIROMETRY $59 $200

AMBULATORY BP MONITOR $75 $200

GLUCOSE (FINGERSTICK TEST) $15 $35

HOME SLEEP STUDY $75 $400

TRIGGER POINT INJECTION (UP TO 3) $100 $175

JOINT INJECTION (SMALL) $100 $175

JOINT INJECTION (MEDIUM) $125 $200

… CONTINUED


SKIN BIOPSY (SIMPLE) $150 $250

LACERATION REPAIR (SIMPLE) $100 $250

TENDON SHEATH / BURSA INJECTION $99 $150

CRYOTHERAPY (SINGLE LESION / WART) $59 $125

NEBULIZER TREATMENT $35 $75

TB SKIN TEST $15 $30

IODINE PATCH TEST $10 $25

ORAL ZINC DEFICIENCY TEST $10 $25

LOST TICKET FEE $0 $25

LAB PROCESSING FEE $0 $50

MEDICATION PRIOR AUTHORIZATION $0 $50

LETTER WRITING $0 $50

RECORDS COPY $0 $25 + $0.2

FORM COMPLETION $0 $25

TOTAL COSTS $2,108 $5,159

CONCIERGE MEMBER SAVINGS $3,051 (41%)

Loudoun Holistic Health Partners Concierge Membership Terms

Active LHHP Concierge Membership Requirements

• Signed LHHP Concierge Membership Agreement• Timely Payment of LHHP Membership Fees via AutoPay

* Quarterly, Semi-Annual, Annual Schedules Available* CC or ACH Debit Required

• Payment of (Non-Complimentary) LHHP Service Fees at Time of Service• Compliance with LHHP Office Policies

Terms of LHHP Concierge Membership

• One-year term with annual auto-renewal• Cancellation without penalty

* Refund pro-rated for membership term and services utilized during membership* Requires 30-day notice of termination

• Unused membership benefits to not carry over to the subsequent membership term• $99 one-time enrollment fee per member

CONCIERGE MEMBERSHIP TERMS & CONDITIONS

1. Services provided during Executive Wellness Examination will be age/gender appropriate and at the discretion of your LHHP provider. Choice of laboratory testing will be determined by your physician in collaboration with you. All laboratory tests will be drawn at our office, but processed at outside laboratories. All billing will be handled by the specific laboratory and may or may not be billed directly to your insurance. Some laboratory fees are not included in the annual fee. Some laboratories require advance payment of fees which may need to be provided at the time of your blood draw. HALO Pap test may require specimen to be submitted to laboratory and any fees from the laboratory are your responsibility.

2. Membership package includes set number of complimentary services. After complimentary services allotment is consumed further usage requires payment of standard LHHP fees. (See fee schedule above.)

3. After-hours communication with your LHHP provider via text and telephone call is limited to urgent medical matters.

4. Membership package includes access to house call visits when available and deemed appropriate by your physician. House calls limited to 2 per membership term. Same day appointments limited to published LHHP office hours. Standard LHHP fees apply to house call visits and same day appointments.

5. Not all services included in the LHHP Concierge Membership are appropriate for all ages and/or all persons. All LHHP services, including those included in Concierge Membership, require approval of an LHHP provider. No substitution of services allowed.

6. Services provided by non-LHHP-employed / owned practitioners/individuals/business entities are offered in cooperation with the named individual/practitioner/business entity and are subject to the pricing, policies and procedures set forth by the named individual/practitioner/business entity.

7. Engagement by LHHP providers/staff with your medical specialists and/or health insurance company does not, in any way, guarantee that your request(s) for medical care/services will be accepted / authorized by the medical specialist(s) and/or health insurance company. LHHP reserves the right to decline to participate in, or pursue, communication/approval/authorization with any entity when it determines said activity to be against the best interests of LHHP staff/providers or members.

8. Participation in LHHP Mobile Wellness Coaching requires Member to purchase and maintain a mobile fitness device compatible with Nudge™ App. Communication(s) included in LHHP Mobile Wellness Coaching domains may not be confidential and should not include communication of confidential personal / medical information and/or to deliver, or seek, medical advice from your LHHP provider.

9. This service is still in development. While every effort is being made to implement the program, deployment before the full conversion of LHHP to LHHP Concierge Medicine is not guaranteed.

10. Remote Memberships and Remote are limited to 25 members at any time. Remote Membership includes access to Dr. Stewart as per the regular membership EXCEPT there is no access to on-site care from any LHHP physician / provider. As such, Remote Membership does not include Executive Wellness Physical. Remote Members may use on-site non-physician services but at non-member rates. Remote Membership does include supplement discounts. LHHP Mobile Health Coaching via Nudge™ App, and membership in the Optimal Wellness Now™ Alliance.

11. Children enrolled in the Well Child membership category who consistently require more than 60 minutes of medical care during their annual membership period will be required to upgrade to the regular Child Membership category during the subsequent enrollment period. Children enrolled in the regular Child membership who do not require acute care during their annual membership period are eligible to downgrade to the Well Child membership category (space permitting).

Documents

Membership Information Packet