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Concierge Medicine 

Drs. Lush and Sinclair Transitioning to a Concierge Medical Model in July 2024

Dr. Tausend Transitioning in January 2025

 

Since 2011, the doctors and staff at North Seattle Natural Medicine (NSNM) have been committed to providing our community with the highest quality medical care in a warm and welcoming clinic environment. However, the rapidly increasing costs of running a small business in the greater Seattle Metro area, increasing amount of time our providers and staff spend providing administrative and care coordination support services that are not billable to insurance (aka Non-Covered Services), and increasing costs of running a practice, have created a challenging environment for us to continue to provide the level of care and service to which we are committed. This has left us with the tough decision to either close our practice, or to ask our community for support.

NSNM continues to expand services and bring on new providers at a time when non-hospital/HMO-affiliated private insurance-based clinics are limiting services, moving to cash-based models, or are simply closing due to physician burnout or low reimbursement from health insurance companies. Across our industry, it is increasingly challenging to operate a patient-centered, profitable business in an insurance-based model.

We understand that our current practice model, while well-intentioned, has its limitations. The demands of managing a high volume of patients within a traditional primary care setting is compromising  the quality of care we strive to provide. Additionally, the scheduling constraints often result in lengthy wait times for appointments, leaving patients feeling frustrated and underserved.

We value our relationships with you and are committed to continuing to provide you with exemplary naturopathic primary and specialty care. In order to do this, we are happy to announce that Drs. Lush and Sinclair will be transitioning to a concierge medicine model option, starting July 1, 2024. Enrollment will be limited, thus allowing the doctors to spend the extra time that is needed to continue to deliver the personalized, quality health care that you deserve. Dr. Tausend will also be making this transition, starting January 1, 2025. 

Enrollment will be limited, thus allowing the doctors to spend the extra time that is needed to continue to deliver the personalized, quality health care that you deserve.

What is concierge medicine?

The concierge medicine model allows us to continue to bill your insurance for services typically provided in a medical setting while delivering additional services, considered by your insurance to be ‘non-billable’ or ‘non-covered', for an out-of-pocket fee. These additional services are what set us apart from the conventional medical model where you get short appointment times and limited interaction with your provider outside of your appointment. 

With high patient loads, Drs. Lush and Sinclair spend 12-18 hours/week providing non-covered services (unpaid work) to our patients. In switching to a concierge model, we will limit our number of patients, thus allowing us to be able to keep up on the quality “out of visit time” care. 

We are offering two plans, the Thrive and Core, as outlined below. In order to remain on Drs. Lush and Sinclair’s panels, patients must enroll in one of these plans. Our support staff is available to aid you in understanding your options, so you can make your selection by July 1, 2024. Dr. Tausend’s patients will need to make their selection by January 1, 2025. 

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Thrive Plan
$79/month

This is the option that we recommend for all of our patients. It includes an enhanced relationship with your doctor, including the comprehensive visits and individually tailored care that you have been experiencing with us, along with priority scheduling. It includes:

  • Direct email access to your provider via our secure portal. 

  • Priority scheduling within 48 hours if necessary for acute/urgent medical appointments.

  • Priority scheduling within 2 weeks for chronic care follow up appointments.

  • 10% off all supplements purchased from NSNM (and they remain sales tax free).

  • 6 free vitamin B12 shots/year ($150 savings)

  • 10% off hormone pellet therapy costs. (between $30-$50 savings per pellet visit)

  • Family discounted rate of $150 / month total for 2-6 immediate family members (instead of $79 per person). 

  • Two free 30 minute sessions annually in the Rejuvenation Room which includes a red light facial mask, red light body light and a sound bath! After you use your 2 free sessions yours are only $25 per 30 minute sessions (versus $35 at the regular price)

  • Discounts on microneedling, Botox, and other new services coming this year. 

Core Plan
$100 per visit

This option provides you the high-quality and personalized healthcare you’ve been receiving. This is not a concierge medicine plan but our option for a Non-covered services plan for patients who only come in 2-3 times a year and do not want the benefits of a concierge plan. We will continue to bill your insurance for services typically provided in a medical setting while delivering additional services, considered by your insurance to be ‘non-billable’ or ‘non-covered', for an out-of-pocket fee.  This non-covered service fee is often covered by your HSA plan.

 

The plan includes:

  • Access to your provider for non-covered services such as referrals, prescription refills, emails, and prior authorizations for 30 days after an appointment.

  • There is no guarantee that if you sign up for this plan that you will be able to stay a patient of Dr. Lush or Dr. Sinclair as priority will be given to the concierge patients. 

Private pay options
no insurance billed for your care at NSNM: 

For our patients who do not have insurance or their insurance does not cover Naturopathic care, you can continue to pay the cash rate for your office visits and you will continue to receive our current 20% time of service discount on the fee typically billed to insurance. You will not be required to sign up for a plan, however, know that if our panels get full, we cannot guarantee you will be able to see either Dr. Lush, Dr. Sinclair or Dr. Tausend.  You are welcome to sign up for the Thrive plan if you want the benefits of the plan. 

Paying cash for your appointment provides you the high-quality and personalized healthcare you’ve been receiving, with continued support for 1 month after your appointment. It includes:

  • Access to your provider for non-covered services such as referrals, prescription refills, emails, prior authorizations for 30 days after your appointment. 

*Pediatric patients*

Patients who are under 18 years old do not need to sign up for our non-covered services or concierge plans. These services are designed for adult patients who are looking for additional beyond what their insurance covers. We understand that minors have different healthcare needs and we are committed to providing them with the best care. If you have questions or concerns about your child's healthcare, please do not hesitate to contact us.

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Q&As

How does Concierge benefit me?

Concierge medicine allows for a deeper patient/doctor relationship. Instead of being restricted by the ever-increasing constraints of the insurance companies, we get to provide holistic care to you as an individual. Naturopathic medicine is built on the foundation of treating the whole person, not just the illness, and this takes time and communication between visits. Concierge medicine allows us to stay true to this principle.

What if I’m already enrolled in a Non-Covered Services Fee Plan for 2024?

As of July 1, 2024 those on the current Elemental and Deluxe plans for patients of Dr. Lush or Dr. Sinclair will need to choose one of the new plans.  Dr. Tausend is still accepting the current $200 Deluxe and $30 Elemental Plans through 2024 and we have three other providers who are currently not in either model (yet).

 

For those patients of Dr. Lush or Dr. Sinclair already enrolled in our Deluxe Plan for 2024, you will get your first three months free making your first $79 payment not due until October 1, 2024.

When is this transition happening?

Enrollment will open on May 1, 2024 on a first-come, first-served basis, and billing will take effect July 1, 2024 for Drs. Lush and Sinclair. Due to high patient volume, Drs. Lush and Sinclair will have to limit enrollment in their practices. Their panels will close to any additional patients once full.

Dr. Tausend’s concierge billing will take effect January 1, 2025.

How will I be billed for the Thrive concierge plan?

We will need a credit/debit card or HSA card on file to bill your membership fees. It will be a recurring charge each month. You can also decide to do a one-time fee to cover the entire year.

Can I request a refund if I don’t use the service?

No refunds will be given, we want you to utilize the services offered.

Why are doctors Lush and Sinclair the only doctors doing concierge medicine at NSNM?

Drs. Lush and Sinclair both have a long wait list and it can be challenging to get an appointment with them quickly. They have up to a combined total of 7000 patients that have been in their care after 20+ years each in active primary care practice.  In order for them to be able to provide the services offered in the concierge programs, they have to limit the size of their practice. This will allow the chance to build a greater doctor/patient relationship. To accommodate the reduction in their practice size, NSNM has increased the number of quality providers for you to choose from.

Will you continue to bill my insurance for my visits?

Yes, we will still continue to bill your insurance for each office visit. You will be responsible for all copays, deductibles and co-insurance as per your insurance plan.

Will you limit the number of patients in your practice?

Yes, in order to deliver on the promises made in our membership plans, Drs. Lush and Sinclair must keep their patient count much lower.

Can I use my HSA for the monthly or per-visit fee?

Your membership is a healthcare expense, so some HSA/FSA accounts can pay for the fee. We always suggest that you check with your company to make sure this will be a covered expense.

Are there discounts available for partners/families?

Yes! The Thrive plan includes up to 6 direct family members for less than the price of two people.

I don’t have insurance or my insurance doesn’t cover naturopathic medicine so I pay out of pocket. Do I need to purchase a membership to see you?

Self-pay patients will not need to purchase a membership to see their doctor, and there is no per visit extra fee. This allows you to see your doctor but does not grant you access to any of the benefits in the Thrive plan. If you wish to take advantage of those offerings, you will need to sign up for that membership plan.

What if I join and then decide that this isn’t the best fit, can I cancel my membership?

You can decide to discontinue care with NSNM at any time. We will need a minimum of 30 days to forward medical records to your new providers (via e-fax so please provide this number to us), and we can refill any necessary medications for 30 days only. Please note that if you do decide to rejoin there will be a $200 restart fee.

What if I want to change physicians within NSNM?

Not a problem, just let us know if you want to change providers at any time. If you are switching to one of our providers not on the concierge plan, you will be dropped from Dr. Lush or Dr. Sinclair’s panel and no longer will be charged monthly. 

We look forward to being better able to serve you! 

North Seattle Natural Medicine 617 5th Ave S Edmonds, WA 98020

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