FAQ's: FREQUENTLY ASKED QUESTIONS
Why Membership?
There is a financial reality to providing primary care in the United States. Most primary care medical offices have thousands of patients assigned to each physician. Typical office visits can be as short as 10 minutes and a physician might be required to see 30 or 40 patients each day just to get by. Doctors are often booked out months into the future. Dr. LaDuca and Dr. Estopinal both recognize that this is not the type of care local residents want, nor does it represent the kind of care we want to give. As such, Coastal Pines Medical Group will be a membership based practice.
Membership allows CPMG to deliver exceptional primary care within a practice that is, given the size of our community, dramatically smaller than a typical medical office. With this model we are able to provide care far superior to that of a traditional office: appointments are easier and more flexible, doctors are more available, extra time and services are offered to provide personalized, proactive and supportive care. Our doctors will have more time to listen to you, research your unique situation and ensure you are not "lost to follow up".
We also recognize that navigating the current medical environment in the United States by oneself is frustrating, time consuming and sometimes literally impossible. CPMG will partner with our members, providing whatever assistance they need, including, but not limited to, contacting specialists, coordinating outside testing (such as CT scans, cardiac monitoring and sleep studies), obtaining prior authorization for medications or tests, interfacing with pharmacies and more. CPMG physicians want to know if their members are ill and will support them if they are hospitalized or admitted to a skilled nursing facility. We know the other doctors in the area and will expect and insist that they communicate closely with us when caring for our patients.
What insurance do you accept?
We accept MOST INSURANCE, including Medicare and Anthem Blue Cross/Blue Shield. We cannot accept HMO ( CCPN) or CenCal/MediCal.
What will be my TOTAL cost?
You will be responsible for your monthly membership fee. We offer numerous discounts to try to make this more affordable for our patients yet still start a successful practice that survives to care for you for years to come. These include discounts for paying a year at a time, for couples and for families.
The membership fee is completely outside of any and all insurance payments, including Medicare, etc. It is literally just that- a membership fee. It does not relate to the costs of a particular visit, procedure, test, etc. It is not covered by insurance, although it is considered a tax-deductible health care expense and can be paid with an HSA account in most cases. Please do not take financial advice from this information - consult your tax advisor.
CPMG then bills for actual visits just as any other doctor's office does- we bill your insurance for the visit, and bill any/all "secondary" insurance policies you have. You will be responsible for any co-pays and deductibles just as is the case with all other doctor's offices.
How long do patients wait for appt? Same and next-day? Average wait time?
The goal of the membership model is to be able to provide excellent service. We will strive to provide available appointments for urgent needs, generally either same-day or within 24 hours. We commit to you that you will not wait longer than 30 minutes for your appointment beyond your scheduled appointment time.
We, of course, will strive to be on time.
Will I have to go out for blood draws?
Sometimes. CPMG has a limited ability at this time to draw and process blood samples. In many cases, when the CPMG doctor orders tests, those tests can be drawn in house.
Tell me about after-hours policies? What happens if I need you at 6pm? 2am?
CPMG members will be provided with a private VIP phone number that will gain them access to our doctors 24/7. Having said that, we are not a substitute for a fully staffed and stocked emergency room, so if you think you are having a life threatening emergency at any time, call 911.
How do you simplify prescriptions?
We work with any and all mail-order pharmacies and will send your prescription electronically to the pharmacy of your choice.
What level of communication can I expect? Text doctor directly?
Doctor-patient communication is the cornerstone to good health and excellent care. Members will have access to a HIPAA compliant portal through the CPMG website, allowing them to send confidential messages to their doctor at any time. Members can expect close communication with their doctor at all times. We do not accept text messages as they are not private nor secure. Our office will be open during regular business hours, 8-5, M-F.
How do you handle specialist referrals? Personally expedite, avoid duplicate orders, etc.?
Our providers have worked in our local hospitals for over ten years, and have personal relationships with many if not all of the specialists in SLO County. CPMG will make every effort to keep patient care local and in-house here in Cambria whenever possible. When specialty care is indicated or desired, we will refer directly from our office. We will provide extra support and assistance navigating the often challenging waters of dealing with specialist offices in every way possible.
What is the difference between RDG, MD, and Coastal Pines?
Dr. Griffith maintains a small practice (RDG, MD) of strictly homebound patients all over the county. This is extremely rewarding and he values his relationships with his current homebound patients. This practice is not connected in any way to Coastal Pines.
Can you take care of urgent care needs?
Absolutely! All of our providers are board certified and are extremely comfortable performing numerous urgent procedures.
Can you do x-rays?
At this time, CPMG is unable to provide radiology services. We recognize the need and would love to be able to offer this in the future.