Learn More from Our Frequently Asked Questions Section

The “Membership Practice” model is one in which each patient who is a member of A Squared Primary Care, PLLC (the “Practice”) pays an Annual Fee that covers most of the primary care received in-office, as well as enhanced services not normally available in a traditional medical practice, such as: extended hours; direct access to Dr. Agrawal by cell phone, email, and secure patient portal; same day or next-day sick appointments; unhurried office visits; short in-office wait time; video visits with Dr. Agrawal; house calls/nursing home visits when necessary; and true coordination of your care with other providers. There will be no other bills from the Practice unless you exceed the services covered by the Annual Fee, as explained below. This new approach is really a return to old-fashioned care. It is a smaller, more intimate Practice that allows you to have a personal relationship with your physician. The goal is to provide care that is more responsive, thorough, and individualized.

Attached is a detailed description of all services covered by the Annual Fee.  Please refer to the Our Services tab.

Services

You may be hospitalized at the hospital of your choice. Although the hospitalist service will be the attending physician of record, Dr. Agrawal will coordinate care with the hospitalist as your personal physician and be available for phone consultations. Dr. Agrawal will decide on an individual basis whether a hospital visit is appropriate. If so, each hospital visit will count as two visits and additional hospital visits are $150/each.

Dr. Agrawal will coordinate your appointment with the appropriate specialist(s) to best address your particular medical condition. Dr. Agrawal will closely monitor your progress while you are under the specialist’s care.

If you are experiencing a medical emergency, please call 911.
Prescription refills, referrals and non urgent messages are best handled by calling during business hours or by email to [email protected] or accessing the portal. For urgent issues please text or contact Dr. Agrawal directly.

Dr. Agrawal will be available by email, cell phone, and secure patient portal after hours and on weekends, except when away for medical conferences and vacation, in which case the Practice will be covered by a colleague. When Dr. Agrawal’s Practice is covered by a colleague, you may be charged a co-payment for any necessary visits, but there will not be a charge for any telephone advice.

Absolutely! Please call the office for a no-obligation meeting to find out if this Practice is a good fit for you.

You may start the process by sending Dr. Agrawal an email at [email protected] or calling the office at 202-559-4450, to request an enrollment package. You will need to sign a Physician-Patient Agreement and submit payment of the Annual Fee in order to become a member. Patients will be accepted in the order in which they join, and once the Practice reaches capacity, Dr. Agrawal will not accept any additional patients into the Practice until an existing spot opens up.

You will need to select another physician. Discuss this with your friends and family. You should be able to receive assistance from the Customer or Member Service office of your health plan.

The following hospitals have referral services that can assist you with finding a suitable physician:

 

Send Dr. Agrawal an email at [email protected] or call the office at 202-559-4450. You may also schedule an appointment to meet with Dr. Agrawal by calling the office.

FINANCIAL QUESTIONS

The office accepts credit cards. Please contact the office by email to [email protected] or by telephone for more information.

Yes, the Annual Fee covers services available to you while you are a member of the Practice. If you leave the Practice for any reason, then a pro-rata portion of the Annual Fee will be returned to you. If you have already received your annual comprehensive preventative health assessment and exam for the year, then $1,000 will be deducted from any pro-rata refund owed to you.

There are no co-pays for services included in the Annual Fee. The Annual Fee includes the annual comprehensive preventative health assessment and exam and 5 additional visits per year (either in-office or by video). (House calls, nursing home visits, and hospital visits are provided when clinically indicated and appropriate and will count as two visits. ) In the event that Dr. Agrawal is on vacation or attending a continuing medical education seminar, she will be covered by a qualified colleague who may submit a claim to your insurance company and may charge you a co-pay.

For any visits (in-office or by video) beyond those included in the Annual Fee, the Practice will collect a fee of $90 to $150/each, depending on the extent of the visit. For each house call, nursing home visit, or hospital visit beyond the included 5 visits, the Practice will collect a fee of $150.

While most insurance plans cover primary care office visits and other services, patients often have difficulty in obtaining timely appointments with their doctor, and rarely have adequate time for their concerns to be fully heard and addressed. Despite their best intentions, physicians are frequently left feeling rushed and unable to fully address wellness and preventive health approaches.

Dr. Agrawal’s membership model provides a level of personal service not generally found in a traditional primary care medical practice, including: extended hours; direct access to Dr. Agrawal by cell phone, email, and secure patient portal; office visits of more than 15 minutes; house calls, nursing home visits, and hospital visits when clinically indicated and appropriate; and true coordination of your care with specialists and other physicians handled personally by Dr. Agrawal.

This membership model is NOT an insurance plan, and you will need to keep your existing health insurance to pay for specialist physician services, laboratory tests not covered under the Annual Fee, x-ray and other diagnostic services not covered under the Annual Fee, prescription drugs, and hospitalizations.

Yes; however, because Dr. Agrawal has opted out of the Medicare program, Medicare will not cover any portion of the Annual Fee or any services provided by Dr. Agrawal that are charged separately outside the Annual Fee (e.g., visits exceeding 5 per year). Dr. Agrawal will not submit any claims to Medicare and you may not submit claims to Medicare for payment for any services provided by Dr. Agrawal. Dr. Agrawal may continue to write prescriptions and orders for lab, x-ray, and other services needed outside of her Practice, and your Medicare coverage will continue to cover all other physicians, hospitals, and labs. Membership in Dr. Agrawal’s Practice will not affect your Medicare coverage for these other services in any way.

Yes; however, it is important to understand that Dr. Agrawal does not participate in any HMOs. If your HMO requires prior authorization from your primary care physician for referrals and labs, Dr. Agrawal will not be able to perform that role. Also, Dr. Agrawal will not submit any claims to your HMO and you may not submit claims to your HMO for payment for any services provided by Dr. Agrawal.

It depends. TRICARE For Life (TRICARE’s Medicare “wrap-around” product) specifically permits Medicare beneficiaries to privately contract with concierge physicians; however, due to TRICARE For Life billing limitations, Dr. Agrawal will not submit any claims to TRICARE For Life and you may not submit claims to TRICARE For Life for payment for any services provided by Dr. Agrawal. If you are covered by any of the other TRICARE plans (including but not limited to: TRICARE Prime, TRICARE Prime Remote, TRICARE Select, TRICARE Reserve Select, TRICARE Retired Reserve, and US Family Health Plan), Dr. Agrawal will not able to provide services to you under her new membership practice model and you will need to select a new physician.

Unfortunately, Dr. Agrawal does not participate in medical assistance programs and is unable to provide services to medical assistance program patients under her new membership practice model. You will need to select a new physician; however, Dr. Agrawal would be happy to communicate with your new physician to assist in the transition.

Because the Annual Fee pays for some services that are not covered by insurance, your insurance plan might not apply the Annual Fee towards your deductible. Each insurance plan may approach this issue differently, so if you have more specific questions, you should contact your insurance company representative. Dr. Agrawal can provide you with paperwork at the time of your annual comprehensive preventative health assessment and exam or office visit, which you may be able to submit to your private insurance, but not Medicare, TRICARE, or any HMO, to seek out-of-network reimbursement. (Again, different insurers approach this differently, so check with your plan.)

In many cases, you may be able to use such funds to pay for all or a portion of the Annual Fee, but policies differ from plan to plan, so please check with your plan administrator. By using pre-tax dollars designated for medical expenditures, you may be able to reduce your out-of-pocket expenses.