Schedule of Services and Pricing

Pricing

Enrollment Fee
Membership Dues

Membership Benefits & Services

Member Discounts

Lab
Radiology/Imaging
Prescriptions/Medication
skinIO Melanoma Screening
Genetic Testing
Included Office Procedures

Member Cancellation
Payment Options

Enrollment: $99 enrollment fee per individual (maximum $150/family), which is nonrefundable. If a patient discontinues membership and later wishes to re-enroll, the practice reserves the right to decline re-enrollment or to require an additional enrollment fee. It may be helpful to think of clinic membership similar to insurance in that you pay $912 to keep your personal doctor on retainer for a year, a cost equivalent to a single visit to the Emergency Department. When you need care during that year, not only can you see your personal physician, but you can see her when you need to, and at no additional cost. The value is blinding when compared to insurance-based care.

Membership Dues: charged in advance, at an interval of your choosing, e.g. annually, semi-annually, quarterly or monthly. Your membership dues are what keep the clinic open, staffed & stocked to meet your needs, whatever they are, whenever they arise.

Monthly Membership Cost by Age =

• 0-17: $35 with adult member, $50 without
• 18+: $80
• couple¹: $150
• family of 4²: $200
• family of 5+³: $250

Annual memberships receive a 5% discount.

MEMBERSHIP SERVICES & BENEFITS

Medical Services Included in Membership

• Office Visits
  • Annual Wellness Physicals
  • Evaluation and Management of Acute Conditions
  • Evaluation and Management of Chronic Diseases
  • Minor Procedures as typically conducted in-office e.g. stitches, skin lesion removal, joint injections, IUDs, Nexplanon, biopsies, etc.
  • Prenatal Care up to 28 Weeks
  • 4th Trimester Care
  • CLIA-waived lab testing including urinalysis, rapid strep, urine
    pregnancy, hemoglobin, INR, glucose, sedimentation rate & more.
  • Diagnostic Testing including electrocardiograms, skinIO, audiometry, spirometry & more.
  • Mental Health Care
  • Same or next day care, as detailed in the *IMPORTANT* BWFM Member Resource Guide!!
  • Whelmed© - a custom goal-setting wellness program
  • CDL/DOT Physicals

• Home Visits as approved by Physician.
• Telemedicine
  
  • Direct Access to Dr. Dall-Winther via our 24/7 secure apps, video chat, email and texting.
• Additional Included Services

  • Advisory, advocacy and assistance navigating beyond primary
    care, as needed.

  • Coordination of care with other specialists.

  • Courtesy visits (within coverage area) if admitted to the
    hospital, as desired. MD does not manage hospital care.

  • Curated Member Patient Education Library.

Discounted Services - available to members- subject to availability and additional cost, often delivered by third-parties through negotiated business relationships.

• Laboratory testing - sent to Labcorp Daily

• Imaging - in clinic, local & regional - we currently offer x-ray, ultrasound, echocardiography & ABI testing in-clinic.

• Surgery and specialist consultations - insurance-based, but we are always expanding our referral relationships, currently with direct pay options in Gastroenterology, Cardiology, Urology, General & Specialty Surgery and Thrive Psychiatry.

• Immunizations - FREE for all uninsured, Medicaid or Medicare
  patients. Commercially insured patients have unique requirements which we can figure out together.

• Genetic Testing - FREE for Medicaid and Medicare patients. Covered by most insurance plans. Uninsured patients navigate Myriad/Genesight’s Compassionate Care Program with our
  assistance. We do genetic testing for:

  • Psychotropic (mental health) medications = Genesight

  • Hereditary cancer risk = Myriad

• Evidence-Based Screening Tests: 
  • Many options available for affordable screenings, some at no cost to patients, e.g. WI Well Woman Program, etc. 
  • skinIO is an AI-assisted technology we use for early skin cancer detection. It is FREE to members with personal or family history of melanoma.

• • Pharmacy - we work with a direct pay distributor who offers meds at heavily discounted prices.

    • We also are masters at navigating drug discount programs through other agencies - we currently are offering several expensive drugs at no cost to our members, e.g. Insulin, Qulipta, Vagifem, Januvia, Nurtec, Emgality, Repatha, Tosymra, Sumatriptan injections, etc.

•  

  Medical Ear Piercing - 50% discount for members.

• Vitamins, Supplements & Homeopathy - our patients receive 20% off on all supplements, vitamins & natural health remedies through Fullscript.⁴  

“Medical Services” shall mean those only medical services that are consistent with the respective physician’s training and experience, and which the physician is permitted to perform under applicable law. From time to time, due to vacations, sick days, and other similar situations, certain physicians may not be personally available to provide the services referred to above. During such times, calls to such physicians may be directed to another clinician who is “covering” during such an absence, although there is no guarantee of such coverage.

Ancillary Services:

You have the choice which “sandbox you want to play in,” when considering ancillary services. You can choose to use insurance, at prices your insurance company negotiated/s with the billing provider. Conversely, you can choose to pay for these services directly at our negotiated & heavily discounted rates.

• Lab = Direct pay pricing offered at up to 90% off.
• Radiology/Imaging = BWFM Medical Imaging Menu 
• Prescriptions =
  • Use insurance at area pharmacy
  • Use BWFM Pharmacy’s direct pay prescription pricing, offered at up to 90% off. Available for in-clinic pick-up & mail order to your home.
  • Using a coupon at an area pharmacy

• Select over-the-counter items are offered at individual direct-pay prices. 

• skinIO skin cancer screening available as detailed here:

	Member diagnosed w/ melanoma	Member - Family w/ melanoma⁵	Low-Risk Member	Non-Member
First Session	Included in membership	Included in membership	$42	$270
Annual Screening	Included in membership	Included in membership	$42	$150
Follow-up screening	$42	$42	$42	$150

 

• Genesight Psychotropic Testing as detailed here:

BWFM Member	Main Payer	BWFM Visit Cost	Test Cost	$ due day of visit
Yes	Medicaid	$0	$0	$0
Yes	Medicare	$0	$0	$0
Yes	Commercial Insurance	$0	$0-$330⁶	$0⁷
Yes	Patient	$0	$0+⁸	$0

 

In Office Procedures

Procedure	BWFM Member Cost	Non-Member Cost
DOT/CDL Exam	$0	$99⁹

Member Cancellation:

Per BWFM/Patient Contract, patients have the absolute and unconditional right to terminate their contract upon giving thirty (30) days’ prior written notice to the Practice. The following fees may apply:

• cancellation within first 90 days of membership: $99
• cancellation within first 180 days of membership: $50
• second lifetime cancellation: $199
• third lifetime cancellation: $199 + loss of re-enrollment eligibility

Payment of Fees is due at the time services are rendered unless otherwise arranged. If you are struggling, please let us know as we’re happy to personalize your schedule. In the absence of such an agreement, outstanding invoices will be subject to the following late-payment timetable:

• 30 days past due = $30 late charge
• 60 days past due = $60 late charge
• 90 days past due = $90 late charge monthly thereafter

________________________________________

¹ Couple = two adults living together or two adults in a romantic relationship

² Family of 4 = 2 adults + 2 children (up to age 26 if living at home or school). Note: 1 adult + 3 children = $185/month

³ Family of 5+ = 1-2 adults + unlimited children (up to age 26 if living at home or school)

⁴ Updated 11/7/23 KDW

⁵ Family = at least one 1st degree family member

⁶ Per The Genesight Promise, 95% of patients pay $330 or less - they will call you before processing if you are not in this category of patients

⁷ You will receive a bill from Genesight once they settle with insurance, likely months later

⁸ Genesight offers a Compassionate Care Program based on household size & annual income w/ prices starting at $0

⁹ Does not include evaluations outside of NRCME standards, nor ongoing care.

¹⁰ preferred

¹¹ Our billing system allows for membership to be sponsored by (i.e. paid for) by another person. That person would have access only to HINT, our billing system. Clinical/medical information always remains private & protected.

¹² The Birchwood Family Medicine Pay it Forward Fund is used to pay for the medical expenses of a person in need, as those needs arise. It is mostly funded by the generous donations of other humans, paying it forward to help their neighbors. Funds are offered at the discretion of Dr. Dall-Winther.