To find answers to the most commonly asked questions, click on a question and the answer will appear.
Q. Can I participate in the Capstone Healthcare Services program if I do not obtain it through my employer?
A. Yes. You do not have to obtain the Capstone Healthcare Services program through your employer to sign up and enjoy the benefits of this invaluable healthcare cost reduction program.
Q. Can I participate in the Capstone Healthcare Services program if I do not currently have health insurance?
A. Yes. You do not need to currently have health insurance to become a Member of the Capstone Healthcare Services program.
Q. What is Telemedicine?
A. Telemedicine is a rapidly growing healthcare cost reduction program that has been written about extensively in the Wall Street Journal, The New York Times, the Journal of the American Medical Association, and many other prestigious publications. It has also been the subject of a Diane Sawyer feature story on ABC television’s nightly news. Telemedicine provides individuals and families with a proven, affordable way to talk to a doctor from home or anywhere 24 hours a day via phone, email, video, or electronic devices. The goal of Telemedicine is to make obtaining healthcare more accessible, affordable, convenient, and to bring down the high costs of obtaining medical care.
Q. How long will it take for me to talk with one of the Telemedicine physicians?
A. Our Telemedicine partner, MyTelemedicine, maintains relationships with hundreds of physicians nationwide to ensure we can provide quality service to Members in each state except Arkansas where telemedicine is not currently permitted. Our goal is to provide access to physicians 24 hours a day, 7 days a week, 365 days a year, with an average call back time of 30 minutes.
Q. Is there any limit to the length of each consultation with a Telemedicine doctor or the number of times I can speak to a Telemedicine doctor?
A. No. You are free to speak with one of our highly experienced telemedicine doctors as often and for as long you need. However, in certain select cases, the tele-physician may feel telemedicine is not the best solution and will direct the member to a local hospital, urgent care facility, or primary care physician.
Q. Why should I use your Telemedicine program when I can simply go to a local urgent care center or emergency room?
A. Urgent care centers and emergency rooms are useful for specific types of services such as broken bones, heart attacks, strokes, etc. However, according to an independent study, 70% of the reasons people visit urgent care facilities or the ER do not require this level of treatment and can be satisfactorily handled by a Telemedicine physician. This has several advantages. 1. Telemedicine costs as low as $9.95 per month versus $100 or more for an urgent care visit, and/or $1,000 or more for a trip to the emergency room. Moreover, if you are signed up for our program through your employer there will typically be no cost to you at all! 2. Going to an urgent care or emergency room requires you to drive to an outside facility when you are feeling ill. In addition, there is always the risk for exposure to bacteria and viruses that can be found in emergency rooms and urgent care centers. By contrast, you can talk to a Telemedicine physician from the comfort and convenience of your own home. 3. Once at an urgent care or emergency room you will likely experience an extended wait. If the facility is extremely busy you may find yourself sitting for hours in a room full of sick people waiting to talk to a doctor. With the Capstone Healthcare Services program you will typically receive a call back from one of our telemedicine doctors within 30 minutes without having to leave the comfort of your home at a time when you do not feel well.
Q. What is the cost of the Capstone Healthcare Services program and how do I pay for it?
A. If this program is provided to you by your employer, in most cases there will be no cost to you at all. If you are paying for the Capstone Healthcare Services program yourself, the cost is just $9.95 for an individual and $14.95 per month for the Family Plan which includes the Member, their spouse, and their dependent children up to the age of 26. For more information, please click on the Sign Up tab which will take you to a section that will provide simple instructions for how you and your family can sign up for this program today.
Q. Is Telemedicine legal and permitted in my state?
A. Telemedicine is currently permissible in every state except for Arkansas.
Q. How can a Telemedicine doctor diagnose and treat a patient without seeing the patient in person?
A. Telemedicine doctors are specially trained to treat patients remotely by phone, email, video, or electronic devices. Using their best medical judgment the Telemedicine physician will attempt to gather the information needed (by talking to the patient, by using video to look at a rash, etc.) to evaluate, diagnose, and recommend a treatment plan. This may or may not include writing prescriptions for medications.
Q. How does a Telemedicine consultation work?
A. Members will be provided with access to physicians for the treatment of non-emergency, common medical conditions that require routine primary care. Common reasons Members contact us include allergies, throat infections, respiratory infections, urinary tract infections, ear aches, and many other every day ailments. If a Member has a medical situation that in the judgment of the Telemedicine physician requires further examination, the Telemedicine physician may recommend that the patient have blood work done, see a primary care physician, etc.
This program provides medical consultations with state licensed and board-certified physicians by your choice of phone, video, secure email, or electronic devices. The medical services offered during a consultation range from providing general advice to making a diagnosis, recommending treatment, and prescribing medication, when appropriate. Broadly speaking there are two different types of consultations available:
- Informational Consultations. These type of physician consultations are strictly informational such as for second opinions or advice. No diagnosis will be given and no medications will be prescribed.
- Diagnostic Consultations. These tend to be comprehensive medical consultations and may often result in a diagnosis and specific treatment recommendations. A medical history is obtained from you prior to this type of consultation and in some cases medication may be prescribed when the tele-physician believes they are medically appropriate. In the majority of cases, people will be able to speak with a state licensed, board-certified Telemedicine physician licensed to practice in your state in an average of 30 minutes.
Q. Where are your services available?
A. All of our services are available from anywhere and anytime in the United States as long as a Member has telephone or Internet access and the appropriate sign-in information and passwords. Members can use the service from home, at work, or on the road. Service will be provided according to each state’s unique laws regarding the scope of practice permissible through telemedicine. Telemedicine services are available to Members 24/7/365. Karis360 services are available to Members Monday through Friday from 9 am to 5 pm.
Q. Is there a minimum age requirement to use this program?
A. Yes. Members must be at least 18 years of age. However, a parent or guardian may participate in a medical consultation on behalf of each underage person who is listed on the Member’s account.
Q. If someone has a pre-existing condition, can he or she still sign up to be a Member?
A. Yes. There are no exclusions or denials because of pre-existing conditions. Moreover, there are no additional charges or fees because a Member has a pre-existing condition.
Q. Do you have physicians in all U.S. states?
A. We can provide our services in all states except for Arkansas where Telemedicine is currently not authorized by Arkansas state law.
Q. What are the qualifications of your Telemedicine doctors?
A. Our tele-physicians are handpicked to provide the best care and service to our Members. They are:
- U.S. residents living and working in the United States
- Board-certified in internal medicine, family practice, emergency medicine, and/or pediatrics
- State-licensed. You will always speak with a doctor licensed to practice medicine in your state
- Highly experienced doctors with an average of 15 years of practice experience
- Verified through the National Physician Data Base (NPDB) and the American Medical Association (AMA) for medical licensure, training, education, work history, and malpractice history. In addition, a thorough background check has been conducted on each Telemedicine doctor
- Our quality processes meet National Committee for Quality Assurance (NCQA) standards. NCQA is an independent, 501(c)(3) not-for-profit organization dedicated to improving health care quality.
- Telemedicine doctors are re-credentialed every three years
- Telemedicine physicians have specialized training in talking with patients and diagnosing over the phone, by email, and online video while adhering to strict clinical protocols
Q. Are your consulting physicians located in the United States?
A. Yes. All of our state licensed, board certified physicians are U.S. based. In addition, all specialists we work with and provide are board-certified and located in the United States.
Q. How do I access the Capstone Healthcare Services program once I sign up and become a Member?
A. After you sign up for either the Individual or Family Plan you will receive New Member Instructions (generally by email) which will explain the benefits of this program and how you can easily access all of the features of the Capstone Healthcare Services program by phone, email, video, or electronic devices.
Q. Does the physician review the Member’s medical history before speaking with a Member and performing a medical consultation?
A. Yes. Each patient must provide a medical history to the Care Coordinator and/or to the Telemedicine doctor prior to a telephone consultation. The consulting physician will review the medical history provided by the Member, plus any other relevant medical records stored in the Member’s personal HIPAA-compliant Electronic Medical Record (EMR) prior to speaking with the patient.
Q. How are patient records maintained?
A. Although we and our provider partners are not an insurance company, we follow the laws and regulations related to the Health Insurance Portability and Accountability Act (HIPAA) to ensure patient privacy. The Member provides their medical history and is responsible for updates and the medical information they choose to enter into their medical record. Additionally, after each consultation, the tele-physician adds their relevant notes to the Member’s record. Assuming that the Member has signed the proper HIPAA release documents, at their options, the Member can elect to have their medical record information shared with their primary care physician or other medical professionals.
Q. Can Members obtain prescriptions through your program?
A. Yes. Our Telemedicine doctors will use their best medical judgment to determine whether sufficient information has been obtained from the patient from which to make an evaluation, diagnosis, and to recommend a treatment plan which may or may not include prescriptions for medication. This entire process is thoroughly documented. Service will be provided according to each state’s unique laws regarding telemedicine.
Q. Are there any limitations regarding what medications physicians can prescribe?
A. Yes. By law, Telemedicine doctors are not permitted to prescribe DEA-controlled (Class II, etc.) medications, psychological medications, and any medication that would elevate blood pressure. Service is provided according to each state’s unique laws regarding telemedicine.
Q. How do you fill prescriptions?
A. We are not a pharmacy and do not profit in any way from prescribing or filling prescription medications. Where the Telemedicine doctor feels a prescription is warranted, the doctor will typically use an e-prescribing tool to send the prescription order to the Member’s preferred pharmacy. Service will be provided according to each state’s unique laws regarding the scope of practice permissible through telemedicine.
Q. Will your Karis360 program help me reduce medical bills for medical issues that occurred before my membership went into effect?
A. No. While pre-existing conditions are not excluded under this program, the incident for which you incurred bills must have occurred during the period you are covered by the Capstone Healthcare Services program.
Q. Do your Karis360 Advisors provide medical advice?
A. Although our Advisors provide many valuable services they do not provide medical advice. Medical advice is available through the Telemedicine program provided as part of your membership and/or you should speak with your doctor about any diagnosis or treatment questions.
Q. How long does it take your Karis 360 Advisors to resolve a situation I bring to them?
A. Your Karis360 Advisor will discuss the anticipated timeline with you every time you open up a new case. The typical bill negotiator case is resolved within 30-60 days after the Advisor receives the necessary paperwork including a properly signed Medical Information Release Form. Cases opened for Healthcare Navigation and Surgery Saver can generally be completed in as quickly as 5 minutes to 24 hours depending on the nature of the situation.
Q. Is the Capstone Healthcare Services program intended to replace the need for a Primary Care Physician?
A. No. Our program is intended to augment but not replace your primary care physician. We provide access to licensed physicians for medical consultations as a supplement to the care available from your primary care physician.
Q. How can I get my employer to provide the Capstone Healthcare Services program as an employee benefit?
A. Simply ask your employer to visit our website (www.capstonehealthcareservices.com) and review the information on the Employer and Business portion of our site. We will be glad to answer your employer’s questions and explain the benefits of providing our program as an employee benefit.
Q. Can a Member access the service from outside of the United States?
A. No. Although this may change in the future, at the present time the Capstone Healthcare Services program is limited to the United States.
Q. How does your program work with my existing health insurance program?
A. The Capstone Healthcare Services program works outside of and independent of a Member’s health insurance plan. The modest fees we charge are not reimbursable under your current health insurance program. All monthly fees associated with the Capstone Healthcare Services program (including Telemedicine) are paid either by the Member or the Member’s employer or sponsoring organization.
Q. Can I select and pay only for the parts of your healthcare cost reduction program I am interested in receiving?
A. No. The Capstone Healthcare Services program was designed to be an integrated package of healthcare cost reduction services. It would be difficult and increase costs to have to customize the program on a person by person basis. While it is not possible to remove portions of the program you may not be interested in, you can simply choose to use the parts of the program you want, and elect not to take advantage of the parts of the program you don’t. In any event, the price is the same if you use only one part of the program or take advantage of the full program.
Q. Is your Telemedicine service the same as a nurse’s hotline?
A. No. Our service is very different from a nurse hot line. Nurses do not have the educational background, training, licensing, or authority to practice comprehensive medicine. Unlike Telemedicine doctors they are not permitted to make a medical diagnosis and cannot prescribe medical treatment or medications.
Q. Do your doctors speak other languages besides English?
A. Yes. We offer the option to provide the Telemedicine portion of our service in Spanish in addition to English.