Capstone Healthcare Services: Common Questions and Answers

A. Yes. You do not have to obtain the Capstone Health Network program through your employer to sign up and enjoy the benefits of this invaluable healthcare cost reduction program.

A. Yes. You do not need to currently have health insurance to become a Member of the Capstone Health Network program.

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, 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.

A. Our Telemedicine partner maintains relationships with hundreds of physicians nationwide to ensure we can provide quality service to Members in each state. 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 or less.

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.

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 $14.95 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 Health Network 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.

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 Health Network program yourself, the cost is just $14.95 for the CapstoneCare™ Individual Silver Plan and $19.95 per month for the CapstoneCare™ Silver Family Plan. The cost of the CapstoneCare™ Premium Plan is $24.95 for the Individual Plan and $29.95 for the Family Plan. Note: the Family Plan includes the Member, their spouse, and their dependent children up to the age of 26. For more information, please click on the Sign-Up Now selection tab and choose Individual/Family Plan. This will take you to a section that will provide simple instructions for how you and your family can sign up for this program today.

A. Yes

A. Telemedicine doctors are specially trained to treat patients remotely by phone, 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.

A. Members will be provided with access to physicians for the treatment of non-emergency, common medical conditions that require routine primary care. Typical reasons Members use our Telemedicine service include the common cold, flu, sore throat, nausea, rashes, pink eye, sinus infections, or to ask the tele-physician a question.  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.

A. Our services are available 24/7/365 anywhere in the United States.

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.

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.

A. Yes

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

A. Yes.

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 Health Network program by phone, video, or electronic devices.

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.

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.

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. In addition, Members can save up to 85% on all FDA-approved brand name and generic drugs.

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.

A. 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.

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.

A. Simply ask your employer to visit our website (www.capstonehealthNetwork.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.

A. No. Although this may change in the future, at the present time the Capstone Health Network program is limited to the United States.

A. The Capstone Health Network 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 Health Network program (including Telemedicine) are paid either by the Member or the Member’s employer or sponsoring organization.

A. No. The Capstone Health Network program was designed to be an integrated package of healthcare cost reduction services.

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.

A. Yes. We offer the option to provide the Telemedicine portion of our service in Spanish in addition to English.