Frequently Asked Questions (FAQs)
Is OPAL healthcare and wellness right for me?
We sure hope so because we are inclusive of everyone! OPAL Healthcare & Wellness is designed for anyone who does not have a primary care provider or has a provider but is looking for more convenient and more personalized care.
Because we are healthcare and wellness practice, we focus on your specific medical conditions (such as high blood pressure, diabetes, and hypothyroidism), dietary preferences (Paleo, Whole30, Keto, vegetarian, vegan, gluten-free), and lifestyle (weightlifting, running, cycling, walking, or even being a couch potato)
Who are the OPAL Healthcare Providers?
The OPAL Healthcare & Wellness nurse practitioners are board-certified nurse practitioners that have been selected because of their focus on building relationships and providing quality long-term care to their patients. Due to State of Texas law they work with a collaborative physician who they regularly meet with and discuss complex medical cases.
What is a Nurse Practitioner?
What sets NPs apart from other health care providers is their unique emphasis on the health and well-being of the whole person. With a focus on health promotion, disease prevention and health education and counseling, NPs guide patients in making smarter health and lifestyle choices, which in turn can lower patients' out-of-pocket costs. For more information click here: https://www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner
What is the difference between a Nurse Practioner and a Physician Assistant?
We get this a lot and it’s a great question! Patients should understand the differences between the career paths and we are here to help you! Each career path has different educational and certification requirements, as well as varying levels of autonomy. But rest assured NPs have been providing primary, acute and specialty health care to patients of all ages and walks of life for nearly half a century.
NPs assess patients, order and interpret diagnostic tests, make diagnoses and initiate and manage treatment plans—including prescribing medications. Millions of patients choose NPs as their health care providers, with visits totaling more than 1.06 billion annually.
What sets NPs apart from other health care providers is our unique emphasis on the health and well-being of the WHOLE person. With a focus on health promotion, disease prevention and health education and counseling, NPs guide patients in making smarter health and lifestyle choices, which in turn can lower patients' out-of-pocket costs.
Can I see my provider in person?
Yes absolutely! That is how we like it! In fact, we believe that our care is often much better than traditional care because your OPAL Healthcare & Wellness nurse practitioner can give you more time and attention. Additionally, your nurse practitioner is available at your convenience. However if you want to see us through telemedicine/telehealth, we have a completely secure text, phone, and video chat through our patient portals-- No driving or waiting! With modern technology, we are able to treat most acute and chronic conditions, completely online.
Can my nurse practitioner at OPAL Healthcare & Wellness prescribe medications?
Yes. Our providers are licensed Nurse Practitioners and can prescribe a wide range of medications available in a traditional office setting.
Are there medications OPAL Healthcare & Wellness does not prescribe?
OPAL Healthcare & Wellness is not accepting patients for pharmaceutical treatment of Chronic Pain. New Opioid Prescribing Guidelines have recently been released by the CDC to combat the prescription drug abuse epidemic, and those patients who use narcotics for chronic pain are encouraged to seek a pain treatment center. OPAL Healthcare & Wellness will refer you to a specialist when you need care beyond the scope of our services. We will work with you to select the specialist you feel is right for you
What if I need to be referred to a specialist? Do you offer access to specialty services?
OPAL Healthcare & Wellness will refer you to any specialist when you need care beyond the scope of our services. We will work with you to select the specialist you feel is right for you.
How do you handle bloodwork, imaging, & Labs?
Just like any traditional primary care however we will draw the blood ourselves! We will then send your blood to Quest, LabCorp, or any other convenient local facility. Your OPAL Healthcare & Wellness nurse practitioner will get the results right away, review them with you, and follow up as needed.
If you have insurance, you would run these visits through your health insurance. If you don’t have insurance, we can help you get a discounted cash price.
How is OPAL Healthcare different from traditional practices?
Traditional primary care physicians simply don’t have time for you. They have about 2,500 patients and must see about 18-30 patients per day to meet their quota. The average patient visit? 15 minutes if that!
OPAL Healthcare & Wellness is a completely new approach to primary care. Our nurse practitioners see a limited number of patients, so they can give you the time and attention you deserve. With our services you get comprehensive, personalized care whether it is in our office, on the computer or phone, at your office, or on the job site. Your OPAL Healthcare & Wellness nurse practitioner is your partner in health, long-term.
How is this different from urgent care and on-demand services?
On demand services are generally not set up to allow patients to form long-lasting relationships with their providers. Typically, when you use an urgent care you are paired with a random physician or nurse practitioner who does not know you or your medical history. In contrast, with OPAL Healthcare & Wellness, you are always connected with the same nurse practitioner (hopefully for many years), who really knows you and the specific issues that are relevant to your care.
How is this different from concierge practice?
Most concierge providers charge between $2,000 and $5,000 per year and are set up to see patients in-person at their office. OPAL Healthcare & Wellness is more affordable and our nurse practitioners are fully-geared to efficiently communicate with patients via in person, phone, text, video chat and our providers even do housecalls! OPAL Healthcare & Wellness enables you to partner with a nurse practitioner that is specifically suited to you.
Who are the OPAL Healthcare Providers?
The OPAL Healthcare & Wellness nurse practitioners are board-certified nurse practitioners that have been selected because of their experience, inclusivity, and their focus on building relationships and providing quality long-term care to their patients.
Is Telehealth/Telemedicine safe & Private?
Yes. The entire OPAL Healthcare & Wellness platform is secure and HIPAA compliant (Health Insurance Portability and Accountability Act) to ensure that the communication with your OPAL Healthcare & Wellness nurse practitioner remains a private matter between the two of you. We take every measure to ensure your privacy and the safety of your data and within our clinic that we actually pay for a HIPPA compliant service to ensure we will never be out of compliance.
What happens when my Nurse Practitioner is on vacation or unavailable?
What’s great about OPAL Healthcare & wellness, our providers get to know and recognize each other’s patients! If one of our providers can not help you through telemedicine or telehealth, you have access to see the other partner who will have access to your medical chart and notes from the previous provider! No worries! We have you covered and thought of this.
What do I do in the case of a medical emergency?
Call 911 or go to the nearest emergency room. Later, inform your OPAL Healthcare & Wellness nurse practitioner of your emergency and they will help oversee and monitor your care.
How is OPAL Healthcare & Wellness different from traditional medical clinics?
We give you the choice. The choice in how you want to pay and the choice in how you want your care delivered. Instead of building the clinic based on what insurance companies and hospitals think is important, we asked our community what they wanted. We collected dozens of pages of testimony. What our community wanted most was time: time to address all your concerns; time to help you consider options; time to be treated as a whole person, not just a disease.
To deliver the time our community wants and needs, OPAL Healthcare & Wellness uses an innovative membership model of care known as OPAL Direct Primary Healthcare Model (DPH). In this model, healthcare practitioners are paid directly by their patients, rather than through insurance companies. Basically, we're cutting out the middle man, along with the hassles and high prices. This model of health care is rapidly growing.
DPH harkens back to a time gone by when the provider-patient relationship was cherished, when providers didn’t have thousands of patients, had plenty of time to spend with you, and you didn’t have to wait weeks for your appointment and hours in a waiting room. Cutting out the middlemen and red tape increases the provider’s and the patient's satisfaction, and dramatically cuts costs.
What can I expect as a patient?
You can expect shorter wait times, longer appointments, and convenient direct access to your provider, who knows you and your family. No more rushed visits or waiting weeks for an appointment. You can contact your provider via phone, or our secure messaging app whenever you need to. Find out more about our benefits in the Services section of our website.
Can I cancel or re-start my membership?
Yes. You can cancel your membership by informing us at least 30 DAYS before your next monthly payment is due.
We believe that building long term relationships with our members is the key to what we do. Therefore, please note that requests to restart memberships are subject to approval and availability. If accepted, a re-enrollment fee of at least $300 per person will apply.
Do I still need insurance?
All patients are encouraged to have at least major medical coverage. DPH alone is not insurance. The ACA legislation does exempt patients from the underinsured/noninsured tax penalty if you join certain health cost sharing ministries.
What insurance do you take?
How can you help me save money on other healthcare costs?
One way to save money on your healthcare is by joining a medical cost sharing organization like Sedera Health.
OPAL Healthcare & Wellness and Sedera offer a total healthcare solution that combines Direct Primary Healthcare for routine care with Medical Cost Sharing for expensive and unexpected needs like surgery and hospitalization.
DPH clinics also strive to minimize insurance claims, and out of pocket costs for medications, lab tests and imaging. Let's say you need some routine lab tests. Why pay $200 toward a deductible you're unlikely to meet when you can get the same tests from a clinic like ours for no more than $15 in cash? (That in many cases can also be applied to your deductible!)
Can my fees be reimbursed by my insurance company?
Usually not. In rare cases, you can submit a receipt for your membership fees or lab/medication costs. Some insurance companies will apply these payments toward a deductible. However, we will not submit claims to your insurance company.
Can I use my Health Savings Account to pay for Direct Primary Care?
The law currently allows the use of HSA money to pay for medications, imaging tests, labs, etc. However, it is legally unclear if HSA funds can be used to pay for DPH membership fees. This is a question for your tax professional. Legislation has been proposed to clear up the question regarding if HSA money can be spent on a DPH clinic's retainer or membership fee
How does DPC work with Affordable Care Act (ACA)?
As the Affordable Care Act was being drawn up, several providers worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Healthcare practices like ours to be a legal option under the health reform bill. Once the health exchanges open in October, many people will understand that a Direct Primary Healthcare practice is an approved option.
In short, the best option for many patients will be an “exchange qualified” major medical type plan combined with a Direct Primary Healthcare provider like our practice. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients.
The Direct Primary Healthcare practices have the ability to decrease the cost of insurance by 30-50%, thus eliminating the need for ACA-style regulation because we can make health insurance affordable again.
How much does it cost?
Our monthly membership fees are based on the patient's age. In addition to low monthly membership fees, patients are also offered wholesale cash prices on lab tests as well, and we are currently negotiating contracts for bottom-dollar access to radiological services such as X-Rays, CT scans, MRIs and mammograms. Call us for pricing information.
How can you guarantee same or next-day appointments?
Considering that managed care insurance has driven most doctors to patient panels of 2,000 to 4,000 or more people, it's no wonder you encounter long waits and rushed visits! We keep our patient panel low so we can spend plenty of time with you and get you in quickly. This is the kind of attention and accessibility we'd want our family to have, and it's what we offer our patients.
Who will take care of me if I need to be admitted to the hospital?
While you are in the hospital, you will be under the care of a Hospitalist. The hospitalist's fees and routine hospital facility fees (nursing care, food, medication, procedures, xrays, etc.) will be charged by the Hospital to you or your insurance company/Medicare, etc. Your OPAL Healthcare & Wellness nurse practitioner will, however, stay in close communication with the hospitalists caring for you, and will be ready to coordinate your post-hospital follow-up care.
How can I contact my provider before or after hours?
Illness and injuries don't always happen during office hours. All members receive an invitation to download our secure messaging app which provides phone and secure text and video communication with your care team. If you need to get in touch with us to order a medication refill or schedule an appointment, you can directly contact our providers anytime, or leave us a voice mail or even a text message. If you have an urgent issue after-hours, Michaela and Christiane are only a phone call away!
Outside of paying for membership, medicine, or labwork/x-rays, are there other fees I might have to pay?
Almost all of the routine procedures performed at OPAL Healthcare & Wellness have no additional charge to members. There are a few exceptions, for more complicated procedures, usually related to the cost of any medication administered. Our pricing page has details. As a membership benefit, Michaela and Christiane will see sick or injured out of town visiting family of our members for a reasonable one-time office visit fee based upon the severity and time requirements of the visit.
Will OPAL Healthcare & Wellness see patients on a fee-for-service basis if they are NOT members?
Yes. We offer cash prices on office visits and minor procedures to non-members. We also provide School Physicals, New Employment Physicals, and Urine Drug Screens very affordably to non-members.