Frequently asked questions

Find some answers here and don't hesitate to ask us anything!

Memberships

The monthly membership fee allows us to provide the vast majority of a person’s primary care in a transparent, less complicated way by offering a simple, fixed price. Much like your Netflix account or gym membership, the membership fee allows patients to better budget their healthcare finances; without worrying about extra costs, co-pays and deductibles for routine care.

Absolutely! We are pleased to partner with you to bring our quality medical services to your employees and save them time away from work waiting at the doctor’s office. Small businesses using direct primary care offer their employees value by offering the accessibility to care which reduces lost time and workers comp claims, while increasing productivity and job satisfaction. Small businesses are also able to offer affordable primary care services within their benefits plans without the high costs of obtaining third-party or self-insured insurance plans. Please contact us to learn more

We do not think of our services as “extra”; rather an independent, alternative and better way to do your primary care. Most of our members save money when combining Althera Alternative Care with a high-deductible health insurance or medical cost sharing plan (vs. standard low-deductible/”copay” insurance plans).

Yes. We do offer episodic medical service for persons not participating in the membership plan. These fees are listed in our service fee schedule.

We do not require members to sign any contract that commits them to a certain period of time. Rather, memberships are ongoing and open but must be paid ongoing in order to maintain service with us. A minimum of the first month of membership and a registration fee is paid upfront and are non-refundable. If you decide to cancel and have a balance of prepaid membership fees remaining, a pro-rated refund will be given to you based upon date of cancellation.

Yes, we do allow for re-enrollment after cancellation, but members will be charged a re-enrollment fee of $200 per member before service can be restarted.

A little, but without the high price tag . . . or valet parking! We provide a concierge level of service to all members but try to make things affordable for people of all incomes, with or without insurance.

Yes. Our memberships (eligibility or fees) are not based upon any existing medical issues or conditions.

No, we do NOT have any income or health guidelines to become a member. Our fees are the same regardless of income, insurance arrangement, level of health or utilization of our services.

That’s great! HIGH FIVE to you! Our primary focus is to keep members well and avoid unnecessary medication use and or repetitive medical care. In following, we dedicate more time to prevention and lifestyle change to decrease reliance on an expensive, cumbersome health care system. However, when you do need care, we are available 24/7 to help get you back on track; and avoid trips to ER or urgent care.

Althera providers are only licensed in the state of New Mexico and cannot practice medicine in other states. For persons residing in New Mexico, we are happy to facilitate your care in our clinic. If a member establishes care (i.e. has a visit) in-person, we can provide remote monitoring of issues over phone and internet for some period of time even if the member is out of state. Ultimately, some care (i.e. sick visits, injury evaluation etc.)  must be provided in-person and for the reason, we do not encourage people to join our practice unless they can reasonably visit us in person as required to most effectively evaluate their complaint.

Fees

Nope. We provide most care to members without any fees at all! If we do charge for non-covered services, we always list prices upfront. If we recommend outside services, we try very hard to find you an upfront, reasonable price if paying cash.

All members have access to many basic lab and diagnostic testing (cholesterol, diabetes testing, strep, EKG, urine dipstick, etc.) for no charge at all. For non-covered labs, we offer significantly discount wholesale prices — 50-90% less than insurance based prices. See some of our prices here If you require labs not listed, you can contact us for pricing of just about anything.

Check out our PRICING page or contact us with specific requests if needed. We are committed to upfront pricing of all of our services.

For any fees for non-covered services, we expect full payment at time of service for most services, including medications, labs, procedures, etc.

We do not charge “per visit”. New members must pay a registration fee and a minimum of one month of membership fees upfront. To get started members will usually pay a minimum of around $100. If any non-covered services are required (labs, procedures, etc.) the first visit cost may be slightly more.

All wellness visits (including most routine labs and pap smears) are provided at ZERO cost to all members! Check out our PRICING or contact us if you are not a member to learn about our fee structure.

Visits

Currently our regular clinic hours are 10:00am – 6:00pm, Monday-Friday and Saturdays 10:00 am – 2:00 pm. However, our retail location stays open until 5:00 pm on Saturdays. Additionally, members may access clinicians by phone or text as needed. After-hours visits are available as arranged by the provider.

While we always seek to offer same day or next-day appointments for our members (even new members…), we appreciate the opportunity to schedule visits whenever possible.

As long as you need! Our providers will take into consideration other patients who may need to be seen, and the number and complexity of medical issues the patient may present. That said, most clinic visits last approximately 30-45 minutes.

Yes. We will make every effort to make time to address your healthcare needs.

Althera providers are experienced, licensed, well known and established in the Albuquerque medical community. Our providers refer patients to specialists and other providers in the community just as any insurance-based practice would do. For some outside services, we can help find reasonable “cash” prices if you are paying out-of-pocket – especially for radiology and lab. We can provide many urgent care type services (acute illnesses, stitches, or injury care, etc.) that can help people avoid a trip to the ER. However, we do recommend additional health insurance in the case of an unexpected, expensive event such as surgery, ER visit or hospitalization.

Yes, as arranged, within the Albuquerque metropolitan area and for a fee. This service is additional to the membership fee structure.

We think of “virtual visits” as a supplement to good primary care – not a replacement for in-person care. Generally, if the issue does NOT require a physical exam, a virtual visit may suffice. For simple acute care issues (e.g. allergies, ankle sprain, acne etc.) and some chronic issues especially those where patients are well controlled (e.g. diabetes, hypertension, etc.) can largely be managed via virtual visit, phone or text message communication. Any issue which requires a physical exam (e.g. coughs, sinus infections, ear infection, new pain, etc.) we will recommend a traditional clinic visit.

Insurance & Health Plans

No. Althera Alternative Care is a great way to receive high quality direct primary health care services, but we do believe insurance is necessary in case of severe illness, need for hospitalization or an unexpected event.

No. Althera Alternative Care does NOT yet contract with any private or public insurance plans.

Very unlikely. However, this type of practice is loosely termed “Direct Primary Care” and is mentioned briefly in the Affordable Care Act as “participating in insurance exchanges with a wrap-around insurance plan”. The details of such are still very unclear, but we are not waiting around for Washington or any other capitols to provide our community with high quality, affordable primary care. We keep abreast of all healthcare mandates and update our customer base on issues that directly affect our care or services we provide.

We do not contract with any Medicaid plans and cannot bill them for our services. Medicaid recipients are welcome to join Althera Alternative Care but will likely also be assigned a “network Primary Care Physician (PCP)” that may be required to access other health plan benefits and services.

We can contract with Medicare beneficiaries to provide stellar primary care services. Our charges cannot be billed to Medicare by us or the patient and the beneficiary must sign a Private Contract prior to joining acknowledging this fact. As Medicare is an open network, patients may continue to use their Medicare benefit elsewhere with accepting providers as usual.

In most cases, yes. Your insurance plans will continue to operate “as usual” at other practitioner’s offices, hospitals and pharmacies. PPO-style plans do not require a designated “gatekeeper” provider for referrals, medications, tests, etc. Althera

Alternative Care clinicians can order or refer just as another practitioner or doctor would do. HMO-style plans (including New Mexico Medicaid plans) do require an in-network designated primary care provider for access to other services, so these do not pair as well with Althera Alternative Care.

For the time being, insurance companies do NOT recognize our membership fees as a reimbursable expense. For non-covered service fees (meds, labs, x-rays, etc.), we can provide a receipt of payment so you can proceed with billing your insurance plan if you wish. However, most of our members have not found it worth the time and effort to do so.

Please contact us or an accounting professional to discuss this matter.

We are not financial or health insurance advisors and recommend you speak with a professional in that industry if you have questions. However, our members often find that high-deductible (or catastrophic) insurance plans pair well when combined with our services. Althera Alternative Care can provide day-to-day services and a high-deductible plan will be necessary to limit the enormous expenses of a major medical event.

Medical Services & Medications

We think of our business model as an alternative to managed care medicine. Additionally, our model of care promotes alternatives to traditional therapies as well purposefully works to decrease dependence on western pharmaceuticals in favor of herbal and or natural treatment options.

No. Althera Alternative Care does not offer gynecologic services, including pelvic exams, pap smears, birth control and or IUD insertion

Absolutely! We love little tikes of all sizes. We can provide all standard childhood health care services including yearly physicals, acute care (i.e. sore throats) and chronic disease management (i.e. asthma, allergies, etc.). We are NOT currently giving childhood vaccinations, but can review records and facilitate referrals to community partners for completion.

Currently we do not offer vaccination services. We hope to offer standard childhood vaccines as our practice grows. Althera Alternative Care clinicians can review vaccine records and refer you to a variety of community partners to complete immunization requirements as needed.

There are many modalities available to help minimize the pain of chronic conditions and aggressively work with people to achieve adequate comfort. Althera practitioners endorse a cautious and conservative approach to the use of narcotic/opiate medications such as hydrocodone, morphine, Percocet and or others and therefore almost never prescribe. This said, our providers will continue to use their best discretion and experience to address pain. Generally, Althera providers will seek to utilize narcotic medications as a last resort for short durations and only in select situations. For more information, please review our Medication Policy.

Althera Alternative Care clinicians are experienced, comfortable and licensed to provide care for mental health problems. Our clinicians generally have a conservative and careful approach when using medications (particularly benzodiazepines such as Xanax or Valium) in this area and strongly promote the use of natural therapies and lifestyle changes prior to medication initiation. Althera providers are capable of prescribing all medications to care for behavioral health complaints. Additionally, Althera maintains an updated list of community providers ready to accept referrals for BH patients were needed.

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