Dear Medicare/DSHS Patient,

This is a letter intended primarily for Medicare/DSHS patients who call the office and request an appointment without a referral.

My practice is limited with regard to Medicare and DSHS patients. It's a financial matter. My practice is not a high volume practice and Medicare and DSHS reimbursements which are already heavily discounted are set up for high volume practices. I also have special skills in Medical Acupuncture and Preventive Medicine both of which are not covered under Medicare/DSHS.

With the above as an explanation the following are the criteria by which I will see new Medicare/DSHS patients:

1. Patients who are referred from another licensed health care practitioner for a particular problem or diagnostic dilemma. Following initial consultation patient will be advised to return to the referring practitioner unless they are suitable/eligible for one of our group services through OPAS.

2. Patients who have a primary care physician and are wanting to see me on account of my special skills in Preventive Medicine and Medical Acupuncture.

Neither Medicare or DSHS pays for acupuncture. The supplemental acupuncture charge is $75.00. Payment is expected at time of service. For the services covered through Medicare we do accept assignment so we will be billing Medicare for you. Medicare does, however, have a co-payment in addition to a one time deductible that will be due as well.

I hope the above is clear with regard to office policies. If you have a special need and would like an exception made to the above policy, please write me and I'll see if I can be of help.

Sincerely,

James K. Rotchford, MD

General Practice