Primary Care One
Primary Care One is available to individuals and small businesses in Fayette and Raleigh Counties. The locations it will be offered are as follows.
- Whipple/Scarbro -Scarbro
- North Fayette -Fayetteville
- Lisa Elliott Center -Lookout
- New River Elementary -Oak Hill
- Mt. Hope Wellness -Mt. Hope
- Gulf Family Practice -Sophia
Patients who are eligible and choose to participate in the pilot program will receive services at the practice locations noted in this filing. Each will need to choose a specific location as a medical home.
Participants will be provided primary care and urgent care services. These services will not be subject to co-payments or medical underwriting. Services will include but not be limited to: sprains; cold and flu symptoms; disease management for cholesterol, high blood pressure, asthma and other disease states; pre-natal counseling; specific immunizations; and urgent care services. There also will be a limited acute care drug formulary at no additional charge. Drugs outside the formulary will be at cost to the patient.
The monthly rate for individuals will be $60.00, and the family rate will be $115.00. Any participant contract will have a 30-day cancellation clause. The initial payment will be $120.00 for individuals and $230.00 for families. This includes first and last month’s payment.
Patients may either schedule appointments or simply present themselves as walk-ins. Pilot patients will be seen and treated on the same basis as all other patients.
Upon agreeing to participate, patients will be checked to determine whether they are currently a NRHA patient or a new patient. For each new patient, an EHR/registration will be entered into the system and a History and Physical (H&P) will be scheduled. Established patients with treatment plans already in existence will have those plans reviewed, and if needed, a physical will be performed.
Patients should understand that under the program they are limited to receiving a defined set of services only at the NRHA sites, and that this product is not an insurance product, nor do they have any coverage for services at any other location, facility or practitioner.
X-ray services (extremities) are available. For x-rays that are included in the pilot program, NRHA will provide both the professional and technical components. No charge will be made to pilot patients.
NRHA has a 340b pharmacy at its Scarbro location and a new pharmacy in Sophia, West Virginia.
NRHA will provide adult immunizations and vaccinations (influenza, Pneumovax and tetanus). Childhood immunizations are also provided.
If children qualify for CHIP and Medicaid they should be enrolled in those programs.
Routine gynecological care, such as Pap smears and post-menopausal care as well as prenatal counseling that would be available in primary care settings including referral, are available.
For certain lab services, NRHA will do the collection and then send out samples for testing and interpretation. An agreement is in place for these services, and a fee schedule will be negotiated (Medicare allowable) for pilot program patients. For samples that can be analyzed at NRHA will be provided to patients at no additional cost.
Dental services are available for all participants subject to our sliding fee discounted rate that is established for NHRA patients.
Behavioral health visits will be subject to a $20.00 per visit co-payment for the next six visits and $40 thereafter. The first visit per year with the psychiatrist is at $50.00 with additional visits being $90 per visit.