Policies and Procedures

HFM Annual Visit Policy

Your Annual Visit:

What Does Your Insurance Cover?

Many of our patients have health insurance plans that cover the cost

(including co-pay) of a "yearly preventive health care visit" - otherwise

known as your "annual" - some(i.e. Medicare) do not include touching

the patient! HFM does so anyway, for "free."

Generally, you may expect that your provider will do the following as needed:

  • Gather or update your comprehensive medical history

  • Outline plans for the reduction of risk factors

  • Provide interventions or counseling to improve overall general health

  • Order appropriate laboratory/diagnostic procedures

  • Order and/or administer appropriate immunizations

  • Manage minor health concerns

"Minor health concerns" include the following and other similar concerns:

* Obtaining a refill prescription for chronic, routine, simple, single, medication.

(allergy or birth control, for example) - not a whole list of serious medications.

* Asking your provider to pay special attention to a skin lesion during the exam.

More specific or extensive health concerns are not covered. These are issues that would normally prompt your to schedule an appointment if our were not scheduled for your "annual." If time permits, some of these concerns may be addressed at the time of your "annual,' however, according to your insurance guidelines, HFM will generate a charge for an office visit, which would include a co-pay. If time does not permit, we can schedule a separate appointment.

Following are examples (not a complete list) of specific health concerns that would not be covered as part of your "annual.'

  • A sinus infection or new cough

  • Sore throat (and testing for strep)

  • Significant review of a consultant's work

  • New or changed headache pattern

  • Abdominal or pelvic pain

  • Depression or anxiety

  • Joint pain, specific or general

  • Sleeping problems

  • Irregular periods

  • Significant changes in status of a chronic health problem

  • Any Procedure (ears, joint inject, etc.)

As it is very common (far more than not) for "annual" visits to stray into "specific health concerns" or even be planned and scheduled that way (a very good idea) and wishing to minimize inconvenience to our patients and our staff, HFM will collect the usual co-pay at your arrival. It will be refunded to you (or credited to your account -- your choice) on departure if the visit was in fact limited to only an "annual" review. Please feel free to remind your provider to indicate on your service record if this was the case - it is at their discretion.

SELF-PAY PATIENTS WELCOME - even a discount!

Heritage Family Medicine values those patients seeking a revolutionary "old" approach to patient-centered medical care - a direct relationship between the patient and their doctor. Patients who pay for their care directly ensure that the physician works only for you, free of bureaucratic interference and consequent overhead expenses. Heritage Family Medicine offers a 30% discount for immediate full payment at the time of service from VISIT fees, 20% off for procedure, lab, and x-ray fees already set low to reflect only the average levels in our community. Payments by cash, check or card are accepted.

We also offer DirectcareMD - a program by which all of our own services are provided without additional charge for $20 - 90 per person, per month. Click

HERE for details.


Like it or not the business of medicine remains dominated by government and commercial insurance companies. They are not evil. For large bills, they are an absolute necessity. For the processing of the relatively small bills of family medicine and other "primary care" services, they are inefficient distractions, raising costs for everyone. Most strive to pay fairly. Medicare no longer even pretends. DSHS (WA public assistance) pays far less than our costs.

Heritage Family Medicine participates fully in most insurance programs, including Uniform Medical Plan, Premera, Regence, Aetna, First Choice, etc. HFM accepts Labor and Industry cases for injuries less than one-year-old. HFM is NOT accepting NEW Medicare patients at this time EXCEPT for those who have joined one of the Medicare Advantage plans offered through Physicians of Southwest Washington (PSW). PSW has partnered with Humana and Premera for 2019. Both offer several plan structures. PSW is prepared to discuss these programs with potential participants at their local Olympia office at 319 7th Avenue SE, Suite 201, Olympia, WA, 98501, or by phone: 360.943.4337.

HFM is currently closed to additional adults on DSHS or Molina. Children with DSHS or Molina are welcome - no limitations. Regretfully, as DSHS pays far less than our costs, such patients must understand that we may not always be able to continue their care with that payment source.

For a more in-depth discussion on managing healthcare costs, we encourage you to read HFM's "Philosophy on Medical Economics", written by Richard Faiola, MD.


On November 4, 2008, Washington State passed the Washington Death with Dignity Act, Initiative 1000 (RCW 70.245). This act allows terminally ill adults, seeking to end their life, to request lethal doses of medication from medical and osteopathic physicians.

Heritage Family Medicine DOES NOT practice euthanasia or Rx for patients clearly intending to take their own lives.

Heritage Family Medicine does believe life to be a sacred gift and its preservation an inviolate trust that physicians have pledged themselves to since the days of Hypocrites - himself a "pagan" - yet, recognizing the utter hubris - an affront to the gods - of deliberately terminating a human life.

Having said that, we DO NOT BELIEVE IN ARTIFICIALLY PROLONGING the process of dying. We will not start a feeding rube, IV lines, and/or respirators when it is clear our efforts will not restore a patient to meaningful interactive life and their wishes in that regard can be ascertained or inferred. Furthermore, we will remove a feeding tube, IV lines, and/or respirators when it is clear our endeavors will not restore a patient to meaningful interactive life and we are certain as to their wishes in that regard. We do not maintain patients in a "Persistent Vegetative State" unless demanded by family, or the earlier expressed desires of the patient. We strongly recommend against the futile use of medical technology and inappropriate resuscitative ("Code Blue") efforts.

In all our dealings with patients, their dignity will be protected and, to the extent possible, their pain will be relieved, even at the risk of hastening their death.

The following articles explain our innovative office routines and financial policies and allow you to better understand how these methodologies will save you time and money while serving you and your family more conveniently:

Our Office Routine

Our Financial Policies

Your Privacy