What to
Expect

In an insurance-based practice, the practice is paid based on how the doctors “code” the visits and the number of patients they see. This is why in a large practice, appointments are often short, the doctor has to see a lot of patients in one day, and the wait time is often unacceptably long. In a Direct Care model, you pay the practice directly and no one else withholds the payments. This allows practices to remain smaller with fewer patients, and visits are much longer and more thorough. It also allows more time devoted to communication, care coordination, and less wait time. In Direct Care there are no bills for copays or deductibles, ever. Your only cost is your membership fee or your appointment fee. Your concerns can be handled before they worsen and possibly turn into an urgent care or ER visit. “An ounce of prevention is worth a pound of cure” as they say.

Currently we offer new patient appointments within 2 weeks. If there are circumstances requiring an appointment sooner than we can offer, Dr. Costello will be available to review your records and determine if you can be booked immediately. *Please note new patient appointments can be delayed by difficulty obtaining records from your primary care office.

Membership is the best option if you need to be seen and in contact with us frequently. This option involves a monthly fee that is automatically deducted from your bank account. The membership fee covers all the care you will receive from us- unlimited access during business hours through visits, text messages, and phone calls, and after hours access when needed. Forms and prior authorizations for medications are covered.

Fee-for-Service is the best option if you only need to be seen 1-2 times per year. In this option, you will pay each time you see Dr. Costello. It is important to understand that any clinical needs, questions, etc will require an appointment. Straightforward non-clinical questions can be directed to Danielle, however all other matters will be discussed during an appointment. Forms and prior authorizations will be charged separately from the appointment charge.

We are “opted out” of Medicare.

We can see patients who have Medicare, however we do NOT bill Medicare for any services at all, and our patients cannot submit claims to Medicare for payment. We use the same Direct Care fee structure (Membership or Fee-for-Service) to privately contract with all of our patients, including those who have Medicare and Medicaid/MassHealth.

We do not accept insurance for coverage of our services, we are out of network for all insurances. We can, however, provide a document or “superbill” that you may submit to your insurance for possible reimbursement. Some insurance plans do provide partial payment for out of network providers. *Please note Medicare beneficiaries CAN NOT submit a claim for reimbursement.

The short answer is yes, it should. It is always possible for insurance to deny payment for anything. Most of the time when a person gets a “surprise bill” or simply unexpected bill for labs or other services, it is usually because there is a deductible that has not been met. It is NOT necessarily because the lab/service is “not covered”. We always encourage patients to know what they pay monthly for insurance, what their copay amount is, and what their out of pocket deductible is.

We have programs that range from very structured with accelerated weight loss, to more flexible plans with a moderate pace. All of our programs include New Direction medical grade meal replacements, to use in place of one or more of your daily meals. When you meet with us to create a plan, we discuss how much weight you would like to lose, along with how quickly you wish to get there. This guides us to the best approach for you- more meal replacements for faster weight loss, or fewer for a slower paced program.

For those looking for an even more gradual approach, who prefer to use all self-prepared grocery meals and food, we do have exceptional Nutrition Education options geared towards weight loss.

All of our weight loss options include and require a body composition scale that pairs with our smart phone application, and we encourage detailed intake tracking. This allows us to monitor more than just your weight during the process.

Yes, I do prescribe AOMs. My approach is to first establish care, and work with you to learn your entire history and current lifestyle. Lifestyle changes will be our first discussion. My patients must be working closely with a nutrition expert (either our own or one of their choosing), tracking all intake and monitoring progress with a body composition scale. When appropriate, I will add in medication as part of the treatment plan.

Four things make us different: Structure, Accountability, Experience and Continuity. We require a Medical Screen where you meet with Dr. Costello, go over your entire history, and discuss the best diet plan for you. You then will meet with Jen every week and Dr. Costello every 1-2 months. If you miss a visit, we will call you. Our app allows Jen to monitor your progress as often as is needed, to provide the accountability that is proven time and time again to be at the core of weight loss success. Our program has been successfully running for over 5 years, and Jen and I collectively have 30 years of experience in the weight management field. You won’t see any other practitioners in our program! Our team is small- Jen, Danielle and myself - but our patients love the fact that they are always in touch with someone familiar.