325 East Sonterra Blvd.

Clinic: Suite 120

Administrative Office: Suite 220

San Antonio, TX 78258

Phone: (210) 614-5100 / Fax (210) 614-5103

San Antonio Orthopaedic Specialists

Open Letter to Physicians

November 2014

Dear Colleague,

Most of you know by this time, that I’ve opted out of Medicare effective July 1, 2008. More than six years later, there still seems to be confusion concerning what it means to be an “opted out” physician and how that affects the care of your patients. I want to, by means of this letter, explain this status clearly, as this status allows me the opportunity to improve the care provided to Medicare patients.

First and foremost, I am happy to see Medicare patients. Currently, Medicare patients compromise about a third of my practice. So no matter what you might hear to the contrary, Medicare patients are welcome in this office. Unlike about half of all participating Texas physicians, I don’t have any need nor any desire to limit the number of Medicare patients in the practice for any reason.

For a quick review of possible physician’s relationships to Medicare, please click here.

Opting out of Medicare concerns only me and my fees. Medicare will cover the hospitalization costs, and will cover all of the ancillary issues such as physical therapy or medications in their usual manner. My bill constitutes only about 5% of the total bill for a surgery. Further, in true cases of need, I am now allowed to provide discounted services without having to pass the same discount along to all patients in the practice.

Many secondary insurance plans will cover some of the expenses that arise out of this office. It is interesting to note that as of this year, Tricare will kick in their usual percentage of Medicare Allowable fees when their insured see opted out physicians. My office will cover the billing of secondary insurances.

At the same time, there are some opportunities for real savings. For example, I have set my fees for total joint replacement, with the most modern techniques, at about that which I charged for the traditional techniques in 1990, when I first charged and collected for my own services. (Not adjusted for inflation.) An informal survey of my patients showed that most people expect fees far in excess of the real number. Patient’s guesses ranged from three to nearly twenty times the real fee. A more formal study was done in Chicago recently.

The bottom line here is that it is my pleasure a to see Medicare patients. I want to “make it work” for as many of your Medicare patients as possible, and, as always, it is a pleasure assisting in the care of your patients.


Adam I. Harris, M.D