What type of conditions do you treat?

I see patients with endocrine related conditions such as diabetes, thyroid disease, early or late puberty, growth delay, unexpected weight changes, insulin resistance, PCOS and menstrual irregularities, ages newborn through 25 years. 

Growth evaluation in new patients:

A big part of the evaluation of growth is making a diagnosis. Often, parents want to make sure that a diagnosis is not missed, or that the treatment their child is receiving makes sense.  I am happy to provide a second opinion, and order and evaluate bloodwork and x-rays if needed. If I think that treatment with growth hormone may be indicated, I will provide you and your primary care doctor with my rationale.

Due to the cost and extensive resources required to perform the all-day growth hormone stimulation test and get insurance approval for starting growth hormone, I am no longer able to perform that test in my office or initiate treatment. I can, however, refer you to another provider if I feel this is an appropriate next step.  I will continue to prescribe growth hormone treatment that is ongoing as medically indicated. Many children have reasons other than growth hormone deficiency for growth concerns, and I am happy to discuss these other reasons and prescribe alternative therapy if indicated.

Where do you see patients?

l see patients in my office in Narberth, PA and by televisit , or a hybrid of the two. 

Up to what age can you still see me?

My training and expertise are in the pediatric and adolescent population.  Guidelines and medication approvals are different for adults. In some cases, however, the condition and treatment of a condition of a 23 year old may not be dissimilar to an 18 or 19 year old, in which case I may continue to see a patient beyond 21 years. 

What is direct pay specialty care?

Direct pay specialty care is an insurance free care model. I do not accept or bill insurance. I receive payment directly from you, so there are no administrative intermediaries to interfere with the doctor/patient relationship. My only loyalty and duty is to you, the patient. I eliminate the enormous costs associated with insurance coding and billing and the countless other non-medical, administrative tasks that come with accepting insurance.

The fee structure in direct pay primary care is typically a monthly membership, however many specialty practices offer fee for service payment options as well.  

Is direct pay specialty care the same as concierge medicine?

No. Direct pay care practices do not bill your insurance. 

In the typical concierge practice, the membership fee — which often ranges from $1200 to $9000 per year— is the cost of enhanced access and does not include medical care. You or your insurance plan are billed for services the same as in a traditional practice, including deductibles and co-pays.  

In the direct pay care membership model, access to your physician is included in the membership fee as part of a comprehensive package of services. There are no co-pays and your insurance is not billed for those services. 

Why would I choose membership over the fee for service payment?

I offer both a membership and a cash-pay, fee for service model. 

Your first visit in this practice will be fee for service. At the time of your second visit you will have the choice to continue as fee-for-service or convert to one of four membership tiers.

In my fee-for-service model you make a cash payment (credit card) for individual services. This is appropriate for patients who may need only a single consultation, infrequent follow up, or simply prefer this option.

The monthly membership is appropriate for patients who have frequent visits, who want greater access to care between visits, patients who take medications that require prior authorizations, or if significant coordination of care with schools or other providers is necessary. You can choose to convert to the monthly membership at any time or vice versa.  

How is this affordable? How can some people save money in this model?

Patients who have insurance with copays, deductibles, coinsurance, and high out-of-pocket maximums can save money in a direct pay care membership model where the fees tend to be lower.  It may be hard to predict, as the visit fees charged by in-network practices/hospitals for doctor’s visits are often not transparent, and patients are unaware of the charge and their cost until the bill arrives.

An indirect way in which families save money with direct pay care is through time saved. Time waiting on phones, time in waiting rooms, time staying up at night worrying, time sorting out questions, time finding parking, etc.

Will insurance reimburse any of the fees?

This depends on your insurance plan’s out-of-network benefits (individual, family deductible, coinsurance, out of pocket maximum), the insurance’s “allowed fee” for the visit, and how much you have already submitted for out of network reimbursement in the plan period. I cannot guarantee that your insurance will reimburse you. 

If you don’t take insurance, can you still write prescriptions?

Coverage for prescriptions depends on your insurance policy. Therefore, what you pay for prescriptions that I prescribe is determined by your benefit plan.

What about specialty medication that requires prior authorization, such as growth hormone, Lupron, semaglutide or durable medical equipment such as insulin pumps?

I will support you to justify such costs to other payers if you are not restricted by participation in an HMO or have Medicaid as primary or secondary insurance. In Pennsylvania, HMO’s and Medicaid may require “in network” providers to do the prior authorizations for these types of medications. There may be a fee for the time required to process the prior authorization (see Fee Schedule).

What about prescription refills?

Follow up visits within the recommended time frame are necessary for prescription refills. Prescriptions will be sent to your pharmacy through e-prescribing. Anyone for whom I prescribe medication is encouraged to participate in the membership model. Prescriptions will be processed by insurance.

Can I do televisits?

Yes. Patients receiving care through telemedicine must have residency in, or physically be in, a state in which Dr. Bardsley is licensed to practice medicine: PA, NJ, DE.  In office visits are often necessary for a physical exam. The fee for televisits is the same as in-office visits.

Do you offer in-office blood draws?

I am not offering in-office blood draws. I will, however, write prescriptions for bloodwork which you can take to your preferred blood drawing center. It is important that you state you would like the fee to be sent through your insurance. 

What about a patient portal or app? 

I use an electronic medical record (EMR) called AtlasMD. It is specifically set up for improved communication between patients and physicians in direct-pay care practices. Text and emails can easily be entered and assigned to patients’ charts if appropriate. It allows for attachments and photos as well. Some features are still in development... such as a user friendly patient portal. There is an app for iOS/apple devices with a few useful features, such as billing management, but no way yet to log on to see labs or records.

What happens if I need to go to the hospital or see another specialist?

I will coordinate with your primary care physician and any specialist. If you are admitted to the hospital, the in-house physicians will care for you and I will be available for consultation. 

Why did you convert your practice from insurance based to direct pay care?

The cost of processing insurance and billing was about equal to the payments I received from the visits. This meant that while I was happy to be providing care to my patients and employment for my staff, I was not getting paid for my work. 

I loved the model of care I had set up: a clean well-lit and intimate office space, a person to answer the phone who knows the patients, staff who I hired and who were dedicated and capable , flexibility with scheduling around my patients and my own needs, efficient processes - short wait times, immediate access by patients to their results and required notes for school, travel and camp. I could walk to work, could allow patients to bring in a pet for a procedure, could recycle, and could offer a setting during the pandemic peak where my patients were not exposed to other patients. 

When it was clear that the insurance based private practice business model was not sustainable, I did not want to go back to a setting where what I knew was working for both my patients and me would be no longer be possible. I want to treat patients, not insurance companys’ bottom lines. I want to spend more time on patient care than on billing systems and data gathering. 

I am not alone. Direct pay specialty care and direct primary care are growing rapidly in the United States as physicians and patients become more frustrated with the state of medicine.

Will I have to pay out of pocket for x-rays and labs?

These will be processed through your insurance.

How do I enroll and make an appointment?

If you are interested in a consultation, please send me an email to make sure that it is a good fit and if so, enroll and make an appointment by following the instructions here.