We provide business consulting, not legal services, to healthcare professionals throughout the US. For 18 years, we have implemented the routine exam model: a century-old, Medicare-compliant approach that frees you to practice your way. No hourly fees, ever. Our approach focuses on implementing the proven routine exam model a system with over a century of success that ensures regulatory compliance while maximizing your practice's potential.
Our services focus on implementing the Routine Exam Model, a healthcare professional-directed care approach that predates modern health insurance and remains Medicare compliant today.
Federal law has long distinguished between items and services that are “reasonable and necessary” for the diagnosis or treatment of illness or injury and those that are routine, preventive, or performed for purposes other than treating a specific medical condition. Under 42 U.S.C. 1395y(a)(1)(A), Medicare excludes from coverage items and services that are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Implementing regulations, including 42 C.F.R. 411.15, further clarify that routine physical checkups and examinations performed for purposes other than diagnosing or treating a specific illness, symptom, complaint, or injury are excluded from Medicare coverage.
These exclusions, refined through statutory updates and regulatory guidance over decades, create a lawful framework for healthcare professionals to offer routine, longitudinal, and preventive care on a cash-pay basis without opting out of Medicare.
Three services, no hourly fees. Practice formation is a modest flat fee. Communications support is a modest percentage fee for the first year only. You keep complete ownership of your practice.
Our comprehensive formation package provides everything you need to create a fully compliant, profitable routine exam practice model tailored to your unique vision.
What's Included:
Key Benefit:With this package, you retain 100% ownership of your practice and all future revenue, with no ongoing obligations to us or to any third party.
A modest percentage of new gross cash revenues from your designed direct practice program, for one year only.
What's Included:
Key Benefit: Unlike corporate platforms that take 25–40% of your revenue indefinitely, this is a modest communications fee based on new gross cash revenues from your designed direct practice program, for one year only. It replaces hourly billing for communications, so your costs stay predictable and tied to what the program actually produces. No long-term commitment and no automatic renewal.
For practices seeking additional support with two critical aspects of success, we offer an intensive full-day, in-person consultation focused on:
What's Included:
Key Benefit: This on-site consultation addresses the two areas that create the greatest challenges for new direct care practices: attracting patients and maintaining ironclad compliance. (Client covers travel expenses.)
Our engagement has two fees: a flat fee for program setup and launch, and a one-time communications fee at the end of your first year based on a small percentage of cash patient fees collected. Unlike many enterprise platforms, we do not take an ongoing share of your revenue nor any ownership stake.
For psychiatrists, psychologists, and other mental health providers, we develop models that:
For specialists seeking to add direct care components while maintaining traditional practice elements, we create hybrid models that:
For practitioners focused on root-cause medicine and holistic approaches, we develop structures that:
For practices focused on prevention and optimization, we create frameworks that:
We help family medicine and internal medicine practices implement comprehensive routine exam models that emphasize prevention and long-term relationships. These models typically feature:
Our implementation process is methodical and comprehensive, ensuring your practice transformation is both successful and compliant.
The routine exam model creates a financially sustainable practice with predictable revenue and reduced administrative costs.
Key Financial Benefits:
The model also creates tax advantages for patients through HSA/HRA/FSA/MSA and employer funding, making your services more accessible while supporting your financial goals.
The routine exam model is based on specific statutory exclusions dating back to 1965. Federal law explicitly excludes “routine physical checkups” from Medicare coverage, making them legitimate cash services:
No payment may be made under [Medicare] for any expenses incurred for items or services… where such expenses are for routine physical checkups” – 42 U.S.C. § 1395y(a)(7), Social Security Act.
This legal foundation allows your practice to offer these services for direct payment without Medicare compliance concerns.
No. Our approach leverages specific statutory exclusions for routine exams dating back to 1965, maintaining full Medicare compliance without requiring opt-out. This provides maximum flexibility for practitioners who wish to continue seeing Medicare patients while offering routine exam services for cash payment.
Yes. Program patient fees are designed to be qualified medical expenses to enable employer/self-employed/HSA/HRA/FSA/MSA funding.
Absolutely. You can remain in-network with insurance plans and bill for covered services as you choose while implementing the routine exam model for non-covered services. This flexibility is a key advantage of our approach. Bill plans never, some, or more.
We believe healthcare professionals should maintain 100% ownership of their practices and future revenues. Our approach ensures you receive comprehensive implementation guidance without indefinite financial obligations to us, unlike corporate platforms that take significant percentages for the life of your practice.
We never charge hourly. Our percentage fee is modest and ends after the first year, and our contract lasts one year at most. Your brand, your services, your pricing.
Health coaching can be properly integrated as a component of your routine exam services when structured correctly. We help create the legal and operational framework to incorporate coaching while maintaining compliance with healthcare regulations and qualifying for HSA/HRA/FSA/MSA and employer funding.
Projects normally require one (1) to three (3) months to complete.
During your consultation, we’ll discuss your specific specialty, analyze potential services, and outline a customized implementation plan that complements your existing practice while creating new revenue opportunities.
Contact Information:
Jim Eischen
Eischen DPSC LLC
2323 Locust Street
San Diego, CA 92106
619-919-5395
jim@eischendpsc.com
Challenge: A four-physician primary care practice wanted to expand beyond individual patients to serve local businesses through employer-funded healthcare.
Solution: We implemented a specialized corporate wellness program alongside their routine exam model.
Results:
Challenge: A functional medicine practitioner needed to create a more comprehensive care model that extended beyond office visits.
Solution: We developed a health coaching integration framework within the routine exam model.
Results:
Challenge: A four-provider family practice struggled with declining reimbursements, increasing administrative burdens, and physician burnout.
Solution: We implemented a routine exam model while maintaining select insurance participation.
Results:
Challenge: A functional medicine practitioner needed to create a Medicare-compliant practice structure while making services accessible through tax-advantaged funding.
Solution: We created a hybrid model with clearly delineated routine preventive services qualifying for HSA/FSA funding.
Results:
Challenge: A cardiologist sought to add a direct care component focused on cardiovascular health while maintaining traditional specialty referrals.
Solution: We developed a specialty-specific routine cardiac assessment program alongside traditional insurance-based practice.
Results:
