In the past decade we have seen significant changes in primary care medicine. Insurance reimbursements have stagnated, government regulations have increased and doctors are being replaced by mid-level providers. At the same time, advances in medical research, diagnostics and therapeutics have completely changed the way that we view and treat disease. Navigating through this new era of medicine can be challenging and high quality primary care is emerging as the avenue to optimal health. It is now more important than ever for patients to have a knowledgeable advocate to ensure that they are receiving the best medical care available.
It was in response to these changes that the Santa Barbara Doctors ExtraCare program was launched. This practice model allows us to provide comprehensive primary care and internal medicine consultative services to a limited number of patients in exchange for an annual fee. This fee covers ALL of the services provided by our office regardless of insurance reimbursement. Limiting our practice size allows us to become intimately involved with our patients and provide a high level of personalized care.
We are the only private primary care practice in Santa Barbara to perform comprehensive laboratory services in house, thus keeping the results confidential and privately accessible only to authorized recipients. We also stock and administer all routine and travel vaccines. Wellness visits include routine cardiac, pulmonary, depression, genetic and nutritional screening. We schedule telephone, video and home visits when appropriate and provide enhanced communication via cell phone, email and secured texting. Members receive a monthly email newsletter and regular communication from us during critical events. We are available to coordinate your care among specialists, oversee your hospital care, and guide you in times of emergency 24/7.
Santa Barbara Doctors ExtraCare offers our patients an ideal primary care environment. Our highly trained medical doctors are professional, knowledgeable and compassionate. Adhering to evidence-based medicine practices; we deliver a premier quality care experience. Santa Barbara Doctors ExtraCare offers the most up to date medical care combined with the latest medical technology to give our patients the care they deserve and the peace of mind of knowing that they have access to their doctor whenever needed. It really is the old fashioned way: having a doctor who knows you and is there for you when you need them. We welcome you to become a part of this exciting practice.
Santa Barbara Doctors
Comprehensive Internal Medicine Services
Lifestyle and Wellness Assessment
Comprehensive Laboratory Services
Focus on Prevention
Extended Physician Visits
Same Day/On time appointments
Secure Video appointments when appropriate
Home Visits when appropriate
24/7 emergency access to doctor via cell phone/text/email
Oversight of hospital care
Care coordination with consulting physicians
Access to Santa Barbara TeleMedicenter Virtual exam room
Monthly health bulletin
Cooperation with insurance companies
COVID 19 Antibody Testing
Concierge Membership FAQ
What services does the annual fee cover?
The annual fee covers:
Any service provided to you by our office including annual wellness evaluation, unlimited office visits with no co-pay, vaccinations, etc.
Same day appointments with little or no waiting time in the office
Monthly health bulletin
Focus on preventative medicine including nutritional counselling, exercise counselling, anti-oxidant testing, cardiovascular risk factor analysis, cancer screening review and osteoporotic fracture risk analysis
24/7 accessibility to doctor via cellphone, secure text, email
Secure video appointments when appropriate
Home visits when appropriate
Communication with consulting physicians
Supervision of the care that you receive in the hospital
The annual fee generally is not covered by your insurance company; however, many HSA and/or FSA accounts attached to patients’ insurance plans may be used to cover the annual fee.
We will submit all qualified office visit charges to your insurance company and these services may be applied to your plans out of pocket deductible.
It is important to know that this program is not in lieu of health insurance. Patients should continue to carry health insurance to cover medical services provided by outside facilities or by other health care providers.
Is the annual fee tax deductible?
Your tax adviser can tell you if this fee qualifies as a tax deductible medical expense.
I’m young and healthy, is this program right for me?
Definitely. The Santa Barbara Doctors – ExtraCare program is designed for patients of all ages, but specifically, young, healthy patients will benefit from being part of this program in the following ways:
Monthly health bulletins with tips on how to stay healthy and updates on recent advancements in medicine
Extended wellness visits that include a focus on preventative medicine including nutritional counselling, exercise counselling, anti-oxidant testing, cardiovascular risk factor analysis, EKG testing, Spirometry testing, cancer screening review and osteoporotic fracture risk analysis
Convenience of video appointments when appropriate.
Same day appointments with little or no wait time
Will Santa Barbara Doctors perform house calls?
Yes, Santa Barbara Doctors is available to visit patients at home when patients are physically unable to come to the office and when medically appropriate. In addition, Santa Barbara Doctors ExtraCare routinely visits patients in various senior living facilities throughout Santa Barbara including Valle Verde, Samarkand, Mission Terrace, Villa Santa Barbara and Alexander Gardens.
Do I need to be a computer wizard to participate in a video appointment?
Not at all. Accessing a video appointment is easy with the use of our HIPAA compliant Zoom video platform. All that is required on your end is either an Ipad, or laptop/desktop with an attached camera. (We will supply a complimentary CISCO high definition camera if needed) We simply email you a link and with a few simple clicks we are connected in a secure, virtual meeting space.
Will Santa Barbara Doctors see me in the hospital?
Santa Barbara Doctors is a member of the medical staff of both Cottage Hospital and Goleta Valley Hospital. Santa Barbara Doctors works closely with the Hospital Admitting Physician group (hospitalists) at both of these facilities to care for her patients admitted to the hospital. This group of board certified internists is uniquely qualified to provide the most advanced inpatient care to you 24 hours a day, 7 days a week. Santa Barbara Doctors will oversee the care that you receive by the hospitalist and sub specialty physicians while you are in the hospital and will work together with this team to provide you a seamless transition from the hospital to the outpatient setting.
Is Santa Barbara Doctors available after hours?
Yes. Santa Barbara Doctors is available to her patients 24 hours a day, seven days a week. In the uncommon event that she is unavailable she will make arrangements with another qualified physician to cover in her absence. This information will be made readily available to the patient.
What if I need to see a specialist?
Santa Barbara Doctors has been practicing medicine in Santa Barbara for over 20 years. This experience has allowed her to forge close relationships with most of the specialists in Santa Barbara as well as specialists in Los Angeles and the Bay Area. If the need arises for you to see a specialist, Santa Barbara Doctors can assist you by finding the best physician for the job, review all studies and notes received from the consulting physician and coordinate your ongoing care.
What if I have any other questions about the Santa Barbara Doctors ExtraCare program?
We are happy to answer any additional questions that you may have. Please fill out the contact form to schedule a complimentary 15-minute consultation with Santa Barbara Doctors and find out if this program is right for you.
What is a COVID 19 Antibody Test?
This test is designed to detect antibodies to the virus that causes COVID-19 in blood specimens. Our test has been authorized by the FDA under an EUA. These test kits have demonstrated a clinical sensitivity of 99.1% to IgG antibodies against SARS-CoV-2 when blood samples were obtained at least 14 days after infection (99.9% after 18 days) and a specificity of 99.8%.
Barbara A. Hrach M.D. FACP
Dr. Hrach practices within a concierge or membership model. In this model, patients pay an annual fee for all services provided by our office.
Vicky offers a fee for service practice model, in which patients pay for services rendered at the time of service. As a courtesy, our office staff will submit claims electronically to your primary insurance company. Your direct reimbursement rate depends on your individual insurance plan.
Vicky is considered an “out of network” practitioner for most commercial medical insurance plans.
Vicky is contracted with Medicare as a participating provider. This means that she charges Medicare allowed amounts for services rendered and accepts assignment for all Medicare allowed services. Full payment at the time of service is expected for all services provided that are not allowed by Medicare.
Fee for Service FAQ
What are the fees for an exam?
Our fee schedule is based on the complexity of your visit, and any additional services performed during your visit. Our fees are commensurate with local insurance reimbursements. Charges for an initial patient evaluation are generally between $150-$250 and follow up visits between $75-$150. There are additional charges for vaccinations or other services that may be provided during your visit.
Will you bill my insurance?
Yes, as a courtesy we will electronically submit the visit charges to your insurance company. Your insurance will reimburse you directly if applicable.
Do you accept Medicare?
Family Nurse Practitioner Pagenkopf is contracted with Medicare as a participating provider. She charges Medicare allowed amounts to all Medicare patients which are generally lower than her standard fees. She accepts Medicare assignment for all Medicare allowed services and expects full payment at the time of service for services provided that are not allowed by Medicare.
Virgina Pagenkopf F.N.P.:
Vicky offers a fee for service practice model, in which patients pay for services rendered at the time of service.
We appreciate the care that our patients receive from the hard working employees of the Cottage Health System. Cottage health employees have been welcome in our practice for years and are some of our best advocates. Cottage employees dedicate their careers to helping members of our community during times of crisis and need. As a show of our appreciation for the care that Cottage Health employees provide to our patients and community, we have chosen to contract with and accept Cottage Health insurance on an assigned basis.