Evergreen Newsletter

August 2021


The values of Evergreen Family Medicine are symbolized in SPIRIT: Stewardship, Patient and Population focus of health care, Integrity, Respect, Innovation, and Teamwork. Each Provider meeting begins with a meditation on one of these values.

CEO Corner

Community Health Workers​


It is the newest emphasis in primary care. It is the motivation behind our Network of Care website that we have worked so hard to develop and implement. It is what has changed most about Family Medicine in my 40 years of practice.


When I started my practice, I waited for the patient to find me, make an appointment, express his needs and look to me for a solution. Sometimes that worked.


CEO Dr. Tim Powell

We have a new vision. It includes the patient not in front of us, unarticulated needs from vulnerable populations, connecting those who need help with the resources they need, and promoting wellness in our community.


Who does that?  And how do you measure it?


When you read the book of Acts, it is a lesson in how to measure health in any community.


“See how they love one another.”  Not a bad gauge of health.

“There was no needy person among them.”   Hard to beat that metric.

“And awe came upon everyone.”   Possibly, the ultimate measure of health in any community might well reside in our ability to stand in awe at what folks have to carry rather than in judgment of how they carry it.


Judgment creates the distance that moves us away from each other. Awe compels us to try and understand what language the behavior is speaking. Judgment never gets past the behavior. What the mind wants to separate, the heart should bring together.  Judgment takes up the room you need for loving. Kinship asks us to move from blame to understanding.

At our monthly provider meetings, one of our providers offers a reflection on an Evergreen value. This is a recent excerpt from one.


"An Evergreen value is stewardship. Responsible planning and management of resources to accomplish the most possible with what we are given.

Why is it important? Because, our health care delivery system wastes $210 billion per year on unnecessary billing and administrative costs. Because, average spending each year per patient in the United States is $10,586, compared to $29 in Tchad. Because, 30% of inpatient antimicrobial therapy, 26% of advanced imaging, and 12% of acute percutaneous coronary interventions are unnecessary or inappropriate. Because, there is no evidence that the more expensive

treatment benefits patients. And much of the excessive treatment and unnecessary testing occurs at the end of life.

The good news: Multiple studies have shown that Family Physicians and Internists practice more cost-effective medicine than specialists and that their patients have better health outcomes."


Dr. Anca Dauer

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Allergy Season


"Pollen counts are up, and Douglas County residents are sniffing, snorting, and scratching. Whether you find yourself dealing with seasonal allergies for the first time this year, or you’re an annual sniffler, there are many over the counter treatments that can help restore your clarity.


For most individuals with seasonal allergies OTC treatments are sufficient:

•        Intranasal glucocorticoid steroid - (Fluticasone)

        3 days to work

•        OTC non-sedating antihistamine (Second generation)

        Loratadine, Fexofenadine, Cetirizine

•        Air purifier in bedroom

•        Keep pets out of the room

If these OTC medications are not providing sufficient control of your symptoms, it might be time to see your provider. Often, using an intranasal antihistamine like (azelastine) until the fluticasone is fully working can be helpful. For those graced with both seasonal allergies and asthma additional prescription medications help mitigate symptoms. Referral to an allergist for desensitization may also be necessary.


During this time of year, many patients are requesting an “allergy shot” or corticosteroid injection to help improve allergic symptoms. While there is particular use for these intramuscular systemic corticosteroid injections, they have many potential side effects and are not generally used for seasonal allergy management.


For example, a 40 mg Kenalog injection is equivalent to receiving 21 days worth of a systemic steroid. Side effects include weakening of the bone, increased blood pressure, increased blood sugar, and unintentional weight gain. Despite the potential benefit, the potential risk is high.


To help better understand how to control your symptoms consult with your primary care provider."

Alexandra Blaine, PA-C

Evergreen Women's Health

Jennifer Estrada

Women’s Health Manager


Women’s Health has had our 3rd Prenatal Class and it has been a hit! One night a week our providers lead the class and cover issues from the most common questions in pregnancy to newborn care. The class is open to the public and is offered one night a week for six weeks.

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Stacie Hannah has a passion for Breast feeding and uses visual aids to give instruction on the best practices.


Dr. Oler reviews some of the unknowns when it comes to Labor interventions and pain management. She covers the differences between elective inductions, medical inductions, and Cesarean delivery. She also reviews medications that are available and often used during delivery.


Dr. Powell addresses common concerns like weight gain, fatigue, depression, and important warning signs. She also covers the challenges of the fourth trimester and the postpartum period.


Dr. Anderson and Dr. Parrish cover newborn care and review feeding, diapering, and sleeping, or all too often the lack of sleep.

What is the Advantage to a Medicare Advantage Plan?

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Choosing the best Medicare plan can be a complicated process. One decision point is whether to obtain standard Medicare, along with a separate Medicare Gap Supplement, as well as a Part D plan for medication coverage. Because the option is to choose a Medicare Advantage plan which is an “all in one” simplified plan.  The Medicare Advantage plan is generally less expensive than purchasing each component separately and may offer more services.

However, all Medicare Advantage plans are not equal. They vary considerably from company to company as to coverage, benefits, and cost. Most have options for various tiers of coverage. The least expensive regarding monthly premiums, is not always the best overall choice. Overall, out of pocket expense, to the patient may be more with some plans.

Some Medicare Advantage Plans cover a comprehensive physical examination by an Evergreen Provider every year. This detailed exam is provided at no cost to the patient, and every applicable diagnosis is reviewed.  This exam becomes a foundation to provide a complete assessment and care plan for our patients. It facilitates better care. Standard Medicare Insurance provides for an Annual Wellness Visit directed at preventative care but does not cover an actual physical exam.  

An independent insurance agent is critical in choosing the best Medicare Advantage plan for you. This service is free of charge for Medicare patients. Ask our staff or see our website for a referral to a reputable local agent.

Billing Tips

Dear Evergreen Family Medicine Patients,


We are so happy to be able to reach out and communicate on how we can work together to make sure that we are not only providing great care but excellent service with your billing. Below are helpful tips that we hope will help accomplish this.


Call or go online with your insurance and ask the following:

1.)  Is my provider in network or out of network?

This can change how the insurance pays on your claim.

2.)  Does my insurance require me to choose a PCP (Primary Care Physician)?

3.)  Do I have a Co-pay? How much? 

This is usually a fixed amount you pay whenever you receive certain health care services or get prescription drugs. Copays may apply before and after you hit your deductible. A copay is different from coinsurance, which only applies after reaching your deductible and is the percentage of your final bill that you pay.

4.)  What is my deductible?

This is the amount you pay for covered health care services before your insurance plan starts to pay.

5.)  What services are considered preventative care?

This is the care you receive to prevent illnesses or diseases.  These services are usually covered for free and include such things as screening and immunizations. 

6.)  Do I have a primary and a secondary insurance?

Secondary Insurance is a health insurance plan that covers you in addition to your primary insurance plan. Typically, secondary insurance is billed when your primary insurance plan is exhausted and may help cover additional health care costs. For example, if you already have insurance through your employer and choose to enroll with your spouse’s health insurance plan (if allowed), that coverage would become your secondary insurance. It is so important to provide a copy of the insurance cards and clearly communicate which is primary and which is secondary. Make sure that you instruct that card to be applied to all family members under that plan. 


7.) COB Coordination of Benefits policies create a framework for two insurance companies, if you have two, to work together to coordinate benefits so they pay their fair share. The primary plan pays its share of the costs first. Then, the secondary insurer may pay up to 100% of the total cost of care, as long as, it's covered under the plans.  It is extremely important that you communicate to both plans and make sure they know about the other.  It is also imperative that if you cancel or if there is a change that you communicate to the other plan.


8.) Billing your Insurance is a courtesy.  We accept assignment of benefits for primary and secondary insurance. It is your responsibility to provide our office with complete and accurate insurance or billing information at the time of service. Our office cannot guarantee the amount that an insurance company will pay. Your insurance is a contract between you and the insurance company.  We are not a party to this contract.  We do not guarantee payment.

We know these are tough times, did you know we offer monthly payment plans?

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