What is direct patient care?

Direct primary care (DPC) and direct specialty care (DSC) are innovative models of healthcare that put the patient first. DPC and DSC practices do not bill or file insurance claims. Instead, the patient pays a membership fee directly for the services provided. It creates an enduring and trusting relationship between the patient and their doctor often resulting in cost-savings, less hospital admissions, and increased joy and satisfaction for both parties.

 

To read more about how DPC improves outcomes click the link below:

https://www.dpcare.org/society-of-actuaries-report-on-dpc-

 

Will it be difficult to see my doctor in a timely fashion?

No, doctors limit the number of patients in their panel which ensures the ability to provide specialized care to each and every patient.

 

How much does it cost?

Annual fees differ between specialties and services provided. Primary care often starts at $1500 per person annually or $150/month. You may be offered discounts for couples and those that pay annually rather than monthly.

 

What is typically included in a direct primary care membership?

• An intake clinic visit either in person or telehealth.  During this visit you will develop a plan of care
• An annual physical examination with associated lab tests
• For lab tests which not able to be completed on site, your blood work will be sent to LabQuest who will bill your insurance independently
• Preoperative exams
• Sick visits as needed
• Follow-up visits as needed
• Management of chronic conditions and associated in-person or virtual visit
• Coordination of medical care with your other doctors
• Convenient on-site Point of Care (POC) testing where available
• On-site EKG as part of the annual physical examination when indicated

***Note: Direct Specialist Care will offer different benefits depending on their expertise - please contact the doctors directly for more information on their benefits

 

Do you take insurance?

No, we are out of network doctors - our services are covered by the annual membership fee. Athough we do not accept insurance payment for medical services, you may use your HSA card for payments

 

Can you pay the monthly or annual fee with a health savings account?

Many states recognize Direct Primary Care and Direct Specialty Care as an eligible medical expense, but the U.S. Treasury and IRS have not officially weighed in. A presidential executive order signed on June 24th 2019 specifically calls on the Treasury to regulate DPC and DSC as an eligible medical expense by the end of September 2019. We advise patients with an HSA account to contact their Health Plan administrator (usually Human Resource office) and/or Accountant to ask if it’s okay to use their HSA funds to pay our annual or monthly fee

 

Do I need to keep my insurance?

Yes!

You need insurance for emergency room visits, hospitalizations, medications, specialized imaging/lab work, and other doctor visits.

It is important to note that the direct patient care model is not insurance and does not meet the criteria for insurance as set forth in the Affordable Care Act.

 

What about emergencies?

Our mission is to keep patients out of the emergency room and to avoid unnecessary, often inefficient and duplicative, urgent care centers by providing timely and appropriate care. However, emergencies do happen. Our patients can receive emergency care at any facility in which they have coverage and we plan to be available for consultation by phone with any emergency care physician. Emergency room care will be billed directly to your insurance.

 

What if I am hospitalized?

This is where we are your quarterback!

We coordinate closely with the inpatient (Hospitalist) team at the hospital where you are admitted. This not only ensures we have details of the hospitalization, but then we will be able to facilitate a smooth transition home and appropriate timely outpatient follow up

***Note: This may not apply for all specialists offering direct patient care, but is absolutely the goal for our direct primary care physicians

 

How do I communicate and schedule appointments?

You can call, email, or text through a secure communication portal to schedule an appointment. This is integrated with electronic health records.