Frequently Asked Questions (FAQ’s)

What is direct primary care or “DPC?”

Direct Primary Care (DPC) is an affordable monthly membership model for health and medical care.  In this model no insurance means no hassle or red tape. Because I don't take insurance, I can keep my overhead low and pass the savings on to you. I charge an affordable monthly fee for unlimited access. There is no charge for office visits or tests that are run in the office; that is all included in your monthly fee. Access by phone, email and text is also included. You will never need to worry if the services provided in my office are covered by your insurance. This model allows for total price transparency. I will never hit you with a surprise fee.

With the DPC model you will also have lower out of pocket expenses for things like imaging, labs and prescription medicines. Believe it or not, when you file these services with your insurance, the cost goes up. If you have a high deductible, you end up paying all of that higher cost out of pocket. For example, I recently priced a HIDA scan at a local hospital with and without insurance. If insurance is filed the scan costs $1,500. The patient is responsible for all of that if he/she has a high out of pocket deductible.  By paying cash up front and not filing insurance, the same patient was able to get the same test for $600. As a DPC physician, I can help negotiate for the lowest rates possible.

I know that some of you have great insurance and want to keep it, no problem! I can also file your insurance for imaging, referrals and labs that I order. If you have an FSA/HSA you can even use that to pay your DPC membership fee. In this model I give you options. Use your insurance if it works for you but I have an alternative if it doesn’t. In the DPC model you will get excellent primary care regardless of your health insurance status. I offer the same high quality care, at the same affordable rates to the insured, uninsured and Medicare patients. 

I strongly recommend (but don’t require) that you carry some sort of coverage for catastrophic events. If you have access to low monthly premium insurance, take it. If not, I can help. I have teamed up with Sedera Health Share to offer my patients an exclusive discount on catastrophic care.

Do you have a referral for Catastrophic Care?

Yes. You can find more information on our Patient Resources page.

Do you have a referral for dental & vision coverage?

Yes. Learn more about our preferred source on our Patient Resources page.

DO YOU ACCEPT MEDICARE PATIENTS?

I Love Medicare Patients!

I will be happy to see my Medicare patients in my new practice. In fact I’ll be able to provide you better care because I’m adopting a new practice model called direct primary care. This is a type of concierge medicine that does not bill third parties.

Traditional medical clinic are incredibly dysfunctional. Calls don’t get answered, referrals don’t get processed or they might be processed incorrectly, billing is complicated and confusing, patients don’t get lab results, and there are long wait times to see your doctor. Unfortunately you will find these issues at any clinic that bills third party payers. The problem is not with the doctors or clinic staff, we are all working hard; the problem is with the overly complicated health care system that has been created by insurance companies and Medicare. We spend an inordinate amount of time and energy on things like “meaningful use” and audits for insurance companies. All of this takes away from our real job which is taking care of patients.

Medicare is actually the main culprit in creating pointless busy work. Traditional medial clinics that bill Medicare are pressured to give patients care that they don't need but can't provide patients the care that they do need. A good example is the Medicare physical. Clinics that bill Medicare must perform Medicare Physicals on their patients, otherwise they will lose money.  Did you know that the Medicare physical doesn’t actually include a physical exam? It doesn’t include a physical, bloodwork, prescription refills, disease management or any preventative services. It includes an EKG and vision screen, both of which will be free of additional charge at my new clinic. I’m also supposed to assess you for dementia and fall risk during the “physical”. Those are things that I routinely assess during medication follow ups just by talking to you and watching you get on the exam table. In my opinion the Medicare physical is a huge waste of time and resources but worse than that, it misleads Medicare patients into thinking they are getting a free physical.

I decided not to bill third party payers such as Medicare and insurance companies because I didn’t want to recreate the dysfunction. In my new clinic I will be able to provide you with the care that you need, nothing more and nothing less. Because I can keep my overhead low, I can pass the savings on to you in the form of low cash pay rates. I will also be able to negotiate for greatly reduced prices on labs and imaging. You could file those services with Medicare but the cash pay rate that I will negotiate may make it not worth the trouble. All in house labs and tests will free of additional charge. Most blood tests that are sent off to an outside lab will be less than $20.

The direct primary care model allows me to offer exceptional care at an affordable rate to all patients regardless of if they are insured, uninsured or on Medicare. In this model the only thing that people really need insurance for is catastrophic events like hospitalizations and surgeries. I encourage patients to save money by going to the lowest monthly premium plan they can find and letting me negotiate for low cash pay rates on everything else. I can also help you find discounts on prescription medicines. You may not realize it but commercial pharmacies charge hugely inflated rates, even on generic drugs. Yes, they have a $4 list but it is short, always changing and constantly shrinking. I have been negotiating with a local independent pharmacy to save patients money on all prescriptions.

In summary – YES, I would love to see my Medicare patients. YES, I will offer you exceptional care at an affordable price. NO, I will not bill Medicare because that opens up Pandora ’s Box to regulations and busy work.  YES, You can file labs, imaging and prescriptions with Medicare but you may not want to since I’ll be able to get you these things at a low cash pay rate.