We Have the Answers to Your Questions

Direct primary care (DPC) practice is one that offers patients the full range of comprehensive primary care services, including routine care, regular checkups, preventive care, and care coordination in exchange for a flat, recurring membership fee that is typically billed to patients on a monthly basis. DPC practices are distinguished from other membership-based care models, such as concierge care, by lower membership fees, which cover at least a portion of primary care services provided in the DPC practice.

The practice membership fee is a set recurring charge billed directly to patients to cover the comprehensive and coordinated primary care services provided by the DPC providers and practice staff under the terms of a practice membership contract.

The opportunity to spend more time interacting with patients and providing ongoing follow-up services is at the heart of the patient-centered care provided in DPC practice settings. The regular and recurring revenue generated by the practice membership fees allows providers participating in DPC practices to overcome some of the pressures associated with the traditional FFS (Fee For Service) payment system. Because DPC providers are no longer generating revenue solely on the basis of how many patients they see per day, many report that they have significantly more time to spend with patients in face-to-face visits. Additionally, many DPC practices provide a larger array of non-face-to-face services, such as tele-visits or e-visits for their patients, to ensure primary care services can be accessed in a manner most convenient for patients and their families.

Patients who receive health care insurance coverage, either through employers or individual insurance plans, can receive primary care in a DPC practice. This is true even if the DPC practice does not participate in any insurance contract. The reality is, however, that receiving care in a DPC setting can increase the responsibility of patients to manage their healthcare-related finances. Insured patients can typically receive reimbursement from insurance carriers for care received in a DPC practice via the claims process.

Put simply: your DPC provider is there when you need them. You get unlimited office visits at no additional charges and they’ll spend as much with you as you need. Typically you’ll be able to book a same-day or next-day appointment, sometimes directly through the practice’s website. Often you’ll have access to your provider’s cell phone number, so you’ll be able to call or text them any medical questions as needed. Some simple diagnostics (e.g. strep tests) and blood tests may be performed in-office for a small additional charge (or no charge at all). If you have a major issue, your provider will coordinate any specialist referrals.

The normal monthly charge is around the same as or less than your cell phone bill. That’s a small fee to pay for a level of service you won’t get elsewhere. Asking your provider for their personal phone number is likely to make them laugh out loud. Alternatively, phoning your local hospital and requesting an appointment for the next is unlikely. With a DPC membership, you get all of these benefits and more.

If it seems like everything is a subscription these days, that’s probably because it is! And with good reason: subscriptions are the best way for a business (of any kind) to offer high-quality service and support over a long period of time.

You may have heard of a similar model called “concierge medicine”. While there are similarities with DPC, the two are different in some fundamental ways. For starters, concierge practices often bill your insurance in addition to a monthly fee (though some don’t—which makes them DPC practices!). This means they’re still a part of the insurance industry’s ridiculously complex reimbursement system, so they have to hire administrators to handle all the paperwork. This gets reflected in your monthly fee; the average concierge practice bills $200-300 per month. By comparison, DPC memberships cost approximately as much as your cell phone bill, or less. 

Absolutely! To be sure, your DPC provider will always be there for you if you get sick or hurt. But they also work proactively to keep you healthy, happy, free of preventable diseases and living a good lifestyle.

Direct Primary Care eliminates the need for insurance for this level of care. There are no co-pays, no deductibles, and no hidden fees. The monthly flat fees are more predictable financially and go directly to the practice. By eliminating the practice of billing for every service performed, the care team can focus solely on the patient-provider relationship and develop an individualized health plan for each person and/or family. By freeing up time and reducing costs, we can focus on your well-being.

Yes, by all means, keep your insurance to cover specialty care, hospitalizations, high-cost imaging, medications, and true emergencies. Plans that work best with Direct Primary Care include catastrophic plans, high deductible plans, and PPO plans. You may want to review your insurance plan options during open enrollment periods to see if you can lower your costs with one of the above-mentioned plan options.

DPC participation is not permitted under Medicare A&B. DPC participation is  however permitted under Medicare Advantage.

No. Federal law prohibits using HSA funds for Direct Primary Care, but new laws have been presented to make membership fees allowable for HSA expenses. Until the current law is changed, however, HSA funds cannot be used to pay Direct Primary Care fees.

We will continue to coordinate care. Your insurance plan should be used for specialty and hospital care.

We strive to address your needs, questions, and refills during office hours but recognize situations that require after-hours care. If you have a concern that needs to be addressed, but don’t necessarily need to be seen, a member of our healthcare team will be available to communicate with you after hours. Although we want to avoid unnecessary trips to Emergency, if you are experiencing a true medical emergency, please call 911 or go directly to Emergency.

Yes, providing a Direct Primary Care membership plus a comprehensive insurance plan for all other healthcare services makes financial sense. If you’re interested, we can set up a monthly payment plan.

Telemedicine is the practice of providing clinical care to patients at a distance using telecommunications technology. In other words, it is a method of treating patients using the internet and telephone. This can take the form of real-time video visits, secure email, or remotely monitoring a patient’s vital signs.

The terms telemedicine and telehealth are often used as if they were the same thing, but technically telemedicine is a subset of telehealth. Telehealth also includes non-clinical uses of telecommunications technology such as self-monitoring, provider and patient education, and medical records management.

This is determined on a state-by-state basis. For example in California and many other states, it is not necessary for the provider/patient relationship to be established in person. However, a prior in-person visit is a requirement in Texas.

This depends on the specific application, but in general, telemedicine software is designed to be as easy to use as other familiar modern applications. Patients and providers with a basic familiarity with online apps should be able to quickly figure out how to use a telehealth application.

In many cases, yes. Many insurers voluntarily pay for telemedicine visits and 26 states have laws requiring them to do so. The laws vary, so it makes sense to learn more about the rules in the state where you live.

Yes, but only when it is conducted using an encrypted platform that was designed for the purpose. Consumer apps like Facetime and Skype are not secure enough for video visits.

The quality of telemedicine as a method of healthcare delivery is confirmed by decades of research and demonstrations. Telemedicine has been found to be a safe, cost-effective, and convenient way to provide healthcare services.

Telemedicine gives patients the opportunity to receive care without a trip to the provider’s office. They don’t have to take time away from work or family responsibilities. They don’t waste time traveling, or money on parking or public transportation. They don’t risk exposure to other patients with communicable illnesses. And they get better health outcomes and become more engaged in their own healthcare.