"Direct Primary Care" means the physician works directly for the patient. The physician provides the patient with primary medical care without insurance or government involvement. The physician sets a fixed monthly fee and the patient pays this directly to the physician. The physician and the practice will not bill insurances for care.
While this is a big change for many patients, it has many advantages. Removing the middlemen (insurance) from primary care makes it affordable for most patients, less than the cost of typical cell phone or cable plans. Without the restrictions of insurance plans, physicians have more time for each patient and can address additional problems at one visit. Flexible, open schedules reduce unnecessary ER visits. When medically appropriate, some care can be managed over the phone or via secure messaging, without an office visit - saving time and money. Multiple problem visits, shorter waits, flexible office hours and more care outside of office visits means less time lost from work or family.
Direct Primary Care is NOT insurance and patients are strongly encouraged to have insurance coverage for emergencies and large medical expenses. Many patients and employers find a lower cost, higher deductible insurance plan works well with direct care and saves more than the price of a direct primary care membership.
Additionally, "out of network" reimbursement may be approved for some visits depending upon a patient's insurance policy. We will provide visit documentation that patient's may submit to their insurance twice annually as part of membership in the practice. Additional forms may be available for a small fee. Whether or not an insurance policy allows this reimbursement varies widely, check with your current insurance for information.
Most insurances, except HMO policies, will cover tests, consultations and procedures ordered by out of network providers. Again, check with your current insurance to confirm this and get details.