What is Direct Primary Care
Direct Primary Care is a month to month membership that “Plan Dependent”, will allow you 24/7 access to Primary Healthcare. Appointments same day or next day are the norm. No Co-Pays, no Insurance paperwork or billing to worry about.
How Does Direct Primary Care Work
Direct primary care is an alternative to paying for healthcare on a fee-for-service basis (Currently used by most clinics). It’s not so much a new system as it is a throwback to former days.
There was a time you went to see the doctor with the expectation of receiving care. More recently the healthcare system has turned a visit into a kind of commodity. Systems are trying to produce a billable event, which can only be achieved by hitting specific items on the checklist. The items may or may not be what you’re expecting, but if you are expecting care, your insurance might not pay for that. With fee for service billing a doctor working in a clinic environment must make so many visits happen daily in order to make a decent living. The first person making money in this scenario are the insurance companies.
Most doctors want to do a good job. They want to feel like they are doing the right thing for the patient and not chasing the bureaucratic whirlwind. However, they also need to make a living. Unfortunately, physicians often find themselves working for hospitals and multi-specialty groups that require them to see 20 and 30 patients a day, practicing medicine with one hand tied behind their backs. There is no time to listen; there’s no time to do the right thing, or to figure things out, or to discuss alternatives. At the end of the seven minute visit, all these doctors can do is refer the patient or prescribe a pill. A lot of the ills of the healthcare system can only be cured with the one thing the doctors are not given: TIME.
So along comes direct primary care. This is a system that allows doctors to work for patients and ignore the interests of insurance companies and multi-specialty groups. In direct primary care, the goal is to generate the greatest value for the patient. Sometimes that means rapid access to specialty for a serious problem recognized by the primary Doctor; sometimes it means watching and waiting according to the priorities and values of the patient; sometimes that means a patient becomes equipped to maintain their own health.
Patient Direct Care plans are purchased by the patient directly and so the doctor answers only to the patient. We are here to do the right thing and do our best not to put you at risk. In many instances, our patients are very fortunate to have an employer purchase the option on their behalf because that employer has understood and recognized the advantages for the health of their employees. Regardless of your payment plan, we hope you understand the impact direct primary care can have on your total health. Thank you for letting us serve you!
Is this considered health insurance or a health insurance plan?
No, it is not an insurance plan or agent for any insurance company, and we do not offer insurance plans. Patient Direct Care plans are monthly subscription membership for primary care services at a competitive price at our clinic.
Can I become a member if I have a pre-existing condition?
Yes, you will be welcome. We will not deny membership for age or pre-existing conditions.
Can I still join Patient Direct Care if I have Medicare or Medicaid?
Yes, We have concierge programs that address that need.
Can I become a member if I don’t have insurance?
Yes, Patient Direct Care is open to everyone, regardless of whether they have insurance or not.
I have health insurance. How does that work with my Patient Direct Care membership?
A membership with Patient Direct Care plans work best with a high deductible insurance plan or with self insured companies, as well as individuals that have no other insurance. Your insurance plan may cover all the outside testing, referrals to specialists and hospitalizations that may be required outside of your membership with us.
What services are provided?
Will my office visit result in a fee?
This is also plan dependent, only one type of plan pays for an office visit, and that’s a plan that is for Telemedicine Only. All other plans include office visits.
Do I need to inform a staff member when I arrive that I have a Patient Direct Care Membership?
Yes, knowing that your membership is through your employer will move things along quicker.
I need to go to the hospital. Will my membership cover hospital visits and/or emergency room visits?
No, your Patient Direct Care membership does not cover these visits. Our purpose is to keep you healthy by providing easy and inexpensive access to a doctor or nurse as needed. Emergency room visits should be for catastrophic, or unplanned issues than can not be resolved at the Primary Care level.
Is my membership tax deductible?
Unfortunately, no. But considering the movement in congress to alter the current healthcare system, this may change in the near future.
Will my medical information be shared with insurance carriers or pharmaceutical companies?
No, we never share your information with outside parties unless you, the patient, request information be shared.
Do you perform sports physicals?
Yes! We are happy to offer sports physicals and fill out appropriate forms as needed.
Are immunizations included in my membership?
Patient Direct Care will post a list of covered immunizations, please review the details of each plan offering.
Do you see children?
Yes, Patient Direct Care is open to people of any age.
Can each family member see a different provider at Patient Direct Care?
Yes, however, currently we have two physicians available. Dr. Ramzi, and Dr Patti Moran.
I’m an employer. How do I enroll employee’s mid-end month to ensure they are active?
Employers have 2 options:
1. Employers can log into their HINT account that is setup for them when we are contracted to provide service and make any additions or deletions of covered members.
2. Employers can contact our membership line 999-5165, or send an email to email@example.com and ask our office to make deletions or additions.