These are some of the mostly commonly asked questions about our practice, the care we provide, and the direct primary care model.
Direct Primary Care, or DPC, is a model of healthcare that puts patients first by getting rid of the red tape that constrains traditional practices. How? It's simple: we don't accept insurance, and – believe it or not – this actually saves you money in the long run.
You won't have to pay a co-pay for office visits or routine physicals. Also you'll be able to avoid many visits altogether by sending your questions directly to us via email and text – something you won't get from a traditional practice. We've negotiated amazing deals for blood tests, X-rays, and MRI/CT scans on your behalf and help find you coupons for discounted medications. If we had contracts with insurance companies, we would be legally obligated to charge higher prices because of the rates THEY set.
More importantly, since you are getting all this amazing care from us, you can cut way back on your insurance premiums. Most DPC patients find a high-deductible, low-premium insurance or health-share plan so they're covered in the case of a major health issue. You can leave your day-to-day healthcare to us, like having a doctor in your family.
Of course! Everyone benefits from a service tailored directly to and accessible to them. That’s why we offer truly custom healthcare. We’re here for you if you're sick or hurt, but we also help you proactively maintain good overall health. Every visit with us will be thorough, relaxed, and as long as you need to address your health concerns. The longer you're our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.
The terms are often mistakenly used interchangeably, but they are not the same. Both DPC and concierge practices charge a periodic fee, however, under the concierge model, this fee only gets you access; that is, it doesn't actually cover any of your care. Instead a concierge practice still bills insurance for your visits. Under DPC, your visits and other care are included in your fee, plus you're provided with other incredible benefits like wholesale pricing for labs and radiology studies, deeply discounted prescription prices, telehealth services, direct digital communication with your doctor, and all the rest.
Here’s a few articles that profile the Direct Primary Care approach to medicine:
The fee covers primary care visits with no copay. This includes the following: annual wellness exams, sports physicals, school physicals, chronic care office visits, follow-up visits, teleahealth visits, basic office procedures and treatment of acute illness or minor injuries, all with minimal wait times in the office. The fee also covers direct communications with your doctor: phone, text, video chat or email. In addition, a full review of your lifestyle with a tailored plan of care full of evidence-based recommendations.
Our patients will also have access to discounted labs, prescriptions and special procedures not included in the membership fees.
We treat all kinds of common everyday problems like colds, flu, strep, rashes and injuries. We also treat more complicated long term medical problems like adult diabetes, high blood pressure, high cholesterol, thyroid disorder, and general men and women's health. All of these conditions, including acute and urgent problems can also be treated via telehealth or telemedicine regardless of where you are located in Texas.
For starters, having such unprecedented direct access to your doctor will limit hospitalizations and specialty referrals in many cases. However when those types of care are required, we will certainly continue to work with your hospital team during your hospital stay as well as work closely with any specialist. Depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.
Yes. We are happy to accept the children of our enrolled clients from age 5 and up. See our pricing page for details.
Of course! Physician access is one of the greatest benefits of the direct primary care model. Because illness and injury do not respect regular office hours, you may call or text your physician whenever you need.
Of course – this sort of care is "baked in" to the DPC model. Because you'll have your doctor's email and phone number, you can reach out to us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation. We’ll also locate the nearest pharmacy, lab or imaging facility and order the most appropriate things for your circumstances.
We maintain high standards of patient privacy. We will never provide your health information to any third party unless you specifically ask that we do so. When you pay cash for services, only you know your business.
Charges will be added and applied to your preferred method of payment.
We expect to have an open, honest, respectful relationship with you. If you are dissatisfied with our service and we can't resolve the issue together or if your needs change, we will gladly allow you to terminate your membership per your membership agreement.
Unfortunately, no. Your retainer is not yet defined as a "medical expense" in most states and as such is not deductible. Please discuss with your tax consultant to clarify tax consequences in your particular circumstances. We can also help you understand this better during your initial consultation.
All DPC clinics are fantastic options, however we are different in that we offer the added benefit of thoroughly discussing your lifestyle with a comprehensive review of your Nutrition, baseline exercise/mobility, the quality of your sleep, causes of stress and how you manage it, how smoking or alcohol may be affecting your health and a general overview of your environment. All this information gives us the insight to recommend evidence-based changes to optimize your health. Plus, we walk with you along the way one-on-one and soon will be hosting webinars, cooking classes and other group activities to help learn more from each other!
No, fortunately for both you and us. Perhaps the most critical distinction in our model of care centers on a direct, personal relationship between you and your doctor. That directness carries over to our business model as well. You might use your auto insurance to fix a smashed fender or other major damages. But you'd never use it to get an oil change, regular maintenance, a minor scratch (or pay for gas!). For some reason, health insurance is currently being used for the equivalent of oil changes and things like that for humans - routine physicals, office visits, simple blood tests, and minor procedures. This just doesn't make sense, it only increases the use of your health insurance which leads to increases in premiums.
We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee removes us from the typical contractual agreements that prevent insurance-based offices from offering wholesale prices on laboratory tests, imaging, and medications.
Yes, we take care of any patient regardless of your insurance situation. Since we work completely outside of the insurance system, none of the billing for care with us is eligible for insurance reimbursement. However, we recommend that everyone have some form of insurance coverage, which is still important in the event of a major health issue - high deductible plans with an HSA or health-share plans are two great options.
Yes. We recommend our patients continue a major medical plan with a high-deductible and health savings account. If you experience a major health issue, you will still need insurance to help cover it. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.
Absolutely! We will be taking Reservations for you to start with us in April 2021.
As the Affordable Care Act was being drawn up, several doctors worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Care practices like ours to be a legal option under the health reform bill. Once the health exchanges open in October, many people will understand that a Direct Primary Care practice is an approved option.
In short, the best option for many patients will be an “exchange qualified” major medical type plan combined with a Direct Primary Care provider like our practice. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients. However, under the 2019 administration, citizens are no longer mandated to have health insurance, so no federal penalty or tax fee exists now. Some states outside of Texas may still impose a state-mandated fee.
The Direct Primary Care practices have the ability to decrease the cost of insurance by 30-50%, thus eliminating the need for ObamaCare-style regulation because we can make health insurance affordable again.
You may want to check with your human resources department regarding the use of Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) as possible payment options for your membership. If you are unable to use these funds to pay for the membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for certain services provided through our office.
Unfortunately, no. Your retainer is not yet defined as a "medical expense" in most states and as such is not deductible. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.
Traditional health insurance is expensive and only continues to increase in cost for everyone. Many people including employers can't afford to pay for traditional insurance for their family or employees. For small/medium businesses and people those stuck in the middle there is another option. A health-share plan acts as a backup to you paying cash for your health services. Sedera Health is one we recommend. You pay a lower monthly premium, pay up to a capped amount per medical need and they negotiate cash rates for you with specialists and hospitals so you don't have to. Your monthly premium is lower and the larger health costs of the group are shared by all the members. We can help guide you to see if this can work for you, your family or your employees (and you get a discount in your health-share premiums for having a DPC membership!).
Lifestyle medicine seeks to address changes from a personal to societal level that may have impacted your health or may be preventing you from full recovery. Traditional medicine approaches and advancements in science are great but may not always offer the best solution for each person. Lifestyle Medicine offers patients new hope that certain conditions can be prevented, reversed and better managed- Lifestyle can be part of your solution.
Lifestyle medicine incorporates principles of all these styles of medical practice. The 6 pillars of lifestyle medicine focus on regular exercise and movement, healthy nutrition that is primarily whole food plant-based, restful and adequate sleep, stress reduction and management, an environment of positivity in healthy relationships, and avoidance of harmful substances. Integrative or alternative medicine have evaluation and treatment approaches that can be applied in each of the lifestyle pillars, tailored to your needs. Holistic medicine simply means the focus in on the "whole" person, isn't that what the Practice of Medicine should be? We sure do think so!
Are you ready to become a member? Great! We’re excited to have you on board. Fill out the form to get the ball rolling.
Still want to learn more about direct primary care or our practice? Check out our FAQ page for answers to many common questions.
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