Frequently Asked Questions

How does Direct Primary Care (DPC) differ from the traditional (fee for service) model?

There are several key differences between DPC and the fee for service model. These are highlighted in the table below. The concept of direct primary care was developed as a way to deliver the type of care that both providers and patients envision, without the challenges that accompany the involvement of 3rd party insurers.

DPC Fee for service
Payment for services Monthly fee paid by patient Insurance billed then provider reimbursed
Average number of patients 400-600/provider 1500-3000/provider
Allotted time for office visit 30-60 minutes 15-20 minutes
Provider accessibility Excellent Variable
Ease of communication with office/provider Excellent Variable

What services are included with membership fees?

The monthly fee covers a wide range of standard outpatient primary care services.  In office visits, telehealth appointments and all communication (phone, patient portal, email, text) are included and unlimited.  Other covered services would include chronic disease management, acute care visits, guidance on healthcare maintenance/screening and some procedures.  Certain point of care testing such as EKG, urinalysis, flu screen, etc will be included as made available.  Over time, we hope to add blood draw services within the office to be included in the monthly fee, and in turn have the ability to offer lab testing at low cost to our established patients.    

How are services paid for?

Unlike the traditional healthcare model, insurance is not accepted or billed in our office.  Instead, the patient is responsible for a monthly recurring payment (much like a gym membership) and in return has unlimited access to the services offered.  Automated monthly payments will be encouraged via credit/debit card or ACH transfer.  Payment can also be made via cash or check.  While not necessary for our services, patients are encouraged to carry some form of insurance for the purpose of prescriptions, hospitalizations, emergency room visits, specialist consultations, diagnostic testing (labs, pathology, imaging), etc.

Why should I pay out of pocket for something my insurance will cover?

This is a question that can only be answered by each individual. We believe that we have the ability to offer a level of service that is unmatched by the traditional model of care. We understand that access, attention, and effective communication are vital to quality primary care, and we feel that patients value these qualities as much as we do. While certainly there are patients that are satisfied with their current care, we acknowledge that many patients are frustrated with the traditional model and are longing for a better experience. By simply having more time to spend with patients and communicating more effectively, we believe that we can handle many issues that arise and as a result minimize urgent care/ER visits, limit specialist referrals, and avoid unnecessary testing, all resulting in saving money in the long run.

How does DPC differ from concierge medicine?

Both models are membership-based forms of care and in reality, most of the core features are the same for both. That said, DPC practices don’t generally accept/bill insurance and monthly fees paid by the patient are significantly lower. Concierge practices on the other hand will often bill insurance for services, as well as charge a much higher monthly membership fee that patients also pay.