Direct Primary Care (DPC) Frequently Asked Questions
What is Direct Primary Care (DPC)?
A membership program in which patients pay a monthly or yearly fee instead of paying a copayment at every visit and billing insurance. For this membership fee you can have unlimited access to your personal physician.
What does the membership cover?
Routine and urgent office visits
Well child exams, including school and sports physicals
After hour visits as needed to prevent urgent care and emergency room visits
Home calls can be arranged when coming into the office is difficult
Basic office tests (urinalysis, strep tests, pregnancy tests, blood pressure checks)
Office screening tests (vision screening, hearing screening, respiratory peak flows)
Basic in-office procedures (laceration repair, skin lesion excision, cryotherapy, nebulizer treatments, etc.)
Same day or next business day appointments
Significantly reduced lab costs
What does membership not cover?
Hospitalizations, Emergency Room visits, outside labs, pathology services, cultures, imaging studies (x-rays, CT scans, MRI, ultrasounds, etc.), evaluations by other physicians and specialists, physical therapy, immunizations, and prescription medications. EKGs will have a charge from the cardiologist for interpretation.
What is the advantage of DPC?
By limiting my practice to about 400-500 patients, I can give you prompt and personalized care tailored to your needs. You would get same day and next day scheduling with no wait. Extended visits of an hour or more could be scheduled, if you’d like! You will have quality time with your physician, answering all your questions. Home visits could be arranged. All this care from your physician that knows your story inside and out.
Is DPC like insurance?
No. You should still carry major medical insurance and consider a health savings account. Health savings accounts may pay for a membership fee. You would need to check with your employer, financial advisor or CPA.
Why would a doctor consider DPC?
The average physician spends about half their day providing medical care and about half their day doing clerical and administrative tasks such as insurance forms, figuring out complex coding requirements, negotiating with insurance companies over prior approvals and computer work. This problem has been getting worse and I expect will get continue to get worse. All of this additional work takes me away from spending time with patients and my family. Without the burden of extra work that insurances require, I can work directly with my patients and provide personal, comprehensive care that is best for you.
Can I become a patient if I have Medicare?
Yes. You will need to sign a waiver declaring that neither you nor I will bill Medicare for my services. Your Medicare will cover all medical services that you receive outside of my office, just as it always has. This includes lab testing, X-rays and other imaging, medication, specialists and hospitalizations.
I am fairly healthy and I don’t go to the doctor very often. How does this benefit me?
Everyone benefits from health care tailored to their needs. You will get the care you need to optimize your health, conveniently and thoroughly. I would encourage you to come in for a Wellness Visit. Most of us end up get ill or injured and need care. When this happens you will see a physician that knows you and can take this into account when developing a treatment plan. If we can prevent just one ER visit, you will probably save a year or more of membership fees.
Are membership fees tax deductible?
Right now, it is not clear. Please check with your tax consultant. The membership fee may not be a “medical expense”. There is a move in Congress to clarify that these fees are medical expenses.
How do I pay my membership fee?
The fee can be paid monthly, or annually. The annual fee has a 10% discount compared to the monthly fee. We prefer the monthly payment be an electronic charge to a debit or credit card on a set day of the month.
What if I need to go to the hospital?
Our hope is that being more available will prevent or reduce hospitalizations. You may go to the hospital of your choice. We will work with your hospital doctors and arrange your follow up after you are discharged.
Can I just wait and join when I have a problem?
We suggest you join before the problem arises so we can get to know you. Dr Dust will only accept a limited number of patients. After about 400-500 patients, a waitlist will be created.
Do patients need to sign an agreement?
Yes. You will be asked to review and sign a Patient Agreement. This is to make sure you understand direct primary and the membership fee. If you have Medicare, you will need to sign a waiver that you understand neither you nor I will bill Medicare directly for my services.
Is Direct Primary Care the same as Concierge Medicine?
These terms are often used interchangeably. However, concierge medicine is more often used as the term for any practice with a membership fee, and especially for a practice that continues to accept insurance and often has much higher fees. Direct primary care is direct- between the patient and the physician. Insurance is not accepted, and the cost is usually quite a bit lower. It is sometimes referred to as concierge for the common person. Boutique and retainer practices are other terms occasionally used.
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