We are very happy to open our practice based on the direct primary care model, and serve our patients in a caring, timely and efficient manner. It has been our pleasure to work with you since January 2015! (Please see our town hall meeting video for information on our practice, or watch the videos below.)
Once you are accepted as our direct primary care patient, we will have an initial appointment with you to discuss your health situation, establish your payment method and generally get to know you. After becoming our patient, we think you’ll find it very useful to be able to call us, and one of us will always answer if we’re not already with a patient, text us and email us. Short-term appointments will be an option for you.
Frequently Asked Questions:
What is direct primary care?
The direct primary care model is a growing model of care that acknowledges that what we do should not be dictated by an insurance company but should be based on the trust relationship that a physician and family can build.
Because we spend less time dealing with the rules of insurers and more time with you, our patients can expect prompter appointments, more time for visits, and addressing your health in a way that is right for you rather than for your insurer.
Is this considered concierge medicine?
This article on the difference between concierge medicine and direct primary care has a great answer to this question. In essence, the most important characteristic of DPC practices is that insurance claims are not filed for medical visits. Direct primary care’s definition, therefore, is any primary care practice model that is directly reimbursed by the consumer for both access and primary medical care, and which does not accept or bill third party payers.
How are immunizations covered?
We will file insurance for childhood immunizations.
Why are you doing this?
Our goal is to offer a practice that serves our patients and community in an affordable personal partnership towards better health. Basically, we want to practice the medicine we’ve always wanted to practice!
Why don’t you accept health insurance?
We do not believe that insurance is needed in the primary care office. We use the analogy of insuring your car for when it gets totaled, but not for routine oil changes and new tires. We believe that third-party payers have driven medical care in America and it is our belief that for primary care, this is not best. Without the added complexity of coding, documentation, prior authorizations and co-pays, primary care can be delivered much more efficiently, and we aim to do just that!
Do I need some type of insurance still?
Yes, even within the direct primary care model, we do think every person needs a high-deductible catastrophic insurance plan that covers hospitalization and prolonged severe illness.
What’s wrong with our current healthcare system?
Primary care in America is in trouble. The typical primary care doctor has 2,300 patients. It is estimated that to truly care for 2,300 patients, the typical doctor would have to work 20 hours per day [reference]. Insurance for the average family of four costs over $16,000 annually and is increasing much faster than the average pay raise [reference].
Will you be partnering with a hospital in the event that hospitalization becomes necessary? user-added question
We do not currently have admitting privileges at a hospital. We have had a longstanding good working relationship with Mercy in Rogers and plan on continuing to maintain a friendly relationship with them. If you are admitted to the hospital we will work closely with the doctors and specialists providing care for you if the need arises.
My employer requires proof of medical coverage and won’t allow me to opt out. Do you have plans in place to satisfy those requirements, and/or avoid the Affordable Care Act penalties for being uninsured? Or is catastrophic coverage sufficient for those purposes? user-added question
Our model is not insurance and will not meet the criteria for the Affordable Care Act. A catastrophic plan might. If you need help finding a qualified insurance broker who can help you ensure that your coverage is adequate, please let us know.
Can you pay the monthly fee from a Health Savings Account (HSA)? user-added question
Yes !
Do you offer direct primary care for businesses?
Yes! Please see this page.
What exactly does “always on call” mean? Will patients still be sent to the ER (huge bill) on holidays/weekends if care is needed? user-added question
What we mean when we say always on call is that you will always be able to reach a doctor. You can talk with us about what is happening and we can help you determine if the emergency room is really the right place. Sometimes, it is. Often times, it is not. If it is not the right place, we will help you figure out the best plan. Because we do not have to worry about the confines of insurance reimbursement, we can provide care whether you are in the office or not. Because we will have substantially fewer patients, we will know who you are and feel comfortable that the plan that we are creating is best for you.
If I need lab, is that extra? If so, can I have that done at an independant lab facility that would be approved under my insurance? user-added question
Labs with your annual physical are free. If you have a more comprehensive insurance plan, we can order a lab at the facility of your choosing. If you do not have a more comprehensive insurance plan, you can review our lab prices below. (effective 1/5/2015, with pricing based on having labs done at Quest, and subject to changes in their pricing.)
Lab | Price |
---|---|
Glucose | $2.50 |
Hemoglobin A1C | $7.50 |
TSH | $6.00 |
Vitamin B12 | $9.00 |
AST/ALT | $2.50 each |
CBC | $4.00 |
CRP | $9.00 |
PSA | $9.00 |
Cholesterol | $7.00 |
BMP | $4.00 |
CMP | $5.00 |
Liver Enzymes (HFP) | $3.00 |
TESTOST (Free & Total) | $35.00 |
Vitamin D | $25.00 |
PAP | $27.50 |
HPV | $35.00 |
Pathology | (est) $50 |
(This list only includes commonly done labs and does not include all the labs that we have access to. If you have questions about other labs, please let us know and we can give you specific pricing before the lab is drawn.)
Also, are there different plans for someone who visits the doctor twice a year vs. someone who has a chronic illness like diabetes that requires more frequent visits? user-added question
We do not offer a different plan based on your number of visits because the fee for service model that currently exists is one of the reasons why it is so hard to see your doctor regularly. If a doctor’s office only gets paid when you actually come in, it becomes that office’s goal to primarily address health concerns with visits, even if this is not the best option, whereas it may become the patient’s goal to not come in due to financial or time constraints, even if that is the best option. Our currently monthly model allows for you and for us to address your health concerns in the way that most makes sense rather than forcing us into interactions that your insurer requires in order for them to consider it “healthcare.”
How does this affect people on Medicare? Will the doctors be allowed to take our medical records with them from Mercy? user-added question
We can see Medicare patients, but our monthly fee cannot be paid by Medicare. We can order labs and imaging as well as make specialist referrals, all of which can be paid by Medicare.