What do you mean you don't take insurance?!
It's a common response. Even though we don't take insurance, you should still keep your insurance for specialists, prescriptions, hospitalizations, and emergencies. This model of care is designed to optimize your health and minimize your healthcare expenses. Really! Read on...
What is Direct Primary Care?
Approximately 90 percent of health care services provided today are referred to as primary care or preventive medicine. Placing these services under the umbrella of health insurance has driven up the cost, making even basic care unaffordable for many Americans. The very poor and the very rich seem to have consistent access to healthcare, but the majority of people in the middle class are consistently being charged prohibitively high amounts for health care. Insight Primary Care is part of a movement in America to provide patients with a “Medical Home”. Utilizing technology and creating small practices makes it possible for clinicians to spend more time with patients, to help coordinate their total health care, and decrease utilization of hospitals and specialists. There is a higher level of satisfaction of both patients and clinicians who operate in small, Medical Home practices.
Why Direct Primary Care?
This model of care allows the two people most invested in your health --you and your provider-- to be in control of your primary health care. This plan results in significant savings: money, paperwork, and time. You are able to see the provider you want, who will have the time to address your needs at a relaxed pace.
I have good insurance. How is paying a membership fee going to save me money?
Familiarize yourself with what you have been paying for health care. How much is taken out of your paycheck? How much is your monthly premium? What is your copay for office visits? What is your deductible? How much did you spend on health care for your family last year? We’ve done the research: About 75% of our families will save money in Direct Primary Care and will know their costs upfront; no more surprise bills from insurance. After you crunch the numbers, feel free to call, email us, or come in (no charge) to discuss further.
Are you a “boutique” or “concierge” practice?
No. The terms above typically refer to medical practices that provide enhanced access similar to us (same-day visits, direct email and phone communication with the provider) but involve high annual membership fees, sometimes as high as $10,000. By keeping our overhead low, we are able to offer similar services at a fraction of the price.
Do I have to be healthy or have health insurance to become a patient?
No. Anyone can become our atient. We do not deny patients because of their age, race, religion, or sexual orientation, economic status, or employment status. We also do not deny anyone for pre-existing conditions of any kind.
I don’t go to the doctor very often. Do you have a “healthy person” plan?
Limiting the number of times you can come in would put limits on your care. The goal is for our patients to enjoy the unlimited access that Direct Primary Care offers. You can call and speak to your provider directly. You can email us. You can have electronic visits with us. In addition, you may find that you are more motivated to address important health issues because you have no limitations and won’t be worried about unforeseen costs coming back to haunt you later. For these reasons, we do not offer a limited “healthy person” plan.
When can I join?
Anytime! We accept enrollment year-round. Once you're a member, you can start taking advantage of the services immediately.
What if I want to cancel my membership or change practices?
Normally memberships are for an entire year and there is a small discount for signing up for the year. Also, you may pay monthly but we ask that you start with a minimum of a three-month commitment. We understand that circumstances do come up. For example, if you move out of state, you may be entitled to a refund of unused months. If you decide to cancel your membership for any other reason, we require thirty (30) days written notice. Once you change practices, we will forward your medical records to your new provider.
Is it a good idea to have medical insurance for serious illness or injury?
Yes. Because our practice is not an insurance company, we encourage those who can afford traditional health insurance to purchase it to protect yourself from large, unanticipated costs associated with serious illnesses or accident. Remember that a “catastrophic” or high deductible plan through your employer is significantly less expensive than a PPO-type plan which covers everything. Pairing a high-deductible plan with a Direct Pay Model for primary care can save you hundreds to thousands of dollars a year.
Will you bill my insurance plan for your services?
No. With the Direct Primary Care model, we do not bill any insurance carrier for our services. Your insurance plan may be billed by others for services such as emergency, hospital, specialty care, laboratory tests, diagnostic imaging, prescription drugs or other goods and services that are ordered by your health care provider but are not performed or provided in our office.
Can I get a discount on my monthly fee if I don’t use all your services or seek care infrequently?
No. Like a health club membership, our care and services are at your disposal whenever you need, even at times that you cannot predict.
If I become seriously ill, will my monthly care fee increase?
No. Your fee will not change based on changes in your health condition. Your fee will only change if we ever have a general fee change. If this were to occur, you would be given at least thirty (30) days notice of such changes, and your fee would not change more than once a year.
How do I pay for services?
You may pay by cash, credit card, or check, and we are happy to set up an automatic withdrawal with whichever account you choose. If you have a Health Savings Account (HSA) or a Flexible Spending Account (FSA) , you may pay your fees with those accounts. Please check with your plan administrator.
What if I have to see a specialist or have an emergency?
When your medical needs extend beyond the scope of primary care, we will refer you to an appropriate specialist. We will provide that specialist with relevant portions of your medical record needed to optimize your care. When his or her evaluation is complete, your clinician will coordinate your follow-up care. Please note that your care fee does not cover outside specialty care. If you have insurance, we encourage you to check with your insurance carrier to ensure your specialist will be covered by your policy.
Are prescription medications included in the monthly fee?
No, though your clinician can write a prescription for any of your medications, the cost of these prescriptions is not included in your monthly fee.
What about other medical expenses, such as lab, x-ray?
In-office lab testing including rapid strep, rapid flu, urinalysis, glucose, and any microscopic exams done in office are NO additional cost. ANY lab that needs to be sent out for testing will be the responsibility of the patient. We have special pricing through Quest Diagnostics which may result in substantial savings, or if you wish we can ask the lab to bill your insurance as is customary in other settings. We do have agreements with local radiology facilities that offer low-cost imaging studies for cash pay. This is usually less than 50% of what they would charge the insurance company. However, just as with your labs, you may choose to have the radiology center bill your insurance directly.
How will you have enough time to care for my family and me?
Most primary care providers care for several thousand patients (average is 2300) and Mark has had as many as 2000 active patients at previous practices. At Mark Baravik Family Practice, a limit is placed on the number of patients so that you are given timely and complete care.
How is information communicated?
Prescriptions are sent electronically from the medical record to your pharmacy. Most referrals, lab, and test orders will also be handled in this efficient way. Lab and test results will be electronically imported into your electronic medical record. There is a secure communication portal used for communication between you and your provider. Often, Mark will call with your results so he may address any concerns you have.
How do I email my provider?
We use a HIPAA-compliant, encrypted email system on the patient portal through an electronic medical record system. It is free for patients to sign up. You can expect a reply usually within 48 hours, although during weekends, holidays or vacations, it may take longer. If you do not receive a response during the expected time, assume the message was not received. If that happens, please call the practice with your question or request. Please understand that medical advice can only be provided to registered patients.
What do I need to know about email?
Email is fast, convenient, and efficient. It works well for many non-urgent questions, requests, or messages you may have for our office. While email can be a very effective tool, it is not a substitute for a physical exam or counseling by your clinician. It is also important to recognize that the confidentiality of email exchanges cannot be guaranteed. While the security of e-mail is comparable to other types of communication (such as phone calls), there are some special issues with e-mail:
1. If your employer provides your email account, all the messages sent to that address may be the property of your employer.
2. If your family shares an email address, other family members may see your messages.
3. There is a small risk that messages may be intercepted by others over the internet (“hackers”). However, we have employed IT experts to ensure our information is as secure as it can be.
4. Generally, the providers handle their own email, but it is possible that a staff member or covering clinician for the practice may have access to email messages.
5. By law, email communication between you and our office will likely become part of your permanent medical record.
6. Please respect our Clinicians judgment when they ask to see you in the office, rather than communicate about a difficult health issue by email. Ultimately we are here to take care of you and make sure we give you the best care we can.