Frequently Asked Questions
What is direct primary care (DPC)?
Direct primary care is a healthcare delivery model. It’s a subscription to primary care—without involving health insurance. For a flat monthly fee, patients get direct access to the physician for all of their primary care needs. Think of primary care as the human equivalent of rotating tires or getting an oil change in a car. Could you imagine how much car insurance would cost if you submitted a claim…for every oil change? DPC doctors do not charge your insurance, which means no copays—and no surprise bills. DPC bypasses insurance, leaving only you and your doctor. This not only makes it feasible to provide unhurried office visits, but these visits are often available the same day or next day. The decreased overhead allows DPC practices to offer discounted medication dispensing, labs, and imaging. DPC doctors often offer secure texting, phone calls and even HIPPA-compliant video chats for increased convenience to patients.
Is Direct Primary Care the same as concierge medicine?
Good question! The terms “Concierge medicine” and “direct primary care” are often used interchangeably, but they are not the same. Both concierge and DPC practices limit patient panel size and charge a monthly or annual fee. Not only are concierge fees are higher (sometimes up to $30,000 a year), but a concierge practice typically continues to charge insurance and collect co-pays each visit. Billing insurance means that patients could be looking at surprise bills in addition to the co-pays and concierge membership fee. In this model, patients pay extra to become VIP patients with enhanced access. In DPC practices, all patients are valued.
Is DPC insurance?
No.
DPC is not insurance.
The monthly service fee is your payment for ongoing primary care services offered by your physician. We strongly recommend that patients do have insurance for care that may be needed beyond what we offer (specialty care, ER or hospitalization, surgery, etc.). Direct primary care pairs nicely with a high deductible “wraparound” or “catastrophic” policy.
Do you take my insurance?
No, we do not accept or bill health insurance. In the DPC model, we contract directly with the patient, not an insurance company, to provide quality care. By eliminating the restrictions and frustrations associated with health insurance, we keep costs low and spend as much time as needed with our patients. Insurance can be helpful in catastrophic situations, and we recommend that you do have insurance for emergencies, but you will find that much of the care you receive through Divergent DPC costs less than it would if you were using insurance.
If I have insurance, can I use it?
If you use Divergent DPC for your primary care, we will strive to keep you healthy and reduce the need for specialty care and hospitalizations, but there may be times that you will still need your insurance for specialty care, surgery, or hospitalizations. Divergent DPC is considered an “out of network” provider, but most insurances, except HMO policies, will still cover tests, consultations and procedures ordered by out of network providers.
If I have Medicare, can I still become a patient at Divergent DPC?
As September 1st, 2020 we are able to accept Medicare. What that means is we will bill your insurance like a typical practice in lieu of a membership fee. Standard deductible and copayments apply.
Are my Divergent DPC service charges tax deductible?
Great question. It is not clear. Charges for labs and medications, however, may be deductible. The laws are in flux, so please consult with your tax accountant or attorney to discuss your particular circumstances.
What happens if I need to be hospitalized?
By providing excellent care with virtually unlimited access to your doctor, we seek to prevent or reduce hospitalizations. When hospitalization is necessary we will collaborate with the hospitalist during your hospital stay. We are able, however, to make social visits to our hospitalized patients and encourage you to let us know if you are hospitalized.
Do you see children in your practice?
Yes! We are a family medicine practice that accepts patients of all ages, from newborns to nursing home residents. We do not currently provide routine vaccinations for young children, but as volume grows we hope to include these. And in the meantime, we will work with you to arrange necessary vaccines.
What if I need medical care while I’m traveling?
This is one of the benefits of being a patient of Divergent DPC—because we know you well, we can usually care for you even when you’re away from home. Many illnesses can be diagnosed and treated by communication through by phone, secure text, email, or webcam. If necessary and appropriate, we can call prescriptions into the pharmacy nearest you.
Will I have access to my medical records?
Our electronic medical record offers you 24/7 access to your medical chart through a patient portal. Your records are your property so you should be able to access them at your convenience and download them for free.
Do you share any medical records with insurance carriers or pharmaceutical companies?
No, unless you specifically request it. We take your privacy seriously, and we are not obligated to provide any third party with a copy of your records unless you specifically ask that we do and sign a release of records.
What if I’m not satisfied?
If you are not satisfied for any reason, please let us know! We will work together to resolve any problems. Open, honest communication is vital to our continued success. We care deeply about your experience as a patient, and we want to hear from you.
How long is the contract?
Divergent DPC operates on a monthly billing basis. There are no long-term contracts, so you may terminate your patient-physician relationship at any time. But we hope you don’t—please talk to us! If you decide to leave Divergent DPC or if your payments lapse, the fee to re-register is $350.
What is your policy on controlled substances?
At Divergent DPC, we prefer to do the most amount of good with the fewest medications possible. However, there are instances where controlled substances are a reasonable tool. This will be addressed case by case. We are able to prescribe suboxone and certify our members for medical marijuana.
No controlled substances are kept in the office.
If I enroll as a patient of Divergent DPC, when does billing begin?
When you register online through our billing software you will be charged a non-refundable registration fee. Your monthly billing will start on the day of your first visit with the doctor. Please note that care cannot be provided through electronic means prior to an initial intake physical exam.