NO. Direct Primary Care is NOT health insurance, nor does Family Doc Direct participate in health insurance plans.
No, Family Doc Direct is not insurance, and cannot replace your insurance plan. We strongly encourage you to carry insurance or health sharing coverage to comply with Federal Law. This ensures proper coverage if you ever need hospitalization, surgery, or specialist referral. A membership with Family Doc Direct offers the potential for huge savings when combined with a high deductible/major medical insurance plans or health sharing plans.
You are not required to carry health insurance to be a member of Family Doc Direct; however, we strongly encourage you to carry health insurance to cover for services that are not included in your membership, such as hospitalization, surgery and specialists visits.
Absolutely! However, we work for you. Thus, your monthly membership fee cannot be submitted to Medicare for reimbursement. You may need to sign a waiver that declares that neither you nor Family Doc Direct (Dr. Raus) will bill Medicare for your membership fees. You could still use your Medicare insurance for specialists visits, hospitalizations, labs, medications, x rays and scans, physical therapy, etc... You do not lose your Medicare coverage for other medical needs just because you are a patient of Family Doc Direct.
Many people sign up for Direct Primary Care because of the premium high quality service it provides. Even patients with "Cadillac" insurance decide that the low monthly membership fee is worth it to them, to have access to discounted medications, lab tests, scheduling convenience, longer and un-rushed appointment times, direct access to their doctor. However, because your membership with Family Doc Direct includes all office visits (no copays) and offers testing, many procedures, commonly prescribed medications at greatly reduced prices, our patients find it worthwhile to change from a high priced "Cadillac" health insurance plans, and instead combine their Family Doc Direct membership with a basic health insurance plan for substantial savings.
Under the Direct Primary Care (DPC) model, the patient (you) receives comprehensive primary health care directly from Dr. Raus. The patient pays for this care through a monthly fee, paid directly to Family Doc Direct. No third party interaction.
No they are not, and the key difference is this:
Concierge medicine is typically more expensive per month, charge an annual membership fee and also bills insurance. Insurance is billed for office visits and patients pay their copays just as they would at any traditional practice.
Direct Primary Care will not charge for office visits. Your insurance won’t be billed and you won’t pay a copay. We choose to work directly with the patient, providing greatly reduced labs and prescripstions, and other costs savings along the way.
The fee covers excellent primary care through as many as needed office visits, chronic disease treatment, annual wellness exams, basic office procedures, in-office testing, treatment of acute illness and extended access to your doctor via email, text messaging, telemedicine, all with minimal wait times in the office.
Our patients will also have access to discounted labs, generic medications and imaging.
This is another freedom we enjoy together as a result of independence from the restrictions of third-party payment. Because we know you well, we can coordinate your care when you’re sick away from home. Many illnesses can be diagnosed and treated with a simple conversation by phone, email, text or webcam. We’ll locate the nearest pharmacy and order the medications most appropriate for your circumstances. Up-north or at ocean shore, we could take care of your medical needs.
In providing superb care with unprecedented sorts of access, we seek to prevent or reduce hospitalizations and specialty referrals. In instances where those types of care are required, we will certainly continue to work with your hospitalist during your hospital stay as well as work closely with any specialist. In some cases, depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.
We maintain scrupulous standards of privacy. We are never obligated to provide any third party with a copy of your records unless you specifically ask that we do so.
Dr. Raus is available via phone, message or email and patients will be notified of any such events ahead of time. This is one of the big differences with Family Doc Direct compared to a traditional practice - you will ALWAYS have access to your doctor, not just an answering service. In the event you need to physically be seen while Dr. Raus is unavailable, she will collaborate with trusted area physicians to ensure her patients receive quality care.
To ensure that Dr. Raus has plenty of time to devote to each individual patient, Dr. Raus plans to limit her patients panel.
Every person is eligible to become a DPC patient. We accept all patients regardless of whether or not they are insured or what type of insurance they have. We simply do not bill the insurance companies. This way, we can provide the best care possible by eliminating the "middleman."
We have negotiated wholesale prices with local labs. Price lists available in the clinic - no hidden fees or big bills a few weeks later!!
You can also use your insurance to pay for labs and imaging if you want.
Our monthly membership fees are the same price for every patient, regardless of pre-existing conditions. Some labs, tests, and procedures may cost extra but we will negotiate wholesale pricing on these! We will manage your health problems to the extent of our practice limitations and will refer to a specialist when necessary. And if a referral is needed, we will still be your quarterback and make sure everyone will be in the loop.
We can make referrals like any traditional primary care doctor (unless you have a HMO, this can sometimes make it tricky because they require a "gatekeeper", but we will work with you). At Family Doc Direct not only do we have the ability to have longer visits to truly adress your health issue with the goal of minimizing referrals, your membership includes e-consults with specialists through RubiconMD in an effort to decrease the need for formal referrals. This connects your doctor with a specialist in 4hrs on average! Way better than that traditional 4 week wait!
If you feel you have a life-threatening emergency, call 911 immediately. While we will focus on preventative care, some things may require evaluation at an emergency room as they would at any clinic. That is a time when is apropriate to use your health insurance. Please call Dr. Raus if you are not sure if emergency room visit is needed, we will advise you.
No it does not.
No worries, you can still be a patient here at Paradigm. We offer all imagings and labs at substantially discounted prices! This is regardless of your insurance status! We do recommend insurance though - but this is for the rare big things like surgeries, true emergencies, chronic diseases such as cancer. Think of it like car insurance - we maintain it because it's the law and to help us pay for any major problems. We don't use car insurance to cover your car's routine maintenance or small problems, so why should we use health insurance like that? There's a reason our premiums keep rising! Because all of your primary/urgent care needs are met with our low monthly membership fee - we recommend a high deductible plan.
Perfect! Like stated above, we believe it is important to have health insurance to help cover the big expenses. If you're worried about "paying double", don't forget you already do! You pay once with your premium and then again with your deductible and out-of-pocket. At Paradigm, we will work to save you money by minimizing total out-of-pocket expenses with our predictable monthly fee and our value-rich clinic! Or better yet, change to a high deductible plan as this will most likely bring you the best savings when pairing it with our clinic. We can guide you to the right avenues to find appropriate plans.
Many people sign up for Direct Primary Care because of the premium high quality service it provides. Even patients lucky enough to have "Cadillac" insurance decide that the low monthly membership fee is worth it to them, for the discounted medications, lab tests, scheduling convenience, longer appointment times, and most importantly, the non-rushed, quality focused care.
Yes. We'd love to talk to your business about helping offer an affordable and ideal healthcare solution to your employees!
If the doctor deems you don't need to come in, let's avoid the hassle. Many questions can be answered without an in-person visit, so we offer texting, email, phone calls, and video-conferencing to our members at no additional fee. We also offer home and work-site visits for an additional fee.
Dr. Raus is always be available via phone , message or email and patients will be notified of any such events ahead of time. This is one of the big differences with Family Doc Direct compared to a traditional practice - you will ALWAYS have access to your doctor. NOT just an answering service. In the event you need to physically be seen while Dr. Raus is unavailable, she will partner with trusted area physicians to ensure her patients receive quality care.
We do not treat chronic pain or carry narcotics / controlled substances in our office. We also do not provide prenatal care (obstetrics).
Nope. We provide most care to members without any fees at all! If we do charge for non-covered services, we always list prices upfront. If we recommend outside services, we try very hard to find you an upfront, reasonable price if paying cash.
Hospitalizations, evaluations by other physicians or specialists, emergency room visits, prescription medications, outside labs, pathology services, cultures, radiologic studies (x-rays, CT Scans, MRIs, ultrasounds, etc.), childhood immunizations, physical therapy, workers compensation.
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