Frequently Asked Questions (FAQ)
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- What is direct primary care medicine, and why should patients be interested in it?
Direct primary care medicine is a healthcare model that offers personalized and enhanced access to primary care. You should consider it because it provides longer appointment times, same-day or next-day appointments, and greater availability to meet your healthcare needs. Panels of patients are generally kept to 600 members or less, versus a typical Family Physician panel of 2400 patients. Also, the doctor is no longer performing time consuming administrative tasks and documentation required by insurance companies; the physician now has that time to spend caring for you!
- Does Dr Trevino take my insurance?
No. As a direct primary care physician, Dr. Trevino does not participate with any health plan or third party payor. You pay a small monthly membership fee in exchange for Dr. Trevino's services. This means no insurance company middlemen to interfere with your care. Dr. Trevino's only concern is you -- she doesn't answer to the insurance company's whims and demands.
All visits are included whether in person, virtual, or telephonic. Procedures are included as well, you only pay for what must be purchased, such as lab fees, imaging, supplies etc.
For example, Simple laceration repair in our office-patient pays at cost for the suture and supplies (approximately $10-20). No procedure charge or office visit charge.
An example of cost prices at an urgent care for stitches, patient pays for an office visit and for the procedure. Urgent care office visit on average costs $150-200. A simple laceration repair in Michigan on average can cost $561.
Dr. Trevino has negotiated discounted cash-based prices on imaging, labs, and medications that she offers.
You can choose to use your insurance for medications, labs, and imaging if you choose, or use the cash pay discounts. (However, if you have an HMO or other managed care plan, you may be required to have an in-network physician to use your insurance for referrals/imaging/labs/medications). Dr. Trevino is not an in-network physician as she does not accept insurance.
- How does direct primary care medicine improve the patient-doctor relationship?
You will have more time with Dr. Trevino during your visits, because she takes fewer patients (her entire panel will always be less than 600 patients). A typical insurance based, physician can have between 2000-2500 patients on their panel. As her panel is much smaller she has more time to get to know you as a person. In addition to that, she has the time and freedom to help come up with treatment plans that are more in line with your needs, beliefs, and concerns--instead of what the insurance company wants. Plans are made between the physician and the patient, not by the insurance company.
She will also be able to address more than 1 item and complex issues at your visit. You will be seeing Dr. Trevino, instead of seeing whoever happens to be working that day in the office, this allows for relationship building and better outcomes.
- Does direct primary care medicine offer preventative care benefits?
Dr. Trevino does offer preventive care services. Screenings are very important to help prevent disease and to also detect it at earlier stages. This helps improve health outcomes and quality of life, and to decrease poor outcomes and medical expenses.
Dr. Trevino performs comprehensive physical exams. This may include skin checks, EKG, cancer screenings (lung, breast, cervical, prostate, as well as screening based on family history) etc.; labs to screen for diabetes, anemia, kidney and liver disease and cholesterol problems; mental health screenings, blood pressure checks etc. We discuss workplace and other potential sources of hazards are discussed as well, to guide screening and treatments.
- How does direct primary care medicine benefit patients with chronic conditions?
If you have chronic conditions, you will benefit from longer visits to address your concerns, lifestyle, and treatment options. Also, you will be seeing Dr. Trevino every time, you will not be just a number, and you will not have to rehash your known medical problems to a different physician or provider every time that you come to the office that you may only see once and never see again. In addition, you will also have access to cash discount labs, meds, and imaging that may not be covered by your insurance or is only covered so often.
- Are there cost advantages in the long run?
Due to improved access, and a quality bundle of services available, DPC patients can often avoid expensive urgent care and ER visits with the high copays that are often required. Many patients also find that they save a significant amount by taking advantage of the highly discounted, cash pay pricing on labs, testing and medications that DPC practices offer. Often, patients find that the cash pay price is less than what it would cost them for copays alone, had they submitted to insurance.
Some examples of our cash-based prices compared to traditional insurance-based provider cash pricing:
Labs
Dr. Trevino cash basis $ Other Cash basis $ CBC w/ diff 4 45 Complete Metabolic Panel 4.51 85 Lipid Panel 7.10 64 HbA1c 6 27-50 TSH 5 65 Vita D (25-oh) 23 17-226 B12/Folic Acid 16 46-60 PSA (Prostate Screen) 18 45 Testosterone Total 15.24 71-131 Imaging/Diagnostics
Dr. Trevino cash basis $ Other Cash basis $ EKG Included in Membership * 102 3-D Mammogram 160 329 U/S Abdomen Complete 170 714 2V Chest X-ray 40 133 Lumbar Spine X-ray 65 167 MRI Brain w/o Contrast 300 1702 * all imaging, diagnostics, labs, medication ordered as needed on an individual basis.
- Can patients in direct primary care use telemedicine?
Yes, Dr. Trevino does offer telemedicine visits when appropriate. This helps you more easily get the healthcare that you need more conveniently. It can make doing your follow-ups or sick visits easy by just logging in. Patients also have access to her by phone and text.
- How does direct primary care medicine allow patients to have more control over their healthcare decisions?
By not accepting insurance, the middleman is removed from medical decision making; and the patient and doctor are in control. Less cookie cutter medicine and more focus on you-the person receiving the care! Direct Primary Care, the new-old way of doing medicine. You will be more aware and in control of expenses, treatments, and how/where the care is delivered.
- NO SURPRISE ACT NOTICE
YOUR RIGHT TO A "GOOD FAITH ESTIMATE"
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost. Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services that you receive that are part of the care you receive from our Practice. This includes related costs like medical tests, prescription drugs, etc.
- You may request that your health care provider give you a Good Faith Estimate when you schedule, or before you receive your medical service or item.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our number on our website.
