The fee covers excellent primary care through office visits with no copay. This includes the following: annual wellness exams, well-child exams, sports physicals, school physicals, chronic care office visits, follow-up visits, basic office procedures and treatment of acute illness or minor injuries, all with minimal wait times in the office. The fee also covers direct communications with your doctor: phone, text, video chat or email.
Our patients will also have access to discounted labs, prescriptions and special procedures not included in the membership fees.
No, we do not require a sign-up fee for a household, family or individual.
doctor direct currently provides care for patients ages five (5) and older.
We expect to have an open, honest, respectful relationship with you. If you have voiced a complaint that we cannot satisfy together, we will gladly allow you to terminate your membership. If your membership is cancelled, you will receive a refund based on the services rendered. If you choose to rejoin, re-enrollment fees will be applied ($100/re-enrollment).
Under the Direct Primary Care (DPC) model, the patient (you) receives comprehensive primary health care directly from their DPC physician (Dr. Walsh or Dr. Kwark). The patient pays for this care through a monthly fee, paid directly to doctor direct.
Because DPC practices do not participate in any insurance or plans, the providers are able to avoid the ever-increasing and costly documentation demands and administrative intrusions that come with accepting insurance. DPC practices also avoid the onerous patient data collection responsibilities which many plans impose. These require staff, time and often amount to substantial intrusions on patient privacy.
Because DPC physicians avoid these obligations to insurance companies, they are free to spend that time listening to and treating patients. And because DPC physicians eliminate the significant overhead costs of participating in insurance, they can pass the savings on to you, the patient – DPC doctors are able to give compassionate, attentive and timely care at an affordable cost.
Yes, sort of… but with a few distinct differences.
Concierge medicine has traditionally described a medical practice for wealthy patients who pay an expensive premium upwards of $5,000 annually to see their doctor. Concierge doctors typically still participate in insurance, so the rules and restrictions of health insurance are still in place.
Direct Primary Care does offer patients concierge like service and personalized primary care. However, direct primary care like doctor direct offers membership fees that are much more affordable (typically only $500-1000/ year) and does not participate in insurance.
This makes personal healthcare without hassles affordable to everyone.
Here’s a few articles that profile the Direct Primary Care approach to medicine:
- FORBES: “Direct Primary Care: Restoring The Doctor-Patient Relationship”
- TIME “Medicine is About to Get Personal”
- US News “Physicians Abandon Insurance for Blue Collar Model”
- AARP “The Doctor Will See You But Not Your Insurance”
- American Academy of Family Physicians “Direct Primary Care”
- WRAL “Patients Pay Monthly Fee, Not Insurance Co-Pay to See Raleigh Physician”
Dr. Walsh and Dr. Kwark treat all kinds of common everyday problems like colds, flu, strep, rashes and injuries. They also treat more complicated long term medical problems like adult diabetes, high blood pressure, high cholesterol and thyroid disorder.
Our providers will coordinate a patient’s care with the hospital’s team and there isn’t an extra charge for this service. If you require hospital care you will be under the care of a specialist, and that’s not covered by our fee. Other hospital charges and associated costs will still apply. That’s when your insurance will come in. Dr. Walsh and Dr. Kwark will then pick up your care upon discharge. They will work closely with the specialists and hospital team upon admission and discharge so that there is continuity in all of your care.
No. Patient privacy is a natural benefit of this medical model. We will never provide any third party with a copy of your records, unless you specifically ask them to do so or if doctor direct is subject to subpoena or search warrant.
In the age of telemedicine, many conditions can be diagnosed and treated via a simple conversation by phone or webcam. If appropriate, we will locate the nearest pharmacy and order medication most suited for your circumstance. If you need to go to the hospital or seek other medical attention while away from home, we can advise you on that as well.
Absolutely, yes! It’s how we do custom healthcare. After normal office hours our members can call, email or text Dr. Walsh or Dr. Kwark directly.
Charges will be added and applied to your preferred method of payment.
Medicare & Insurance Questions
Absolutely yes! We recommend that you do have insurance to comply with Federal Law. doctor direct is not an insurance plan, nor does it replace insurance. Ideally we encourage our patients to carry a high deductible, major medical plan or a plan with a health savings account. This ensures financial help should hospitalization or referral to a specialist be necessary. You should consult with your insurance provider to help you find a plan that works best with our medical model and that will meet your specific needs.
Not for our services, but doctor direct will be able to order your labs, x-rays and medications at the facilities preferred by your insurance if you would like.
In many ways, patients already are paying twice: co pays, co-insurance, non-covered services, out-of-network charges, the list goes on…
The average family of four pays over $4,065 in out of pocket medical expenses over the course of a year. With Direct Primary Care, like doctor direct, you can save hundreds of dollars in out of pocket costs – upwards of 25%.
Become a patient at doctor direct and receive more value for your healthcare dollars.
Awesome. High five! Good health is what we all strive for.
Chances are, however, you will at sometime get unexpectedly sick or have an inconvenient accident or injury. doctor direct will be there for you, able to give you the care you will need without long waits or expensive Urgent Care copays or ER fees. With out-of-pocket deductibles close to or over $5,000, it doesn’t take much more than a trip or two to Urgent Care or the ER for the cost of doctor direct to be well worth the low monthly fee.
Yes. However, your monthly membership fee cannot be submitted to Medicare for reimbursement. You must sign a waiver every two years that declares that neither you nor your doctor will directly bill Medicare for your membership fee.
Medicare and medicare supplemental insurance will still cover medical costs that you incur outside of doctor direct. For example, prescriptions that you fill at an outside pharmacy, or labs run at an outside lab, or hospital charges, physical therapy, x-rays and scans are covered, just to name a few. You do not lose your Medicare coverage for other medical needs just because you are a patient of doctor direct.
Many times patients purchase expensive “Cadillac” plans that require little or no co-pay and that cover all lab costs and prescription costs. However, with doctor direct your monthly fee covers all office visits, basic labs and there are no copays. Our patients may find it worthwhile to change from a “Cadillac” health insurance plan to a basic health insurance plan to save money. Most people find that a DPC like doctor direct along with a basic health insurance plan (that covers hospitalizations, surgeries, specialists, ER visits) result in a cost savings.
HSAs & FSAs are a smart way to pay for your health care needs with pre-tax dollars. IRS regulations make it pretty clear that all DPC services are covered medical expenses reimbursable through HSAs and FSAs, but at the same time, the IRS claims that DPC memberships are health plans, and therefore fees are not reimbursable when employees combine DPC with any other “health plan” (like the catastrophic or high deductible insurance most DPC patients need). It gets even more complicated as the Affordable Care Act and several state laws have decided DPC plans are not insurance. The issue is being addressed at the federal level with legislation called the Primary Care Enhancement Act. In the meantime, the best thing to do is check with your health plan, insurance broker or employer.
Absolutely not. Our doctors’ motivation is simply to improve patients’ health care. There is actually a provision in the ACA that allows for this type of practice. Both Dr. Walsh and Dr. Kwark believe that this approach provides the best care at the best price for almost every patient.