Frequently Asked Questions
What is Direct Primary Care?
Direct Primary Care (DPC) is an innovative alternative payment model improving access to high functioning healthcare with a simple, flat, affordable membership fee. No fee-for-service payments. No third-party billing. The defining element of DPC is an enduring and trusting relationship between the patience and their primary care provider. Patients have extraordinary access to a physician of their choice and physicians are accountable first and foremost for their patients. DPC is embraced by healthy policy makers on the left and right and creates happy patients and providers all over the country.
Will I benefit From Direct Primary Care if I Do Not Require Frequent Medical Attention?
Of course, everyone benefits from a service tailored directly to them. That’s why we offer custom healthcare. We’re here for you if you’re sick or hurt, but we also help you proactively maintain good overall health. Every visit with us will be thorough, relaxed, and as long as you need to address health concerns. The longer you’re our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.
How Will I Save Money?
You won’t have to pay a co-pay for office visits or routine physicals. Also, you will be able to avoid many visits all together by sending your questions directly to us via email and text-something you won’t get from a traditional practice. We’ve negotiated deals for prescription medications, blood tests, X-rays, and MR/CT scans on your behalf. If we had contracts with insurance companies, we would be legally obligated to charge higher prices.
Most importantly, since you are getting the amazing care from us, you can cut way back on your insurance premiums. Most DPC patients find a high-deductible, low-premium insurance plan so they’ve covered in the case of major health issues. But leave the rest of the healthcare to us.
Want to Know More about Direct Primary Care?
Here are 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
What Does the Membership Fee Cover?
The fee covers excellent primary care through; tele-medicine visits, home visits, and when needed office visits with no co-pay. This includes the following: annual wellness exams, sports physicals, school physicals, chronic disease care management and follow-up visits, basic office procedures if needed and treatment of acute illness or minor injuries, all with the minimal wait times. The fee also covers direct communications with your doctor: phone, text, video chat or email.
So How Much Does the Membership Cost?
See our prices on our pricing page. For a low monthly fee, you get longer visits, your doctor’s cell phone number and a whole lot more.
What Medical Conditions Do You Care For?
We treat all kinds of common everyday problems like colds, flu, strep, rashes, and injuries. We also treat more complicated long-term medical problems like adult diabetes, high blood pressure, high cholesterol, thyroid disorder, sexual dysfunction, and hormone replacement.
What Happens If I Need To Go To The Hospital or See a Specialist?
For starters, having such unprecedented direct access to your doctor will prevent hospitalizations and specialty referrals in many cases. However, when 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. Depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.
Can I Contact My Physician After Hours?
Of course! Physician access is one of the greatest benefits of the DPC model. Because illness and injury do not respect regular office hours, you may contact Dr. Banor through her private line exclusively provided for Pulse Healthcare Solutions members only.
What If I Need Medical Attention, While Away From Home?
Of course- this sort of care is “baked in” to the DPC model. Because you’ll have your doctor’s email and phone number, you can reach out to us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation. We’ll also locate the nearest pharmacy and order the medications most appropriate for your circumstances.
Do You Accept Insurance?
No, fortunately for both you and us. Perhaps the most critical distinction in our model of care centers on a direct personal relationship between you and your doctor. That directness carries over to our business model as well. You might use your auto insurance to fix a smashed fender or other major damages. But you’d never use it to get an oil change, or pay for gas. For some reason, health insurance is currently being used for the equivalent of oil changes for humans- routine physicals, office visits, simple blood tests, and minor procedures. This just doesn’t make sense.
We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee frees us from the typical contractual agreements that prevent non-DPC physicians from offering special prices on laboratory tests, imaging, and medications.
I Don't Have Insurance, Can I still Join?
No, fortunately for both you and us. Perhaps the most critical distinction in our model of care centers on a direct personal relationship between you and your doctor. That directness carries over to our business model as well. You might use your auto insurance to fix a smashed fender or other major damages. But you’d never use it to get an oil change, or pay for gas. For some reason, health insurance is currently being used for the equivalent of oil changes for humans- routine physicals, office visits, simple blood tests, and minor procedures. This just doesn’t make sense.
We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee frees us from the typical contractual agreements that prevent non-DPC physicians from offering special prices on laboratory tests, imaging, and medications.
I Don't Have Insurance, Can I Still Join?
Yes, we take care of any patient regardless of your insurance situation. Since we work completely outside of the insurance system, none of the billing for care here is eligible for insurance reimbursement. However, we recommend that everyone have insurance coverage, which is still important in the event of a major health issue.
As A Patient Will I Still need Health Insurance?
Yes. We recommend our patients continue a major medical plan with a high deductible and health savings account. If you experience a major health issue, you will still need insurance to help cover it. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.
If I Have Medicare Can I Still Join?
Yes. Medicare benefits can continue to be used for all medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.
How Does DPC work with Obamacare?
As the Affordable Care Act was being drawn up, several doctors worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Care practices like ours to be a legal option under the health reform bill. Once the health exchanges open in October, many people will understand that a Direct Primary Care practice is an approved option.
In short, the best option for many patients will be an ” exchanged qualified ” major medical type plan combined with a Direct Primary Care provider like our practice. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients.
The Direct Primary Care practices have the ability to decrease the cost of insurance by 30-50%, thus eliminating the need for ObamaCare-style regulation because we can make health insurance affordable again.
Is The Membership Fee Elgible for HSA or FSA Reimbursement?
You may want to check with your human resources department regarding the use of Health Savings Accounts ( HSAs ) and Flexible Spending Accounts ( FSAs ) as possible payment options for your membership. If you are unable to use these funds to pay for the membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for certain services provided through our office.
Is My Membership Fee Tax Deductible?
Unfortunately, no. Your retainer is not yet defined as a ” medical expense ” in most states and as such is not deductible. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.
Are my Medical Records ever Shared with Government Agencies, Insurance Carriers or Pharmaceutical Companies?
We maintain high standards of patient privacy, and will ensure we are all HIPPA compliant. We will never provide your health information to any third-party unless you specifically as that we do so.
When Do I Pay my Fees For Non-Covered Labs and Procedures?
Charges will be added and applied to your preferred method of payment.
What if I decide to cancel?
Pulse Healthcare Solutions operates on a month-to-month membership. 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 at the end of the month.
Can I still join your email list if I am not yet ready to become a member?
Certainly! Please email us at pulsehealthcaresolutions444@gmail.com and get free health tips from Dr. Banor.
Still Have Questions?
We are here for you, and would love to hear from you, and answer any questions that you may have. Please feel free to give us a call at 480-590-5146, or contact us here.
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