What is dpc
Direct primary care is an innovative model of health care that puts patients first. DPC practices do not bill for file insurance claims; instead, the patient pays directly for the services provided. We operate on a fee-based membership with transparent pricing and no surprises. This model of care provides the physician and the patient the freedom to enjoy personalized, patient-focused medicine by reducing the overhead cost of business and allowing each physician to have fewer patients under their care. This allows for more individualized, comprehensive, timely, reliable and consistent access to care with the same physician.
How is Simon Direct Primary Care different than traditional medical clinics?
SDPC uses an innovative model of care in which doctors are paid directly by their patients, rather than through governmental payers or insurance companies. Basically, we are cutting out the middle man, along with the cost and excess red tape that comes with them. This model of health care is rapidly growing. DPC is reminiscent of the doctor-patient relationship in the past, when doctors took time to with you and you didn’t have to wait weeks for your appointment.
What can you expect as a member?
You can expect very short wait times, longer appointments, and almost 24/7 access to your doctor. No more rushed visits or waiting weeks for an appointment. You can contact your physician via phone, text, email, or social media, day or night.
Do I still need insurance?
All patients are encouraged to have at least major medical insurance coverage. The ACA legislation does exempt patients from the underinsured/non-insured tax if you have major medical/catastrophic coverage and a physician on retainer, which is what most obtain with Direct Care.
One way to save money on your healthcare is by getting insurance with low premiums and high deductibles. DPC doctors strive to eliminate insurance claims. Let's say you need some routine lab tests. Why pay $200 toward a deductible you're unlikely to meet when you can get the same tests from a DPC doctor for much less.
Can I use my Health Savings Account to pay for Direct Primary Care?
The law currently allows the use of HSA money to pay for medications, imaging tests, labs, etc. However, it is legally unclear if HSA funds can be used to pay for DPC membership fees. This is a question for your tax professional. Legislation has been proposed to clear up the question regarding if HSA money can be spent on a DPC physicians retainer or membership fee.
How can you guarantee same or next-day appointments?
Dr. Simon only plans to accept approximately 300 patients. Considering that managed care has driven modern era physicians to patient panels an average of 2,000-2,500 patients or more its no wonder you encounter long waits and very little time with your doctor. We keep our patient panel low so we can spend plenty of time with you and get you in quickly. This is the kind of attention and accessibility we wouldd want our family to have, and its what we offer our patients.
Will Dr. Simon still take care of me if I need to be admitted to the hospital?
If admitted to different hospital that she does not have privileges to, Dr. Simon will not be able to see you there but will work closely with admitting physicians to ensure a smooth transition home and follow up.
Outside of paying for membership, medicine or labwork/x-rays, are there other fees I might have to pay?
Almost all the routine procedures we perform will have no additional charge to members. There are a few exceptions, more complicated procedures or procedures requiring specialized equipment may require a fee. Our pricing page has details. Dr. Simon may charge mileage at IRS rates for out-of-town house calls.
Will SDPC see patients on a fee-for-service basis if they are NOT members?
Yes, but only for urgent need or certain procedures, not for routine medical care. We offer cash prices on minor emergency or elective surgical procedures (such as sewing up cuts, or benign skin lesion removal) to non-members. We are happy to provide some minor cosmetic surgical procedures for patients who are not members at very affordable prices. This is because most insurance plans will cover no "cosmetic" procedures. So if you have a benign, but annoying mole or skin tag for instance, insurance or Medicare wont cover its removal. These simple procedures are very expensive without insurance, traditionally. We also are happy to provide CDL Physicals, PRP Injections.
SDPC will also provide affordable office visits to visiting family members of members. We understand that its always miserable to get sick or hurt when you are away from home.
Do you make house calls?
Yes! There are times when a house call is the best answer, and Direct Primary Care affords family doctors the time to get out of the office, when necessary, just like in the good old days. Obviously if we are driving, we can't be caring for people, so we'll be limiting house calls to those necessary. For house calls out of town, we will charge mileage, otherwise, there is no additional charge.
Does Dr. Simon still deliver babies?
Dr. Simon does not currently offer full obstetric care any longer. However, she plans to continue to offer prenatal services and then will transfer care of expectant mothers to delivering physicians by the end of the first trimester.
How can I contact Dr. Simon after hours?
Illness and injuries do not always happen during office hours. If you just need to get in touch with us to order a medication refill or schedule an appointment, you can directly email or call the office and leave a message for Dr. Simon anytime, If you have an urgent question, one that probably shouldn not wait until tomorrow, members can send Dr. Simon a text message and expect a prompt reply. Lastly, if you have an emergent issue after-hours, Dr. Simon is only a phone call away and will do everything she can to keep you from going to urgent care or an ER if it is an issue that is appropriately taken care of in the office.
