Why doesn't Direct Neurology Care take insurance?
Simply put, we value freedom of medical choice- both yours and ours. Have you ever been compelled to work your way down your insurance's medication algorithm before you were able to get something that you suspected would be best for you to begin with? Who suffered the side effects, you or the person who decided on the algorithm?
Privacy is another important reason to choose a Direct Care practice. Let's assume you don't want the insurance company, employer, or government to have access to your personal health information. Or, maybe you just don't think it is appropriate to have your information used for purposes other than to benefit your individual health. Then allow us to suggest that you might not want to let that information rest on a computer system that is mandated by, controlled by, and interconnected with the government or the insurance company (and by extension the employer). To the extent allowed by law, Direct Care practices are shielded from these intrusions.
How about cost transparency? Anyone trying to decipher an "Explanation of Benefits" letter cannot help but think that the insurance companies want you to feel confused by the cost of medical care, and perhaps a little scared- otherwise why would you need them? At Direct Neurology Care, we practice medicine, not financial shell games, and we don't try to scare our patients. That is why you can find our price list right on our website.
We also really like fair prices. Hiring several staff members to deal with the Insurance company's shifting requirements, complex rules, and claw-backs doesn't help to keep prices low, for us, or for you.
Am I eligible to obtain Direct Neurology Care Services?
If you have no insurance, high deductible private insurance and have not yet met your deductible, or are not planning on using your private insurance for this care episode, we would be honored to take care of you. We also welcome those who are members of a health sharing ministry.
There are currently many prohibitive limitations on private direct pay relationships that have been put in place by Medicare, Medicaid, and the Office of Veteran's Affairs. As a result, it is our deepest regret that we cannot see either VA or Medicare/Medicaid eligible patients at this time. Rest assured, once these intrusions into the patient's personal choice are lifted, we will also welcome this deserving population. Please use our Contact page if you have further questions about Medicare/Medicaid or VA induced limitations. We would be happy to discuss this with you further.
How does Direct Neurology Care differ from a traditional Neurology practice?
Although there is no strict definition of "Direct Care", the general principle is a service, provided by your Physician (or allied health care professional), which is typically paid for on a monthly basis. For their monthly membership fee, patients have unrestricted access to a specific set of healthcare services offered by the physician. Patients have no deductibles nor co-pays, and neither patient nor physician has to bill a third party payer for the services. There are no surprise expenses for patients. In addition, many Direct Care practices offer their patients access to prescription medications that can be significantly less costly than if they were to use a traditional insurance plan for their drugs.
In contradistinction to the traditional medical practice, a Direct Care practice is freed from the massive overhead typically dedicated to interfacing with insurance companies and complying with insurance mandates, so patient panels can be smaller, appointments can be longer, and charges to the patient are lowered. Most importantly, the physician/patient relationship can once again be based on transparency and trust.
Should I continue to pay for insurance if I am being seen in a Direct Care practice?
Yes, most likely. When insurance is used as it was initially conceived, as a means of protecting one's self against the unexpected and catastrophic medical costs that sometimes arise, it is a very useful tool. However, as currently used, it is a costly and unnecessarily complicated means of paying for predictable, low acuity care.
To illustrate, imagine if your car insurance covered all tire rotations, brake replacements, oil changes, and car washes. How expensive would it have to be? If you guessed "prohibitively expensive" you would be correct. That is the current situation with medical insurance.
Most Direct Care physicians seem to agree, the optimal way of managing health care is to combine the patient responsive Direct Care practice for predictable or low acuity care, with a low cost/high deductible plan or Health Sharing Ministry for hospital based care, preferably in conjunction with a Health Savings or Flexible Spending Account (HSA/FSA).
Can I continue to use my insurance?
Depending on your insurance policy, you may be able to apply for reimbursement for some services provided by a Direct Care practice, although this will vary from company to company. We can provide documentation and will do our best to help, but cannot submit bills on your behalf and cannot guarantee that we will meet your insurance company's individual requirements. The exception is Medicare/Medicaid eligible or VA patients who also receive care through a direct care practice. As a general rule, patients are NOT able to submit charges to those entities for these services. Currently, Direct Neurology Care is not able to accept VA or Medicare/Medicaid patients. Please see "Am I Eligible to Obtain Direct Neurology Care Services?"
Can I use my HSA or FSA to pay for Direct Care Services?
Most HSAs and FSAs can be used to pay for direct care practice fees, but you should confirm this with your individual plan.
Is there a long term agreement?
The initial consultation is a one time charge. A billing agreement is not necessarily established at this visit, unless you decide you need further care.
If, after the initial consultation, it is determined that either ongoing medication or interventional management is required, we will bill a monthly fee. However, you can cancel or put your agreement on hiatus when needed (hopefully because you are feeling better). A 30 day notice is required and your account must be current to avoid subsequent charges.
If you choose to restart care after the hiatus, this may be subject to additional charges.
What is included in the monthly fee?
All office visits, phone calls, video calls, text communications, secure messages, and injection/ procedure fees are included in the monthly charge. We can see you in person or through video/phone chat up to twice a month, at your discretion. Text or secure messages are as needed. Basic lab work and limited generic medications may be included, depending on what is required. Other medications, labs , or procedure supplies may incur additional charges, but these are always discussed before hand.
Do I need a referral to be seen at Direct Neurology Care?
You don't need a referral, but it is best that you have a primary care person with whom we can coordinate. If you are referred by a Direct Primary Care practice, you may also be eligible for a discount.
If you self-refer and find the issue is not a neurologic one, or decide that this service is not for you, there may only be a minimal one time fee (see our services menu for cost).
How do I get started if I have a Neurology question?
Take a look around the website. Visit our SERVICES page to review the diagnoses that we treat, and the PRICE LIST page. If a Direct Neurology Care appointment seems right for you, visit our CONTACT US page to call, text, or email for an appointment or to submit additional questions. Show up to the appointment. Let us help you. Pay at the time of service (cash, credit, or debit accepted.)
Pretty simple right?
Do Direct Neurology Care Doctors prescribe controlled substances?
For the most part, we do not. For instance, we believe opiates are best handled by a Pain Management Specialist. Most neurologic pain is treatable without opiates or opioid drugs and we will work with you to manage these situations. Various Epilepsy medications are monitored substances, and we may be able to prescribe these if necessary.