Frequently Asked Questions
Membership Coverage
Screening visits- annual physicals and wellness exams, well child visits, school and sports physicals, women’s health preventive visits (Pap smears, etc) which may also address vaccines, preventive screening tests for cancer and other preventable conditions.
Treatment of chronic health conditions- high blood pressure, diabetes, COPD, depression, anxiety, asthma, stomach problems, arthritis and more.
Health modification visits- assistance with quitting smoking, making lifestyle changes to address obesity and reduce stress.
Women’s health services- screening exams, STD screening, IUD insertion and removal, discussion and prescriptions for birth control.
Urgent visits for acute illnesses or problems- UTI’s, respiratory and throat infections, rashes, injuries, suturing for minor lacerations.
Office procedures- skin biopsies and skin lesion removal, skin tags, wart treatments, joint injections, trigger point injections, EKG’s, ear wax removal, urine tests. Any additional fees related to procedures will be to cover the wholesale cost of the medication administered or used for the procedure.
Yes! We are basing our services around wellness care and expert medical advice. Our belief is that EVERYONE benefits from wellness care. Additionally, when you have direct access to your physician, simple questions can be answered that can head off bigger problems or even potential trips to urgent cares or emergency rooms. Last, we never know when an unexpected health crisis can occur. Being a part of a direct primary care practice ensures your physician knows you, knows your health background and is available to coordinate your care in the event a more serious event occurs.
Health insurance is not health CARE. The current healthcare model often includes unexpected fees, high copays and deductibles and exclusions of services. It places burdens on physicians that often cause long wait times for you to get appointments or answers to your questions. It also tends to fail in terms of its reliability and consistency because there are so many moving ‘players’ in the traditional system siphoning money away from direct patient care and pressuring primary care physicians to manage huge patient panels while doing excessive paperwork and documentation. Patients who sign on to the direct primary care model are helping ensure consistency and availability to access their physician when they need him or her. In this way, patients don’t need to avoid accessing their doctor to avoid fees. Preventive care can actually flourish in this model.
- Many vaccines are not available for administration in office. We tend to work with the health department and pharmacies for our patients’ vaccinations needs.
- Chronic pain management is not offered at LAYF Wellness DPC.
- Controlled medications when needed for conditions are kept limited.
- Additional monitoring per FDA and state licensing agency guidelines for patients being prescribed certain medications is necessary for any of these medications to be prescribed, even in small quantities.
- ADHD diagnosis is not available at our practice.
- Psychological evaluations and forms for competency or guardianship are not offered unless the patient is very well known to the physician evaluations and certifications for Social Security.
- Disability applications are not offered.
- Worker’s Compensation cases are not accepted.
Billing and Fees
No. We do not participate with or bill insurance or third party payers for your care. Your care is covered by our monthly member fees. This allows us the freedom to provide the level of care that we feel our patients deserve while improving the quality and satisfaction on both sides of the interaction. With the reduction in administrative burdens for us, we can focus on YOUR care and do the work we were trained to do.
If you have access to health insurance, we feel it’s important to keep it. Your health insurance can be used for emergency room visits, hospitalizations, surgeries, specialty physician visits, labs, high cost diagnostic testing, and prescriptions. NOTE: Please be advised that as direct primary care physicians don’t bill to or participate in traditional insurance, some types of insurance can be difficult for us to work with to coordinate your care or do referrals for (specifically HMO type insurance) Please inquire further with us about what insurances we feel we will have difficulty working with.
No. Concierge medicine is typically more expensive than the membership fees for direct primary care. In addition, concierge medicine practices tend to still participate with certain insurances and will bill for some or all fees. Last, there might be some unforeseen fees in the concierge medicine model.
Care Coordination
The majority of care can be conducted during normal business hours but you will always have access to your physician or a covering physician after hours or on weekends to have your questions answered. When your physician is away on vacation or unavailable, coverage will be arranged with a covering physician. Prescription refills will only be addressed during normal business hours. While we prioritize great customer service and will typically handle refills within 1 business day, we do ask for 3 day notice when refills are needed.
You will be notified in advance if your doctor is going to be away and unavailable. We will work to ensure refills, etc. are addressed prior. During these times, urgent care visits may be necessary. However, a covering physician will be identified and in many cases, will be available to see patients for visits during the normal physician’s time away from office.
You are always free to seek care at an emergency room or urgent care if the situation warrants it. We can often provide guidance in situations to determine if an ER or UC visit is really needed. Referrals to specialists when needed will be arranged by LAYF Wellness DPC on your behalf and follow up care will be coordinated with your doctor. If you are uninsured, we will work to secure best pricing for the specialist you need to see. If you are hospitalized, your care will be managed by a hospitalist physician. Where possible according to hospital rules and availability, our physician will visit you in hospital for a courtesy visit.
