Frequently Asked Questions
Direct Primary Care
Direct Primary Care, or DPC, is a model of healthcare that puts patients first by getting rid of the red tape that constrains traditional practices. How? It’s simple: we don’t accept insurance, and this saves you money in the long run.
You won’t have to pay a co-pay for office visits or routine physicals. Also, you’ll be able to avoid many visits altogether by sending your questions directly to us via email and text – something you won’t get from traditional practice. We’ve negotiated amazing deals for prescription medications, blood tests, X-rays, and MRI/CT scans on your behalf. If we had contracts with insurance companies, we would be legally obligated to charge higher prices. More importantly, since you are getting all this 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’re covered in the case of a major health issue. But leave the rest of your healthcare to us.
The terms are often mistakenly used interchangeably, but they are not the same. Both DPC and concierge practices charge a periodic fee, however, under the concierge model, this fee only gets you access; that is, it doesn’t actually cover any of your care. Instead, a concierge practice still bills insurance for your visits. Under DPC, your visits and other care are included in your fee, plus you’re provided with other incredible benefits like wholesale pricing for labs and radiology studies, deeply discounted prescription prices, direct digital communication with your doctor, and all the rest.
We charge a flat monthly fee, and in exchange, you get virtually unlimited office visits, wholesale prices on prescription medication, your doctor’s cell phone number, and a whole lot more. See our prices on our pricing page.
Because we use a membership model, we are able to treat patients with and without insurance. We actually do not bill insurance at all. This eliminates cumbersome billing practices and paperwork which take time away from patient care. At LAYF Wellness DPC, each doctor will only take on a panel of about 500-600 patients or less. That’s in comparison to fee-for-service providers who see on average 2000-3000 patients. More great news, Dr. Babs uses a secure app where you can text or email us anytime, anywhere. Your doctor—not an answering service or covering provider—will be the one responding to your questions. We offer same-day or next day visits and you will never have you worry about long wait times or time limit on your visits. What could be better than this great Healthcare Membership Model instead of Sickcare Traditional Practice Model?
Yes, we have a discounted membership per month for children enrolled with an adult member. Please note that we do NOT administer childhood vaccinations in our office. We will assist with our children members obtaining their vaccinations through the local Health Department. See our prices on our pricing page.
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.
We maintain high standards of patient privacy. We will never provide your health information to any third party unless you specifically ask that we do so.
We believe that controlled substances, including narcotics (Lorcet, Lortab, Norco, Oxycontin, Percocet, Vicodin, etc.), benzodiazepines (Ativan, Klonopin, Valium, Xanax, etc.), and stimulants (Ritalin, Adderall, etc.) have a limited role in primary care and therefore Dr. Babs prescribes them rarely and only very sparingly. We believe chronic pain requiring narcotics is best managed by a pain management specialist, but we are happy to work with you on non-narcotic options for your pain and to manage your other medical conditions. We do not treat anxiety with benzodiazepines but are happy to offer other medications and techniques often successful in treating anxiety. No controlled substances are kept in the office.
If you have any documents that you find helpful, any lab results, physicals, or office visits, you can bring them to the appointment. You can also have your primary care provider fax us your information. We will send you an email with instructions on paperwork to fill out that will give us a comprehensive view of your health.
Insurance, Billing, and Fees
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 wholesale prices on laboratory tests, imaging, and medications.
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.
Yes. We recommend our patients have insurance to pay for emergency room and hospital care, surgeries, and other services that are outside of primary care that are not included in your membership. Many patients find that they save considerably by purchasing a high deductible health plan and health savings account. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.
Yes, but not at this moment. When you would need only, sign a waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain unchanged and can continue to be used for all other medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.
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 “exchange 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.
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.
After you register online through our website, you will be contacted to schedule your intake appointment. Your monthly billing will start on the day of your first medical visit with the doctor. Dr. Babs welcomes you to come in for a “Meet and Greet” visit prior to your first medical visit to answer any questions and ensure that this practice will be a good fit for you – there is no charge for this visit. Please note that medical care cannot be provided through any means prior to the initial intake physical exam.
You are always welcome to cancel your membership, although we do require 30 days’ notice.
Unfortunately, No. Your retainer is not currently identified 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.
Charges will be applied to your preferred method of payment at the time of collection/completion.
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.
Because you’ll have your doctor’s email address and cell 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 or a short virtual visit. We’ll also help locate a nearby pharmacy and order the medications most appropriate for your circumstances.