Direct Primary Care Questions and Answers

Learn More with This List of Direct Primary Care FAQs

General Questions

Direct primary care is an agreement between you and your doctor. We agree to take care of all your basic and preventive medical care for a flat monthly fee. You receive unrestricted access to all the services we directly provide, as often as you need them. Learn more by visiting our direct primary care page.

Just call, email, or submit an online appointment request. In the future, we plan to offer direct online scheduling so you can book your own appointments directly on your doctor’s appointment schedule. We often have same-day or next-day appointments for your convenience.

Your doctor does. In most cases, patients and physicians both prefer to manage care efficiently over the phone or by email. If your doctor believes that it is safe to do so, and that they can provide high-quality care, they will save you a trip to our office. They will require an in-person office visit if they feel it is important. Of course, you are always welcome to request an office visit any time that you like. Our office staff has guidelines for offering virtual visits and will offer to schedule them when appropriate.

Continuity of care is extremely important, especially if you’re managing a chronic condition. You can continue seeing your same doctor or specialist as a member of our practice. As a primary care provider, it’s common for our patients to maintain certain relationships for specialty care. However, if your current doctor is also a primary care physician, your ProPartners Healthcare physician will assume those responsibilities and your medication management.

If you can’t find the answers to your questions on this website, we are happy to speak with you in person. Submit your questions using our contact form or call (913) 451-5709.

Insurance Questions

With our direct care model, insurance claims are unnecessary because our costs are already less than you’d pay out of pocket after your insurance coverage. We do not file insurance claims. As part of your membership, you agree to not file insurance claims for service received through our practice.

Yes. Most of our members have some form of traditional healthcare insurance. We strongly encourage you to maintain health insurance to cover expensive and unpredictable medical services like hospitalizations, surgeries, and specialist care.

No. You can continue to utilize your health insurance with participating providers. These providers will bill your insurance in the same way that they always have.

Yes. In the event that you need a referral to a specialist or diagnostic service outside of our office, we will attempt to refer you to providers that participate with your insurance. Orders for lab tests, CT scans, MRI scans, and referrals to specialists are generally honored and covered by health insurance when ordered by ProPartners (out-of-network) physicians. If you have a plan that does not, your doctor will refer you to a specialist or “gate-keeper” physician that is acceptable to your insurance for any specialized tests or specialist’s care that you may require.

Direct primary care is specifically described in the Affordable Care Act and, when combined with a high-deductible “wrap-around” insurance plan, meets the “individual mandate” for health insurance coverage.

Membership Questions

Simply read, complete, and submit the online enrollment form, and you’re all set! You will immediately receive an email confirmation, welcome letter, and Member’s Guide.

Yes. There is a one-time initiation fee payable at the time you agree to become a direct care member. The enrollment fee is $90 for individuals and $150 per family unit. Your monthly membership fee will be charged to your credit card of choice.

By paying an affordable monthly fee for your primary care needs, you no longer need to worry about copays, office visit charges, or hitting your deductible. Another financial advantage our practice offers is that we get our diagnostic tests and scans at cost or at a discount.

We don’t recommend it. We are currently enrolling members and expect to fill our patient lists or “panels” quickly. If you wait, you run the risk that your preferred doctor may not have any membership openings or that our physicians might be full.

No problem. If for any reason you are not completely satisfied with our care, you may cancel your membership after the first 90 days with no penalty. You would simply need to notify ProPartners Healthcare in writing 30 days prior to your intended termination date.

Currently, all membership fees are accepted via automatic monthly charges to your credit card of choice. We accept Visa, Mastercard, American Express, and Discover.

Membership fees are charged according to your age. If you “graduate” to the next age tier, your monthly credit card charge will automatically increase the month following your birthday. Like most things in life, it is possible that our prices may increase over time. We promise they will increase only modestly and will never increase more than once a year, and that we will notify you of any planned increases in advance.

Some of our members have chosen to pay their membership fees directly from their health savings account (HSA) or flexible spending account (FSA). Healthcare law and governing agencies’ interpretations are in flux and continue to change periodically. ProPartners Healthcare does not advise any individuals or employers on the advisability or legality of utilizing HSA/HRA/FSA or other similar accounts to pay memberships or incidental fees. Additional information about this subject can be found at DPC Frontier. We recommend checking with your tax adviser, attorney, employer, and/or health insurance representative to determine if your particular account may be used.

Unfortunately, no. Direct primary care membership fees are not yet defined as “medical expenses” in most states and are not tax-deductible to individuals. We recommend that you discuss this further with your tax adviser or accountant.

Direct care members enjoy high-level unrestricted access to all member services in our office. This includes unlimited office visits, virtual visits with the doctor by phone or email, after-hours access to a doctor, and all diagnostic tests and treatments that can be performed at ProPartners.

ProPartners Healthcare offers our signature comprehensive Milestone Health Assessment (executive physical) for a heavily discounted price (about 20% of retail). If you wish to complete this executive physical, call us for the details.

Yes. Lab tests that are ordered from outside labs are offered to direct care members at cost. This is generally about 10% of retail and less than 30% of what you might pay when using your health insurance. One advantage of membership is transparent pricing of services that you can control your costs. We will always tell you the accurate cost of lab tests before they are performed, rather than giving you a rough estimate that is subject to change.

Other services that may not be available at all ProPartners locations are billed at a heavily discounted or “at cost” price. These services currently include Milestone Health Assessments, treadmill exercise EKG, meetings with a registered dietitian, or a diabetes educator consultation.

Yes! You may schedule an appointment whenever you need it, as often as you feel the need, and you may decide how much time you need with your doctor. Appointments can last up to one hour.

Every direct care member is given a direct-dial access number that rings to their doctor’s cell phone when our office is closed. Your doctor wants you to be able to reach them at all times with urgent medical problems, should they arise.

Email is a very efficient way to communicate with your doctor in many situations. Members can send messages directly to their doctor and their staff. Keep in mind that while you may choose to share your personal information over email, this method of communication is unsecure. Your doctor will always send electronic communications to you via the patient portal.

Regardless of which of these methods you use, you can expect a response back the same day to all communications submitted during our regular office hours.

Your doctor will generally be accessible to you 24/7. If you need to be seen in the office, you can get an appointment the same day or the next. In the rare event that your doctor is unavailable, one of our other physicians will provide care and will have full access to your electronic medical record. Our doctors do occasionally take a vacation. If they are “off the grid,” you will have access to one of our other doctors 24/7, and your direct-dial number for your doctor will ring to the alternate physician.

Contact your pharmacy using the phone number printed on the bottle, their website’s patient portal, or through their smartphone app. Even if the bottle says “0 refills,” contact your pharmacy and they will contact the physician who prescribed the medication.

Medical Situations Questions

No problem. ProPartners Healthcare provides management of all common chronic conditions such as diabetes, hyperlipidemia, and low testosterone. You can see your physician as often as needed, without any additional charges. Many visits to our office can be avoided altogether, such as when your physician determines that your situation can be handled by email or telephone.

No. If you need to be hospitalized, you will be admitted by an internal medicine hospitalist who participates with your health insurance. Your ProPartners Healthcare physician will be kept informed about your care and will follow up with you after you are sent home.