The Direct Care Difference

 In News

Dr. Crute had the pleasure of discussing some information about Spectrum Dermatology and why the Direct Care approach can have a positive impact on many aspects of your healthcare experience. Watch her video in its entirety here, and read about some commonly asked questions and answers regarding this unique approach.

Direct Care Commonly Asked Questions

  • What is “Direct Care”?
    • Direct care, also known as direct-pay, is an insurance-free approach to healthcare services.
  • What is meant by “Insurance-Free”?
    • While insurance-free does not mean anti-insurance, we are not contracted with any insurance programs, commercial or government. Therefore, no version of health insurance is accepted.
  • Why would a practice choose to be “Direct Care” or “Insurance-Free”?
    • This approach to healthcare minimizes the increasing constraints imposed by insurance and government programs which lead to increased health care administrative costs, increased patient case load, and reduced quality time with patients. It allows the patient to have more control and choice in their own healthcare and promotes more personalized care with the physician.
  • How do patients know what they will be charged for their visit?
    • Direct care (insurance-free) practices strive to provide upfront, transparent pricing on all services. There are no copays and no surprise bills weeks after the visit. Fees are generally based on the appointment length and any procedures needed during that visit. These fees are discussed openly and honestly and are due in full at the time of the appointment. If a fee for an unanticipated service arises, this is discussed and agreed upon at the time of the visit to ensure complete clarity.
  • What types of patients would benefit from a “Direct Care” approach?
    • While we welcome any patient to seek out care at a direct care/direct-pay practice, this approach can be particularly helpful for those who are uninsured, those with high copays and/or deductibles, those who utilize medical cost-sharing plans, or those who prefer to use HSA or FSA funds. Of course, any patient who desires a more personalized healthcare relationship, longer appointment times, and increased ease of scheduling would benefit from this approach.
  • What methods of payment are accepted?
    • While this can vary from practice to practice, in general, cash, credit cards, HSA and FSA funds, and occasionally checks are accepted forms of payment.
  • Is there any alternative way that insurance can be utilized in a “Direct Care” practice?
    • Patients with commercial health insurance benefits may request a superbill and supporting documentation from their provider following the completion of any visit. They can then, on their own, submit this documentation (along with any other required forms) to their insurance provider to be considered for reimbursement. There is no guarantee that the request for reimbursement will be approved or that the reimbursed amount will exactly match the fees charged for the visit.
    • Patients with government-funded health insurance benefits (e.g. Medicare) will not be issued a superbill or other documentation to submit for reimbursement. Requests for reimbursement are not permitted for patients with these insurance policies. These patients must sign a private contract acknowledging and agreeing to this restriction and must resign this private contract every 2 years.
  • What if I need additional healthcare services such as prescription medications or labs?
    • Patients are free to use their commercial or government health insurance policies to obtain prescription medications, laboratory tests, or pathology services. If a patient does not have insurance or wishes to explore alternative cost-savings options for these services, we can discuss cash pay options and discount opportunities.
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