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© 2018 Jerry Anderson & Diane Hellman Insurance

Direct Primary Care

WHAT IS DIRECT PRIMARY CARE?

  • Direct Primary Care (DPC) is a healthcare model that gets back to the patient-provider relationship. We do not bill or accept insurance. No more middle man. No more trying to figure out what is and isn’t covered. Just you and the provider making decisions about your care.

 

 

Do you long for the old days of medicine? There once was a time when you knew your provider. You were partners in getting and staying healthy. This is the foundation of Direct Primary Care, a membership-based model where primary care payment arrangements are made between patients and providers without sending claims to insurance companies.

CostCare Direct takes the middleman out of the healthcare equation so you and your provider can determine what is best for you without the red-tape of insurance bureaucracy.

DPC allows you FREE in-office visits. Each provider has no more than 600 patients to care for which allows more personalized care and access, 24/7, through clinic visits, text, email, phone, and video calling. No more waiting rooms or waiting a week to get a call back.

With CostCare Direct, our goal is to be as accessible as possible for diagnosing, treating, and triage so that you can keep your costs down with less referral, ER, and urgent care visits. By not billing insurance we can keep our costs and overhead down. Direct Primary Care is a model that allows both the provider and patient to feel in control.

 

Direct Primary Care (DPC): A Health Care Revolution

HOW IS DIRECT PRIMARY CARE DIFFERENT FROM TRADITIONAL HEALTHCARE?

DPC clinics differ from traditional fee-for-service plans primarily through the payment structure. In a traditional model, you pay when you are seen with costs being predetermined based on complexity of the problem or duration of the visit. Labs, x-rays, and procedures are offered at rates predetermined as well, often leading to expensive bills. Unless you have a “gold” or “silver” health insurance plan, you will typically be responsible for the entire bill until your deductible is met which, at present time, can be over $6000 per individual. This model also requires billing and coding staff, creating more overhead, which leads us to the “do more, bill more” mentality that is bankrupting our healthcare system.

In a DPC model, payment is received as a monthly membership fee. Office visits and in-house labs are included.  X-rays, labs, and procedures are often 80-90% less when compared to traditional healthcare models. Direct Primary Care is NOT insurance and we highly recommend having a wrap-around high deductible insurance plan for emergencies.

BENEFITS:

 

Benefits of DPC are availability, flexibility, transparency, cost, and convenience. DPC providers spend more time with fewer patients in order to provide them with better quality care. Patient memberships are typically kept around  600 patients per provider allowing those patients better access and longer clinic visits when needed. However, we understand you are busy, and not all healthcare needs require an in-house visits. DPC providers utilize today’s technology in contacting and responding to patients. Email, text, phone, and video calls are standard methods of communication used to keep providers and patients in contact to discuss health concerns. This allows us to be more accessible, 24/7.

DIRECT PRIMARY CARE SERVICES

 

WELLNESS AND PREVENTATIVE CARE

  • Wellness exams

  • Immunizations

  • Routine lab work

  • DOT exams

  • Sports physicals

  • Cancer screenings

  • Dietary counseling

 

WOMEN’S HEALTH

  • Pelvic exams

  • Pap smears

  • HPV screening

  • Colposcopy

  • IUD insertion and removal

  • Nexplanon insertion and removal

  • Hormone services and pellet insertion

 

CHRONIC DISEASE MANAGEMENT

  • Type 1 and Type 2 diabetes

  • High blood pressure

  • High Cholesterol

  • Asthma and COPD

  • Thyroid disorders

  • Skin issues

  • Call our office for a full list. 

 

IV MEDICATIONS AND FLUIDS

  • Fluid hydration

  • Medications for nausea and vomiting, infections, and allergic reactions.

  • We DO NOT offer any pain medications outside of anti-inflammatory medications.

 

IN-HOUSE PROCEDURES

  • Laceration care

  • Skin biopsy

  • Joint injections

  • Cryotherapy/wart treatment

  • IV fluids and medications

  • Tests including; rapid flu, strep, RSV, pregnancy, urine dip, and monospot. 

 

DIAGNOSTICS

  •  EKG

  • Audiometry

  • Spirometry

  • We work closely with our local radiology service groups to offer you the best price possible for x-ray, cat scan, MRI, and ultrasound when needed.

 

URGENT CARE NEEDS

Our DPC providers bring a wealth of urgent care experience to the table. All three clinicians have worked in urgent care and emergency department settings. We have the knowledge to treat most acute needs and injuries and the experience to know when referral to a hospital is appropriate. 

 

COORDINATION OF CARE

If the need arises, our providers can refer you to any local specialty group and coordinate your care. We attempt to keep our referrals to a minimum but there will be times when specialty care is needed. You can trust we will refer you to a trusted specialist.

 

NUTRITIONAL COUNSELING AND WEIGHT MANAGEMENT

  • Our clinicians are well-versed in the current nutritional guidelines and extend that knowledge to their patients. We would much rather prevent disease with proper nutrition than treat with medication, if possible.

  • Members also receive a $150 discount on our CostCare nutritional BootCamp.

 

AESTHETICS

  • To all of the members of the DPC, CostCare Direct will be offering Botox and Juvederm at steeply discounted pricing. This is a cost savings program like no other in Missoula. Our Botox pricing will be $9 per unit and Juvederm will be $450 per syringe.

DPC BENEFITS & RATES

 

24/7, UNLIMITED ACCESS

That’s right, complete access to your provider through email, text, phone calls, and video calling anytime. Choose which method works best for you.

 

NO OFFICE VISIT CHARGES OR CO-PAYS ON ROUTINE VISITS

Walk into the clinic for a routine visit, walk out with no charge.  You won’t get a bill in the mail three weeks later explaining why your insurance plan will not be covering your visit…again. The monthly membership fee covers all visits including those for diabetes, hypertension, high cholesterol, contraceptive management, urgent care needs – all of it. 

FREE IN-HOUSE LABS

All “CLIA-waived” tests that are done in-house are free. Strep throat, influenza, urine dip, urine pregnancy, RSV, monospot, and finger stick INR testings are all free. 

SAME-DAY SCHEDULING

Need a visit today? No problem. Call us! It might be something we can take care of over the phone and if not, we can get you in. With a smaller patient membership base, our ability to fit you in TODAY, is almost guaranteed. We’ve got you covered, today and everyday. You’re important and we treat you as such.

RELAXED AND EXTENDED VISITS

Do you need 60 minutes to talk about your diet and diabetes? We think so too. We want our patients to be educated so they have the tools to care for themselves. Instead of adding another medication to “make you better,” we counsel our patients on how nutrition can improve their health and prevent disease. We want our patients to have the knowledge to improve their health beyond the prescription pad.

COST TRANSPARENCY FOR OFFICE PROCEDURES

Pay a flat fee of $20 for certain procedure including skin biopsy, toenail removal, IUD or Nexplanon placement, simple laceration repair, joint injections, colposcopy, foreign body removal, abscess drainage, and cryotherapy. Procedures that require biopsy are subject to a lab fee as they have to be viewed by a pathologist for diagnosis (see below).

LABS AT COST + 10%

In traditional insurance-based models, insurance companies set the reimbursement rates on labs and clinics make money on marking up the charge. At CostCare Direct, we provide labs and pathology at OUR cost +10%, resulting in 80-90% savings to you. This alone covers a large portion of the yearly membership.

FREE IN-HOUSE DIAGNOSTICS

Our in-house diagnostics are free to you and include EKG, audiometry, and spirometry. We work closely with our local radiology service groups to offer you the best price possible for x-ray, cat scan, MRI, and ultrasound when needed. Fees for those services are not included in the membership but we have worked to contract the best rates possible for our members.

DISCOUNTED HORMONE PELLETS

Hormone pellet insertion costs $50. The hormone pellets are $16, our cost+10%. Under this model that’s more than a 50% savings. 

AESTHETICS

With your membership comes the added benefit of getting Botox and Juvederm at discounted prices. We charge $20 for the procedure and then, depending on the amount needed, you are charged for the product. Botox will be $9 a unit (typically $13), and Juvederm will be $450 per syringe with normal pricing around $600. We also offer Kybella and Voluma services.

COSTCARE BOOTCAMP

One other benefit to the membership is reduced costs to our popular 6-week nutritional bootcamp. DPC members will receive a $150 discount to the program. 

 

DIRECT PRIMARY CARE F.A.Q

 

What is Direct Primary Care or DPC?

Direct primary care is a membership-based model of primary care. We take the middleman out of healthcare, allowing the patient to become the center of care.

Does CostCare Direct bill insurance for DPC?

We do not bill insurance. The red tape, billing, and administrative burden it takes to deal with third-party payers are some of the reasons healthcare has become so expensive. By not billing insurance, we can keep our overhead down, allowing the savings to be passed on to patients.

 

If I'm a DPC member, do I still need insurance?

Direct primary care is NOT insurance and, as it stands now, insurance is required by all Americans. We recommend having an insurance plan with the highest deductible you and your family feel comfortable with to provide wrap-around coverage in case of a major medical event.

 

Does my CostCare Direct membership cover referrals to other providers or specialists?

In the event you need to be referred to a surgeon or specialist, your DPC membership will not cover their services.

 

Can I see CostCare Direct providers if I have Medicare or Medicaid?

Yes. Medicare patients will need to sign a waiver confirming their understanding that we will not be billing Medicare for any of our services.

 

Is there a CostCare Direct contract or can I opt out at any time?

There is no formal financial contract. We do review a care agreement so that you understand what is included in the membership. You pay month-to-month. You can opt out anytime and upon doing so your membership will be cancelled. However, keep in mind that our providers will see 600 patients or less. If you cancel and the 600 slots become filled you will not be able to renew your membership until a slot becomes available.

 

How do I pay for CostCare Direct membership?

Payment can be made monthly or yearly, it’s up to you. We can take payment in the form of automatic monthly withdraws from your checking account or credit card.

 

Where is CostCare Direct located and what are the clinic hours?

CostCare Direct is located at 2819 Great Northern Loop Ste 100 Missoula, MT, 59808. We are off Mullan Road between Reserve Street and Broadway. Clinic hours are Monday through Friday, 9:00 a.m. to 5:00 p.m.

Direct Primary Forms

 

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 Jerry Anderson & Diane Hellman Insurance are your local insurance professionals

We have over 60 Years of experience serving Western Montana!