Direct Primary Care

[iris lilies]

I’ve been poking around media coverage and discussion boards on concierge/direct care physicians, and I learned that my own physician is expanding yet again to her third town. I’m not sure I am on board with that. She wants her practice to be 1000 patients, and what I’m reading says direct care practices are 600 to 800 patients.

The last time I went into the office I saw her nurse practitioner, a new employee. If this becomes a process where I can’t access the real doctor, that is a dilemma. However, the main reason I go to that practice is because it’s just too easy, is in downtown Hermann in a little Victorian building that’s so easy to access.

[dado potato]

I wonder if the concierge MD accepts Medicare.

Medicare reimbursement for say, seeing a patient 10 minutes (Billing Code 99212-CG) has a "Medicare-Approved Amount" = $145.30. Does Medicare take a dim view of MDs assessing a monthly/annual membership fee aside from Medicare's approved amount for a quota of a physician's time with a Medicare patient?

[iris lilies]

I wonder if the concierge MD accepts Medicare.

Medicare reimbursement for say, seeing a patient 10 minutes (Billing Code 99212-CG) has a "Medicare-Approved Amount" = $145.30. Does Medicare take a dim view of MDs assessing a monthly/annual membership fee aside from Medicare's approved amount for a quota of a physician's time with a Medicare patient?

I’m on Medicare. I have a direct patient care membership (If you want to call it that. )

Very simply, the doctor doesn’t bill Medicare for her time or for any in-office procedures and tests. Her time is not a factor in the insurance game.

[Simplemind]

I've been interested in this since the last time we discussed it long ago..........

[iris lilies]

I've been interested in this since the last time we discussed it long ago..........

So to elaborate and give an examples: my doctor or her tech draws blood for a complete blood count test. There’s no charge for that or anything her office incurs in that procedure.

She sends it off to a lab. The lab bills my Medicare for reading the blood and reporting back to my doctor.

my doctor does an ?Ultrasound? In her office with her own equipment. It was a procedure on my chest a few years ago when I had a rash and an obvious cyst. I knew it was a cyst, she knew it was a cyst, but ya gotta check that out if it’s anywhere near breast tissue. That was not charged. She sent me to the local hospital have a mammogram 10 minutes later and that of course was charged to my insurance.

If I had a dog bite of minor proportions I would go into her office and she would sew it up. There would be no charge for that.

I have not had inoculations in her office, so I’m not sure if she charges for the drug itself or what exactly.

She also does dispense medication from her office if I choose to buy it there. That means I pay her directly for the medication and yes there is a charge for that. It might be cheaper than running it through my insurance, I really haven’t compared because my drug costs are not very much.