What is Direct Primary Care?
Direct Primary Care is a business model that eliminates the middleman (insurance companies). The model allows health care providers across the country break free from regulations that require unnecessary paperwork and complex reimbursement codes. Direct Primary Care removes all the red tape and allows the health care to focus on what matters most….YOU!
What is it like being a Direct Primary Care Patient?
You will SAVE money by avoiding deductibles and co-payments per visit. Paying an affordable monthly subscription allows you to pay for the services you need when you need them. Some of the benefits you will enjoy are 24/7 accessibilty to your provider, onsite lab draws, wholesale prescription costs, extended visits, same day or next day scheduling and the convenience of telemedicine visits at no extra charge.
Do you bill insurance?
The answer is no and yes. No, I do not bill insurance for clients that are not on Medicare. Nor do I provide superbills for you to submit to your insurance for reimbursement. The reason is because the codes used for reimbursement of services that I would provide are more than I would charge a typical subcription client. Since I can’t change the reimbursement codes or the cost associated with it, I have to bill it as is. This would be considered discriminatory practice, in that I would have to charge you double or more, than the low monthy subscription I charge everyone else.
Yes, I will bill Medicare. I am choosing not to opt out of my Medicare contract so therefore these clients are not able to sign up for a monthly subscription. I prefer not to deal with any insurance companies but I am not willing to exclude an entire population from receiving excellent health care because of government regulations.
Do you charge a co-payment with each visit?
No. All office and telemedicine visits are included in the low monthly fee.
What if I decide to cancel my membership?
No problem! You can cancel at anytime with a 2-week notice in writing.
If you want to restart your membership, that’s not a problem either, just pay a $49 reinstallation fee plus the month.
Do I still need insurance?
Yes. We recommend you secure a plan with a low cost and slighty higher deductible. You can use the plan, if needed for services not covered ( non-routine labs, some medications, imaging, specialty care, emergency care, hospitalizations, surgery).
Hope Wellness Center & Spa will always make your care a priority and refer services to a specialist when necessary. Consider a plan that does not require an in-net-work provider. This will allow us to be full participants in the coordination of referral and collaboration process.
What happens if I need hospitalization?
You can go to any hospital of your choosing. At the time of sign up, you will be informed of any affilitate hospitals. During your hospitaliztion, care will be provided by a hospitalist on staff. You are welcome to discuss your care with your provider at Hope Wellness Center & Spa.
Is there a physician on staff?
No. In the State of Illinois, nurse practitioners are allowed to practice independently. We are required to contract with a collaborative physician and consult quarterly.
What happens if I need a specialist, X-ray or other imaging?
If you need to see a specialist or a higher degree of care we will direct you in the right direction. If you need a x-ray or other imaging, we can order it for you. You can use your insurance to help cover it or if you would rather pay cash we have negotiated cash prices at certain local centers.
I’m ready to join! What’s next?
Click here or call 773-985-5734. Either way we look forward to hearing from you!