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FAQs

What is Direct Primary Care?

Direct Primary Care (DPC) is a healthcare model where patients pay their PCP directly for comprehensive services via a monthly or annual membership. The provider does not bill the patient's insurance, so they are not required to see a high number of patients per day. Instead, the provider is able to spend more time with a few patients per day, be available for direct communication, and accessible for needed appointments. DPC cultivates strong provider-patient relationships and covers a vast spectrum of primary care needs.

 

How is this different from a traditional clinic?

Traditional Primary Care Providers have a patient panel size of 2000-3000 patients. Your provider will have a panel of only 200 patients, affording more time to build a patient-provider relationship and focus on your healthcare needs. Another key difference with DPC is accessibility–you are able to communicate with your PCP when you need to via call/text/email, and schedule appointments at your convenience.

 

Is DPC the same as Concierge Medicine?

DPC is not the same as Concierge Medicine, though this is a very common misconception. With Concierge Medicine the fee only gets you communication access to the provider and does not cover any of your care. Direct Primary Care membership covers all primary care services.

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What Services are included?

Amalura Health Direct Primary Care provides the full spectrum of primary care needs including urgent care, chronic condition management, lifestyle management, behavioral health–read more on our Services page.

 

INSURANCE

 

Is Direct Primary Care insurance?

Direct Primary Care is not health insurance and does not replace traditional health insurance. Direct Primary Care membership compliments health insurance by covering your primary care needs. DPC patients are still recommended to carry health insurance, especially for "catastrophic coverage." Generally, a "low premium, high deductible" insurance plan works well with a DPC membership. 

 

DPC practices are able to accept patients without health insurance. This creates opportunities for uninsured/underinsured patients to engage in preventive healthcare and health maintenance at an affordable, transparent cost.

 

Does Amalura Health bill my insurance, Medicare or Medicaid?

Amalura Health does not bill insurance, Medicare, or Medicaid. Because we work directly for the patient we never bill any insurance companies or programs.

 

Can I still use my insurance company for lab testing, imaging, referrals and prescriptions?

You can still use your health insurance for lab testing, imaging, referrals and prescriptions. Amalura Health assists patients with needed prior authorizations or approvals, and can connect patients to an insurance specialist and other resources.

 

GENERAL

 

Will I benefit from direct primary care if I don’t require frequent medical attention?

Yes, of course! Your DPC provider will really get to know you. And when you do need medical care, you won’t have to navigate the traditional healthcare system on your own. With DPC, you always have access to your provider for questions or concerns that pop up in your daily life. Getting real time advice on your health provides significant peace of mind.

 

What happens after hours or on weekends?

We still have you covered after hours and on weekends! Check out the Member Connect page. 

 

What happens if I get admitted to the hospital or need to see a specialist?

Your provider will coordinate any necessary referrals to providers in your insurance network. Specialists will bill your insurance for services they provide. 

 

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