Direct Patient Care FAQs
While there has been a rise in direct patient care (DPC) practices across Tennessee, many individuals still have questions about this new approach to care. Patients are conditioned to believe they have only two options – the hassles of insurance or the expense of pay-out-of-pocket. But with the membership model Rheumatologix offers to our patients in Knoxville, you get the highest-quality rheumatology care on an affordable monthly budget.
When you can leave the worries and waiting behind, you can get one step closer to a life with less pain – both physically and financially!
Why do you charge a membership fee instead having patients pay for each visit?
This is a common question I get from patients. One of the primary advantages of a direct pay practice is the availability afforded to patients in the form of telemedicine and same day or next day urgent care visits. This is especially important for rheumatology patients where a flare-up can quickly become debilitating. If you've experienced these you can attest to the need to get into the doctor quickly and not have to wait for several days or longer. DPC doctors like myself can offer this enhanced availability because, by design, we serve a smaller number of patients than most practices. This is all made possible by the consistent income from the membership fees. Without those fees we would either have to charge much higher prices on a per visit basis, or maintain a much larger pool of patients to fill our appointment schedules and ensure enough income to pay our bills and run the practice. Many DPC doctors operate on this membership model. Ultimately, it enables the flexibility and superior care that patients need.
Do I still need insurance if I join your practice?
Absolutely! While your membership at Rheumatologix will cover the majority of your rheumatological needs, you still need coverage for catastrophic events (like a car accident or cancer), labs, medications, and the like. These are the kind of events that insurance was made for, and without it they could financially cripple many people. In fact, we feel so strongly about this that we advise patients who have to choose financially between health insurance coverage and membership with us to start with insurance first. You still have options though. For example, many patients with direct care memberships will often have higher deductible, catastrophic insurance plans with lower premiums, freeing up money to cover their direct care membership fees. Just be sure you have enough savings to cover the high deductible if the need arises.
Can I submit my Rheumatologix fees to my insurance company for reimbursement?
As all insurance companies and plans are different, this is a good question to ask your insurance company directly. We can provide a superbill of our services for you to submit to your insurance company for reimbursement or credit toward your deductible if your insurance plan allows this.
Can I use my Health Savings Account (HSA) to pay for my membership fee?
This question enters into a bit of a gray area regarding how the IRS views direct patient care, health plans, and health savings accounts (HSAs). Based on a proposed rule in July of 2020, it is our understanding that it is possible to pay for your Rheumatologix membership using pre-tax, HSA dollars. However, we encourage you to consult with an accountant or tax professional before taking any such action as the regulations are still in flux.
What if I have an urgent need and you're on vacation?
It's true, everyone needs a day (or week) off every now and then, even doctors. When I take vacation I will notify all of my patients ahead of time and will still be reachable via my work phone. Don't worry, I'll still be there if you need me.