Direct Primary Care FAQs

Direct Primary Care or DPC is an innovative model where patients pay their primary care doctor directly, rather than through their insurance company. Said another way, the doctor is employed by the patient, not employed by the insurance company. These practices offer the full range of services that you would expect from your primary care doctor’s office for a flat, periodic membership fee. Typically, patients receive enhanced services beyond what traditional fee-for-service medicine offers. These may include real-time technology access to their personal physician, extended visits, and highly personalized, coordinated, and comprehensive care administration, with no additional visit charges or insurance company involvement or influence. Essentially, it cuts out the middleman.

Fee-for-service medicine often comes with a lot of unnecessary stress - there are so many prior authorizations and billing headaches, and doctors have to see more and more patients in less and less time. A focus of DPC is that the doctor’s income is no longer based on how often a patient is seen in the office and how many patients they see per day, as it is with the traditional “fee-for-service” model. Instead, the doctor is just paid to keep patients healthy. With fewer patient visits per day, the physician has more appointment times available and more time to spend with each patient, including office visits, phone calls, and email communication.

Both DPC and concierge practices have membership fees. With DPC, the fee pays for the visits and care patients need throughout the year without additional per-visit charges. DPC practices do not involve insurance companies by definition. The care is “direct,” from doctor to patient, and does not involve a third party. Concierge practices have an annual retainer fee but also charge for visits and bill the patient's insurance for services rendered.

Not taking insurance allows us to concentrate on you, the patient. In traditional fee-for-service practices, doctors spend up to half of their time on administrative tasks, such as insurance paperwork, phone calls with insurance companies, documentation to prove to insurance companies that the care they were trained to provide is “deemed appropriate” by the insurance company, and so on. Without the administrative burdens and invasive requirements, we are able to save time and money, and therefore, keep our patient panel to a much more manageable size of 600-700, versus 2000-3000 in insurance-based practices. Patients want to choose a provider whose opinions and recommendations they trust. So it is unfortunate when an insurance provider instead tries to dictate what type of care they feel the patient should receive. By eliminating needless clerical chores, we are able to spend visit time on what you actually came to discuss – giving you a truly personalized experience. We are also able to offer extended visit time and more availability via technology. We want you to feel like a part of our family and not a number/commodity. By not taking insurance, we are able to offer you more care at a lower price, including access to labs and commonly prescribed medications at greatly reduced prices.

Yes. You still need insurance for hospitalization, ER visits, surgeries or procedures, specialist visits, labs, X-rays or other radiology, or any other medical services outside of the primary care office, if needed. Because most patients’ medical care can probably be managed through the primary care office, this might mean that a higher deductible, lower-cost insurance plan would be a better option to go along with a DPC practice and typically drastically reduces the patient's overall medical costs.

Although we do encourage everyone to have some coverage for catastrophic events as long as you pay the monthly membership fee you can join our practice. Just to be clear though we are not an insurance program/company.

COS DPC prides itself in providing equal access, non discriminatory care to all. Whether you need basic preventive care services or have multiple medical concerns, COS DPC's board certified Internal Medicine doctor is highly trained to meet your needs. Internal Medicine doctors see patients over the age of 17. At this time we are unable to actively enroll beneficiaries of federally funded insurance programs (ie Medicare/Medicaid and Tricare) however if you are a recipient of federally funded insurance services, please contact us directly to discuss your situation. In the state of Colorado, direct primary care practices are prohibited from caring for beneficiaries of Medicaid/Health First Colorado. Colorado is one of only two states in the US that have this restriction. If you find this unfair and limiting of your health goals, please contact us for a prewritten, stamped, and addressed letter to send to your Colorado State Representatives.

Lab fees are not included in your membership but some labs are available for in office collection with cash pay while others may require draws at Quest Diagnostics facilities where patients must pay the lab facility directly. Outside imaging services, such as Xray’s, MRI, CT Scans and Ultrasounds, are not included in your membership but will be ordered in an economical manner. COS DPC has negotiated deeply discounted prices for imaging services with local imaging facilities. We will send the imaging order electronically to these contracted imaging facilities and you will pay the facility directly for the imaging services.

If you are hospitalized, we will work closely with your hospital team and arrange for quick follow up after you are discharged from the hospital to allow for a seamless transition and most importantly to prevent you from returning to the hospital. Your membership to COS DPC does not include services by any other doctors or hospitals, and those costs would have to be paid by you or your insurance company.