FAQs
What all is included in Primary Care?
Primary care refers to the “day to day” medical issues, in other words it includes wellness care/check ups, outpatient care for most chronic medical conditions (High blood pressure, diabetes, thyroid disease, arthritis and much more), urgent sick visits (cold, flu, sinus infection, allergy flare and much more), most minor injuries (like splinting/casting a broken arm), stitching of minor wounds, and minor procedures (such as skin biopsies or mole removal).
Is there a contract/can I leave the practice?
There is an agreement form signed upon enrollment, but there is no contract and you can leave the practice at any time. It is important to us that your healthcare is a good fit for you – both your doctor and the way you pay for it.
Is my membership fee covered by my insurance?
Not at this time. The burden of paperwork that comes with billing insurance is one of many reasons healthcare is so expensive. By streamlining the process of care delivery, we can keep the total cost of your care much lower.
What if I wait and sign up once I’m sick or injured and need an appointment?
This would not work well. One important component of DPC is that by having an established relationship with a doctor, who knows you, has your records, etc., you and the doctor are both set up for success when something comes up. Also, the enrollment process involves completing a Patient Agreement, and it would be unethical for us to expect you to sign such an agreement when you are in the midst of an urgent or emergent medical situation.
If I have insurance can I use it to pay for labs, imaging, or pathology test?
Yes, you can. You can submit the order to your insurance company to see if its covered.
Can I see you for just one visit?
We only offer one-time visits to non-members who desire OMT and even then additional visits are often recommended depending on Dr. Bilyeu’s evaluation. We do not offer one-time visits for any other healthcare issues. We believe in long term relationships with our patients. It’s our specialty and it improves healthcare.
Will I always get to see my doctor?
Yes. Anytime you have a scheduled appointment/need to be seen, it will be with Dr. Bilyeu.
What if I have Medicare or Medicaid?
We can still see you! You will be responsible for the monthly fee and will sign a waiver acknowledging that we will not bill Medicare and that you cannot submit your membership fee for reimbursement.
If I have a membership and come in for an illness or injury, will there be any extra charge?
No, it’s part of the membership. If you and Dr. Bilyeu decide to get imaging, blood work or send anything for a pathologist reading you will pay a set price (with no mark-ups). The price will be known to you before Dr. Bilyeu places any orders. There are no unknown or hidden costs.
What if I need to be admitted to the hospital?
Depending on the reason for your hospital stay, your care there would be managed by a hospitalist (a doctor who takes care only of hospitalized patients, and is specialized in this type of care) or a surgeon.
How do I pay for my membership?
We offer automatic, electronic monthly withdraws from your bank account or debit/credit card. This eliminates the need to hire a billing and collections staff member and that means you save money! You can also pay with cash/check, which is usually only done by non-members receiving OMT.
Does my membership cover care by specialists or surgeons?
It does not. If you need a referral to a specialist, it is not covered under the DPC model.
Do I need to have insurance?
We recommend that you do maintain some form of insurance, much like your car insurance, for catastrophic events like surgery or accidents. A health cost sharing plan (such as Christian Health Ministries) works nicely for this option and is generally less expensive than traditional insurance. You may also find low-premium/high deductible catastrophic options when looking at Non-ACA (Affordable Care Act) plans, which often have prices similar to health cost sharing plans. Most of your outpatient care needs can be done in the clinic and are covered by your monthly fee.
How is it that lab, imaging or pathology tests can be discounted if I have a DPC membership?
When clinics, labs, or hospitals work with insurance companies, this actually adds expense for them. Insurance companies have created complex billing requirements (which means added billing staff for the labs/hospitals/etc.), they often find reasons to deny claims (leading to repeat billing), and they generally do not pay promptly. On the other hand, when a lab or hospital knows that it can be paid promptly, without having to submit multiple complicated claim forms, then the billing process is less expensive for them, and they are often willing to give a more favorable price.