WHAT IS DIRECT PRIMARY CARE (DPC) AND HOW IS IT DIFFERENT FROM TRADITIONAL PRACTICES?

In a Direct Primary Care (DPC) practice, you receive medical services the way they were meant to be delivered: directly between you and your doctor with no interference from insurance or government middlemen. We offer all the primary services you need with incredible savings due to the decreased administrative costs to the practice. We then pass those savings on to you through very affordable monthly membership fees paid to us directly. We also provide labs and equipment, and dispense our own medications at wholesale costs. Even without billing insurance, most patients spend much less on their healthcare in a DPC practice than they spend on their insurance's out-of-pocket costs. Oftentimes, its more than enough in savings to cover the membership!

WHAT ARE THE ADVANTAGES OF DPC?

1. Access when you need it with appointments with your doctor usually the same day
2. Appointments lasting 30 minutes to an hour to address all your concerns
3. Open communication with your doctor via phone, text, email, and video chat, even afterhours
4. In-office medication dispensing at wholesale prices up to 90% less than market price
5. Included access to all medically indicated procedures as well as discounted rates for elective procedures
6. Discounted labs and equipment
7. Hospital care by your doctor if you’re admitted to Ashe Memorial Hospital
8. Pregnancy care by the doctors who know you best for huge savings
9. And most importantly, the kind of relationship with your doctor that you’ve always wanted, based on trust, respect, and direct communication

WHAT SHOULD I EXPECT AS A PATIENT?

At New River Family Wellness, you should expect to be provided high quality, affordable primary care services through an innovative, membership-based model. We eliminate barriers to the doctor-patient relationship through direct, open communication with your doctor. You’ll always be able to get directly in touch with them, even after hours. We provide fairly priced medications and labs, near immediate, around-the-clock availability, and compassionate service that sets us apart from any other healthcare experience our patients have ever had.

DO I STILL NEED INSURANCE?

A membership at NRFW is not insurance and we encourage our patients to maintain insurance coverage (including Medicare with supplements if applicable). You will be able to use it as you normally would for specialist referrals, hospital admissions, imaging, and ER care. Our affordable memberships often allow patients to obtain lower cost, catastrophic plans they can afford. They also allow people who aren’t provided insurance from their employers and who can’t afford insurance themselves the opportunity to get the primary care they need at incredible prices. We do not file or accept any insurance or government payments, but you should be able to obtain outside services if needed as you normally would. While insurance does not usually reimburse for our services, some health sharing ministries may reimburse for your membership.

IF I'M AN EMPLOYER, CAN I ARRANGE MEMBERSHIPS FOR MY EMPLOYEES AND THEIR FAMILIES?

A Direct Primary Care practice is a wonderful option for small business owners who want to help their employees get the primary care they need, but who can’t afford to provide them with insurance. Our membership Pricing is fair, transparent, and a huge value. Whatever your circumstances, from initiating services for the first time, to combining memberships for your employees with a catastrophic insurance plan, at New River Family Wellness, we can partner with you to find a solution that fits your size, budget, and needs. Not only will your employees get incredible healthcare, but you’ll get a healthier, more reliable and productive workforce. Take a look at our Employer page for more information.

CAN I USE HSA OR FSA FUNDS? WHAT ABOUT SUBMITTING BILLS TO INSURANCE?

Federal laws and regulations are contradictory when it comes to using HSA/FSA funds for membership in our practice. We recommend that patients ask their HR department and tax accountants. You can safely use HSA/FSA money for labs and medications. In general, insurance companies will not accept our invoices or office notes in consideration for reimbursing patients directly should you choose to attempt to file a claim yourself. You should not expect to successfully be reimbursed for services received at our practice.

WHAT AGES ARE TREATED?

As doctors trained and board certified in Family Medicine, Drs. Allen and Sullivan see all ages, from newborns to geriatrics. We even do routine prenatal care for our pregnant patients. We are truly a one-stop shop for healthcare throughout the lifespan and we enjoy being able to take care of multiple generations within the same family.

HOW DO YOU HANDLE ACUTE CARE?

Our doctors are only accepting a limited number of patients. That ensures that they will always be able to fit you in when you need to be seen. When you have an acute need, you’ll be able to see your doctor that day (or possibly the next morning if scheduling after noon on a business day). In general, you’ll find that our patients are able to get in touch with their doctor directly, easily, and without getting the run-around.

HOW DO I GET IN TOUCH WITH MY DOCTOR AFTER HOURS?

If you have an afterhours need, you’ll be able to call or text your doctor’s cell phone directly for advice. If they can address your problem over the phone, they will. They may video chat, meet you at the office, or schedule an appointment for the next day. Your doctor will try to return your call or text message within 1 hour to the best of their ability, but guarantee to return them within 4 business hours. As our practice is small, there may be times when only one of our physicians is in town and your doctor may be unreachable by phone. If this is the case, your calls and messages will be forwarded to and managed by our other doctor. In general, you’ll find that you are able to get in touch with our doctors directly, easily, and without any hassle after hours.

WHAT IF I GO TO THE HOSPITAL?

Our doctors will care for you if you’re admitted to Ashe Memorial Hospital. This is a huge asset as it allows the doctor who knows you best to care for you when you’re at your sickest. As discussed on the Pricing page, there is a daily hospital visit fee of $30 to cover the time it takes our physicians to leave the office and manage your hospital care, but you’ll find this to be much less than the normal fees physicians charge for hospital services. The hospital will still bill you and/or your insurance for the stay, medications, labs, and imaging that takes place in the hospital as it normally would. In addition, other doctors and specialists particpiating in your care during your stay and before our doctors take over will also bill you and/or your insurance. The good news is that with first-class primary care services, you hopefully won’t visit the hospital as often, saving huge sums in the long-run! If you're admitted to another hospital, or need to be transferred from Ashe Memorial to another hospital, your doctor can communicate with the other hospital team to help coordinate your care. As our practice is small, there may be times when only one of our physicians is in town. If this is the case, your care will be managed by our other doctor while admitted to Ashe Memorial.

WHAT IF I BECOME PREGNANT?

Both of our doctors are board certified in Family Medicine and are trained to provide prenatal care and to attend normal vaginal deliveries. Patients who become pregnant and wish to receive their prenatal care with their doctor may do so; we can also refer patients elsewhere if they wish or if they are higher risk. Because of the time and expense in providing prenatal care, our practice charges a global pregnancy fee of $750 once during the pregnancy. This includes routine labs, and the physicians delivery attendance and hospital care for mom and baby but does not include ultrasounds performed outside the practice or the hospital's charges for your stay. Our global pregnancy fee is a huge discount compared to traditional out-of-pocket costs for pregnancies which frequently approach $3,000.

HOW DO LABS WORK?

Our practice obtains labs in the office and bills you directly at substantially discounted cash prices compared to traditional lab fees. There won’t be any lab bills in the mail after-the-fact and you’ll always receive clear, transparent pricing up front as you and your doctor make decisions about testing. You’ll always hear directly from your doctor the day your results come back, so there won’t be any unnecessary anxious waiting.

HOW DOES RADIOLOGY WORK?

Our practice will help you make informed decisions about any imaging you elect to have done. While we can’t control the pricing practices of external imaging centers and radiologists, when possible, we will attempt to find fair cash prices for our patients. You may also elect to use insurance or Medicare coverage for imaging and if this is the case, your doctor will send an order for the studies and the radiologist will bill your carrier directly. Our office does have an ultrasound, but this is only for obstetrical dating and use with procedures and is not a substitute for radiologist performed imaging procedures.

WHAT ABOUT REFERRALS?

While Family Medicine doctors have broad training, they do not know everything and may occasionally require additional input from specialists. If you already have a specialist provider, we will communicate with them on your behalf as we co-manage your medical care. If your doctor is not able to determine the appropriate treatment regimen despite extended appointment lengths and a limited patient panel size, they may reach out to local specialists by phone. Our doctors also belong to a network of specialist consultants and may forward your case for review. If our doctors determine your condition warrants direct referral to a specialist or the proper course of action is not identified with the peer-to-peer communications described above, they will refer you to a specialist in the region for formal consultation which will be billed by the other practice as normal. Please note that if your doctor determines that a specialist consultation is warranted and you do not agree to follow through on the recommendation for referral, you will be asked to sign an Against Medical Advice form as membership in the practice does not preclude medically necessary specialist evaluation or referral as deemed appropriate by your doctor as stated in the patient contract.

DO YOU COORDINATE HOSPICE OR NURSING HOME CARE?

Our doctors can be your attending physician both for hospice and in nursing homes. While we don’t have standing arrangements with any specific hospice organizations or nursing facilities, it is traditionally possible for independent physicians to manage care for patients in both settings. We can coordinate this process on a case-by-case basis for patients interested in having hospice or nursing home care. Please note, there is a home/facility visit fee of $30 per visit as described on our Pricing page to compensate our doctors for the time it takes to leave the office and manage your care, but you’ll find this to be much less than the normal fees physicians charge for such services.

DO THE DOCTORS MAKE HOUSE CALLS?

Our doctors do have the flexibility to make house calls when they deem them medically necessary. This process is at the sole discretion of the provider and incurs a home visit fee of $30 per visit as described on our Pricing page to compensate our doctors for the time it takes to leave the office to manage your care, but you’ll find this to be much less than the normal fees physicians charge for such services.

CAN I GET ALL OF MY MEDICATIONS FROM YOU?

One of the most important and valuable benefits we offer to patients is wholesale medication prices which are most often less than their insurance copays and universally less than cash prices at other pharmacies. It also helps save time because you can get most new prescriptions in the office at the time of your appointment. Plus, you’ll know exactly how much the medication will cost while you and your doctor discuss various medication options. If the medication being prescribed is not one of the many we keep in stock, we can usually have it in the office within a few days. We can always write traditional prescriptions to send to your pharmacy if you prefer, but we find this to be more costly for most patients. If you have medications that are prescribed to you by an outside physician and you find that it is cheaper through us, if it’s a medication our doctors feel comfortable prescribing and monitoring, you can get that from us too!

WHAT DOES IT COST?

You’ll find that our pricing, unlike most other areas of the healthcare field, is always clear, transparent, and fair. Memberships range from $1-$85 per month based on age and are billed at the beginning of each month to pay for the prior month’s services. Additional fees for labs, medications, equipment, pregnancy care, and visits at locations outside the office exist and are always fair and far lower than at other offices/pharmacies. These are added to your monthly bill and you’ll always receive an invoice each month so you know what you’re paying for. There is an enrollment fee as well equal to one month’s membership due at initial sign up. There is much more information about pricing on our Pricing page and in our Patient Agreement on the Forms page.

OTHER THAN THE MEMBERSHIP, LABS, AND MEDICATIONS, ARE THERE ANY OTHER FEES?

As described on our Pricing page and in the FAQ above, additional fees exist for labs, medications, equipment, pregnancy care, and visits at locations outside the office. These are always fair and far lower than at other offices/pharmacies. These are added to your monthly bill and you’ll always receive an invoice each month so you know what you’re paying for. There is an enrollment fee as well equal to one month’s membership due at initial sign up. There are a few elective procedure fees and rarely used administrative fees that will always be disclosed prior to the services; these are listed in our Patient Agreement on the Forms page and explained further on our Pricing page.

WHAT ABOUT VACCINATIONS?

We do not stock vaccines at this time because of the high cost to keep a supply of immunizations always available. We are able to prescribe adult vaccines to be ordered by a local pharmacy which our patients can pick up and then bring to our office where we can administer the vaccine. Most children in the state of North Carolina have access to free childhood immunizations at their county’s health department. We would be happy to assist in setting up immunization appointments for our patients at the local health department’s vaccination clinic.

DO CHILDREN HAVE TO BE VACCINATED TO BE ENROLLED?

In general, our doctors believe that vaccinations are proven effective and safe, and that the benefits of routine immunization far outweigh the risks. When individuals are not immunized, it can be dangerous for both the unvaccinated person and for the community. However, we do recognize that some parents have concerns about vaccines and are hesitant to have their children immunized. While we do maintain the expectation that our pediatric patients will be vaccinated according to standard practice, we will not deny any patients enrollment on the basis of their unvaccinated status because we believe everyone deserves access to comprehensive primary care. We are happy to discuss questions and concerns parents have on a case by case basis. If there were ever an outbreak of a disease in the community that is prevented by vaccinations, we may institute a required home-visit-only policy with accompanying fees during the outbreak for unvaccinated children in order to protect their health as well as the health of our other patients. This would be clearly communicated in advance in the unlikely event that it occurred. In addition, parents will be required to sign a vaccination refusal form whenever a recommended vaccination is declined.

CAN A NON-MEMBER BE SEEN?

Our doctors are here to serve the community, not just our patients. That’s why we provide access to specialized procedures that can be extremely difficult to afford or not even available in the community otherwise. These include colposcopies, LEEPs, vasectomies, and newborn circumcisions. These procedures and how to arrange them are discussed on our Non-Member Services page in further detail.

IF I'M NOT A MEMBER YET, CAN I SIGN UP WHILE IN THE HOSPITAL?

Our practice only sees our current members at Ashe Memorial Hospital. Non-members are taken care of by their current providers or the hospital’s doctors. If you are currently hospitalized and would like to become a patient, you may set up a Meet and Greet Consultation to discuss the practice and membership requirements for when you’re no longer hospitalized. This meeting will be the first step in becoming a member and will not be a medical appointment. Our enrollment process is discussed further on the Enrollment page where you can also request this first meeting.

WHAT ABOUT CHRONIC PAIN, ANXIETY, INSOMNIA, AND WEIGHT LOSS MEDICATIONS?

Opioid prescribing guidelines from the CDC to combat the prescription drug abuse epidemic are more stringent than in the past, and those patients who use narcotics for chronic pain are encouraged to seek a pain treatment center. Our doctors are not pain specialists and do not prescribe narcotics for the treatment of chronic pain. They can help wean patients off these medications if patients desire to do this. They similarly do not prescribe controlled sedatives for the treatment of chronic anxiety or insomnia. In addition, our doctors do not prescribe certain weight loss medications, due to lack of proven long-term effectiveness, and adverse risk profiles of such medications.

WHAT IF I DON’T LIKE DPC?

We hope to care for patients who value their relationships with our doctors. If you are unhappy with your care, you may cancel your membership at any time. However, there will be a fee to rejoin later. In addition, if termination of your membership occurs before the end of the initial six-month period, you may receive a termination charge equal to the remainder of the six months membership. The Termination Charge represents liquidated damages for the work of the practice in the initial visit (and any subsequent visits), and the loss to the practice of the income from other patients that the practice could not treat because of the limited number of members the practice can accommodate. Additional details can be found in our patient contract on the Forms page.