Do I need to enroll in a Direct Primary Care or Concierge Medicine membership plan to be seen as a primary care patient in the clinic?

YES. All patients who want Dr. Ramos as their primary care doctor are required to enrollment in one of our membership plans. *Please note, the weight management/loss program, sports performance testing and/or body composition analysis are independent programs that DO NOT require patients/clients to belong to our membership-based direct primary care or concierge medicine model.

NO. DPC is NOT insurance or a replacement for insurance. We strongly recommend all our patients maintain insurance in some form, either a traditional plan or a high deductible plan paired with a health savings account (HSA). We see DPC as a way to limit your healthcare expenses by reserving your insurance for more expensive healthcare needs, like surgery, prolonged hospitalizations, rehabilitation and expensive medications.

NO. DPC is NOT insurance or a replacement for insurance. We strongly recommend all our patients maintain insurance in some form, either a traditional plan or a high deductible plan paired with a health savings account (HSA). We see DPC as a way to limit your healthcare expenses by reserving your insurance for more expensive healthcare needs, like surgery, prolonged hospitalizations, rehabilitation and expensive medications.

What is the difference between Direct Primary Care and Concierge Care/Concierge Medicine?

Both provide a personalized approach and better access to your doctor. Both emphasize the primacy of the “doctor-patient relationship” in medicine and not the interests of insurance companies or 3rd parties. The main difference is in how you pay. In the concierge model, we will bill your insurance. This is available for those with Medicare and private insurance in which our doctors are “in network.” However, you will still be responsible for your co-pay, co-insurance and deductibles. Medicare and private insurers with whom we are contracted/in-network restrict their subscribers from enrolling in a membership model like DPC. However, their members are allowed to be part of a concierge care plan. The concierge membership fee is not re-imbursible by Medicare or your insurance. It is specifically used to cover services that are not paid for by Medicare or Insurance, also known as non covered services.

Does Concierge Care provide services that are not covered by Medicare or private insurance?

The short answer is yes. Your concierge membership fees are used exclusively for non-covered services such as direct enhanced access, same day or next-day appointments, tele-medicine or virtual communication not restricted by the originating location of evaluation. In addition; certain imaging, diagnostic tests, labs, counseling and evaluations especially those that may be integrative, complimentary, alternative or functional medicine in nature are not covered by Medicare and most insurances. Certain screening test are restricted by medicare to specific time intervals and not covered at all if they occur more frequently. Some examples include bone density measurements, or screening EKGs.

If I need hospitalization will I be followed by my doctor in the hospital?

Yes. At Austin Medical Partners we are unique as the only DPC and Concierge Practice in Austin that will admit or follow you during hospitalizations at Seton Medical Center Austin. If you are hospitalized at a non-covered facility*, we will provide personalized care coordination with the ER, Hospitalist and Specialist, leveraging our decades long expertise in Hospital Medicine. *additional hopsitals may be added in the future

Yes. At Austin Medical Partners we are unique as the only DPC and Concierge Practice in Austin that will admit or follow you during hospitalizations at Seton Medical Center Austin. If you are hospitalized at a non-covered facility*, we will provide personalized care coordination with the ER, Hospitalist and Specialist, leveraging our decades long expertise in Hospital Medicine. *additional hospitals may be added in the future

Will DPC or Concierge Medicine save me money?

Each patient’s circumstance is unique and DPC or Concierge Medicine may help save you money. Here are a few scenarios where this is the case; a) Decreased monthly healthcare cost. When paired with a low premium, high deductible insurance plan, the money you save on the premium may be much less than the cost of the DPC or CC membership. b) Access to major discounts on common lab tests and medications. c) Utilization of generic medications when efficacy is equivalent to brand-name medications. d) Access to discounted imaging tests. e) Enhanced availability with simple and direct access to primary care, ultimately avoiding costly trips to the ER or Urgent Care, and possibly the need for hospitalizations. f) Less time away from work with appointments that start on time and phone or virtual appointments (when safe and appropriate). g) During hospitalizations, enhanced care coordination to minimize your days in the hospital and ultimately the total cost of your care and your expenses. h) No surprise bills.

Will Medicare or private insurance cover my concierge medicine membership fee?

No, Medicare and private insurance do not cover concierge membership fees. Your membership fee goes toward services that are consider non-covered services. Some example of non-covered services include personal training, certain complimentary or alternative medcine evaluations or non-covered imaging or services such as body composition scanning, or sport performance testing such as VO2 Max testing.

Why is the DPC payment model not available to Medicare patients or patients who want to use their insurance?

Medicare regulation requires a claim or bill to be submitted for each specific visit and specifies a specific fee for each service rendered. The DPC payment model is different in that each visit is not dependent on satisfying this regulatory requirement. Medicare only allows patients to participate in a membership-based practice through a Concierge Care payment model in our practice as we are not opted out-of-medicare. This also applies to patients with private insurance with whom we are in-network. Our Concierge Care model does allow access to additional services beyond what Medicare or insurers allow in a traditional fee-for-service model.

Can I participate in the clinic’s weight management or Fitness & Sport Performance programs if I am not an enrolled as a member of the DPC or Concierge program?

Yes. These are separate comprehensive programs that evaluate your nutrition, sport performance and cardiovascular fitness. We can make recommendations for your PCP to follow if they are interested. We can follow and track your fitness and it's improvement over time and the implications for your health. These evaluations are more focused when not paired with DPC or Concierge Medicine Programs. Enrollment in our DPC and Concierge Care programs allows for the most integrated approach to manage your weight, nutrition, fitness and sports performance in the context of your personal medical history and your overall health and wellness. We are the only practice in Austin providing this service.

Can I use my insurance to pay for labs, imaging and medications?

Yes, we actually recommend this. We, however, are not responsible for costs not covered by your insurance plan. Austin Medical Partners has negotiated and access to cash-pay prices with local labs and imaging facilities. In addition, we have access to discounted medications that are a fraction of what these same providers will charge your insurance plan. Many times it costs less for you to pay the cash price, using your HSA or FSA debit card, than the co-pay for you insurance. This is particularly true for medications.

Can I submit my DPC office bills that aren’t covered by my DPC membership fee for re-imbursement to my insurance company?

Yes. We will give you a document with all the appropriate codes so you can file this with your insurance company. Outside of providing appropriate documentation codes we do not assist otherwise in the insurance billing process.

+ What if I’m still unsure if membership medicine is right for me?

Call us for a free 10-20 minute informational phone meeting to answer your questions. And if you still have questions, we’ll schedule a time for you to visit the clinic in person to see if it’s right for you.

Direct Primary Care & Concierge INTERNAL Medicine

A Better & More Personalized Approach To Your Health in Austin, TX

At Austin Medical Partners, we provide direct primary care and concierge medicine services to patients in Austin, Texas. Primary care is provided exclusively via a membership-based practice model and requires enrollment to become a member. Our clinic is built on a foundation of time with your doctor and highly personalized care. We emphasize a proactive and preventative approach to health and wellness and only see primary care patients as part of our membership model.

Primary Care

Direct Primary Care (DPC)

Concierge Care/Concierge (CC) Medicine

Key features of the DPC membership

All primary care office visits included with membership
Same day or next day appointments (virtual appointments when in person appointments are not feasible or possible)
After-hours access for urgent matters when the clinic is closed
Virtual appointments via talk, text or telemedicine when clinically safe and when non-emergent care is needed
Annual physical exam
Chronic disease management for hypertension, diabetes, cardiovascular disease, etc.
Acute or urgent care and chronic disease management
Discounts on outside labs, imaging, and medications at certain pharmacies

*Medicare patients are ineligible for DPC membership due to federal Medicare regulations. Medicare patients must enroll in the Concierge Care model to participate in a membership-based practice. Similar rules apply to those with private insurance with whom we are in-network.

Key features of the CC membership

Exceptional access for all primary care office visits
Same day or next day doctor appointments (virtual appointments when in person appointments are not feasible or possible)
Extended new patient and follow-up appointments
Direct 24/7 after-hours access to your physician via cell phone or text
Virtual appointments via talk, text or telemedicine when clinically safe and when non-emergent care is needed
Virtual appointments can originate from any location with cell phone or internet access
Comprehensive annual preventative medicine physical exams (the initial preventative visit or “Welcome to Medicare” exam is specifically excluded from your CC membership fee, per Medicare regulations)
Annual preventative health counseling on diet, nutrition, healthy aging
Baseline and annual Fitness/Sport Performance evaluation available at additional cost
- VO2 Max
- Aerobic & Anaerobic Threshold
- Optimal HR training - fat loss & aerobic fitness
Fitness tracking
Unmatched continuity of care compared to healthcare delivered through traditional fee-for-service clinics

What is NOT included in the DPC membership?

In-office minor surgical procedures, such as laceration repairs, incision and drainage of abscess (a small fee will be applied to cover the cost of supplies and medications and will be disclosed before any procedure is performed)
Imaging studies at outside facilities (cash prices have been researched on your behalf and are available at a discount compared to what your insurance plan is charged); it may make sense to pay the cash price rather than use your insurance
Vaccinations (due to their high cost and limited shelf-life, these are provided through your local pharmacy)
In-office Rapid Strep/Flu testing
- In-office Rapid Strep and Rapid Flu testing is available for approximately 50% less than most urgent care centers and retail pharmacies
- For positive tests, we send prescriptions electronically to be filled at your preferred pharmacy.
Prescription medications
Outside labs, imaging, and other diagnostic testing
Physical and Occupational Therapy
Vaccinations for shingles, pneumonia, Hepatitis B and Hepatitis C
Skilled nursing home care
Home healthcare, RN, PT, OT, and medical devices or equipment
Inpatient or outpatient surgeries
Hospitalizations, inpatient rehab or skilled nursing care
Specialist consultation and specialty care

*For tests and procedures not covered by your Direct Primary Care (DPC) membership, patients are provided with the appropriate billing codes to submit to their insurance for reimbursement.

*Inpatient management or co-management is available at Seton Medical Center Austin but is NOT included in your monthly membership. Your insurance will be billed and you will be responsible for out-of-network co-pays and deductible.

What is not a part of the CC membership fee?

Services listed below although not a part of your concierge care (CC) membership fee are often covered by your insurance and medicare.*
In-office minor surgical procedures, such as abscess incision and drainage, laceration repair depending on severity (sutured vs skin glue)
In-office vaccination for flu (billed to insurance or Medicare, when in stock)
In-office Rapid Strep/Flu testing
Urinalysis, urine pregnancy test
EKGs
Prescription medications
Outside labs, imaging, and other diagnostic testing
Physical and Occupational Therapy
Vaccinations for Shingles, Pneumonia, Hepatitis B and Hepatitis C
Skilled nursing home care
Home healthcare, RN, PT, OT, and medical devices or equipment
Inpatient or outpatient surgeries
Hospitalizations, inpatient rehab or skilled nursing care
Specialist consultation and specialty care
Acute/urgent care and routine chronic disease management are provided and usually covered by your insurance. We will bill Medicare or your insurance, per regulations

*Any services which are provided by AMP and are covered by Medicare or your insurance must be billed to Medicare or your insurance, per regulations.

*Please see our FAQ tab for questions about coverage. If you still have questions please contact your insurance or Medicare for specific questions or details about coverage.

Hospital Medicine

Unique to our DPC and CC practice, you have the OPTION to be cared for by your primary care doctor when hospitalized at Seton Medical Center Austin
Austin Medical Partners is the ONLY DPC and CC practice in Austin to offer the OPTION of inpatient management or co-management and medical consultations for our patients while hospitalized
Decades long experience in Hospital Medicine
Your doctor caring for you when you’re most ill and you need them the most
Unmatched continuity and personalized care from admission, throughout your hospitalization, discharge and post discharge care

For a new standard of medical care, contact at Austin Medical Partners or call 512-640-2691 today.

Direct Primary Care and Concierge Medicine