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.

How CAN DirECt CARE moDEL Help Your business?

Are you an employer priced out of the traditional healthcare market in Austin, TX? Do you want to provide affordable high-quality healthcare for you and your employees? Check out the Direct Primary Care (DPC) or Concierge Care (CC) memberships at Austin Medical Partners! The video below provides an inside look at what Direct Primary Care and Concierge Care memberships offer, in less than 5 minutes. We truly value our patient’s health as you do your employees, and we understand that the cost of employee benefits can be difficult to afford. We encourage you to learn more about DPC and CC for not only more affordable health care, but for a better connection with your Doctor. Click here for membership details, or contact our office to discuss the best options for you and your employees.

Employer+meeting.jpg — Employer Benefits

Curious about employer benefits?

see below for the many benefits of offering DPC/CC to your Employees!

Reasons to offer DPC or CC to your Employees:

Lower employer insurance premiums when paired with a low premium, high deductible health plan
Increased employee work attendance, by keeping employees healthy through early medical intervention, preventative care and proactive management of chronic conditions
For employees, lower out-of-pocket costs by accessing primary care for most of their chronic health or urgent health needs rather than very expensive options like the ER or Urgent Care
Convenient urgent or acute care visits with same day or next day appointments; minimal waiting time for office visits
Multiple modes of communication, including phone and virtual visits, to facilitate timely care; since you will be dealing with “your own doctor” treatment is personalized and efficient
Employee satisfaction—one of the key drivers of employee satisfaction is feeling appreciated and valued by their employer; employer-sponsored DPC demonstrates that they are valued and you’re invested
Attract and retain your best employees—giving employees a practical benefit they’ll actually use and will save them and you money

Employer-sponsored DPC—It’s a Win-Win!

Call us today to discuss how employer-sponsored DPC can work for you.

How CAN DirECt CARE moDEL Help Your business?

Curious about employer benefits?

see below for the many benefits of offering DPC/CC to your Employees!

Reasons to offer DPC or CC to your Employees:

Employer-sponsored DPC—It’s a Win-Win!

Contact Us!

Call Today 512-640-2691

Employers

How CAN DirECt CARE moDEL Help Your business?

Curious about employer benefits?

see below for the many benefits of offering DPC/CC to your Employees!

Reasons to offer DPC or CC to your Employees:

Employer-sponsored DPC—It’s a Win-Win!

Contact Us!

Call Today 512-640-2691