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Frequently Asked Questions

Please see below for some of the most common questions we receive, and do not hesitate to reach out to us to discuss or clarify anything

What is Direct Specialty Care?

Direct Specialty Care means we are focused on providing the highest quality Endocrine care to you, and are not restricted by insurance companies and their profit targets - since we do not accept insurances we share a direct relationship for both care and fees. Our patients can choose to become a member or to pay per service (e.g., a visit and a treatment), and then if their insurance allows them to submit their bills for reimbursement.

What is the benefit of a membership?

A membership is ideal for patients who would have a high deductible insurance plan (e.g., $2500/year or more), seek more than a few visits a year, who would want to have a clear expectation regarding their medical costs for the year, and would wish to have priority and same day booking available. Patients with the comprehensive membership plans are currently the only patients who can also receive primary care services.

Do you provide primary care services?

Yes, we are testing it out! We are starting with a limited number of established patients with our comprehensive membership plan who can be seen by Dr. Telford as both their primary care physician and endocrinologist - call Geri and Elsa for details

How will primary care services work?

Primary care and endocrinology visits will be booked separately so we can focus on one area of your health at a time. A major benefit will be a collective effect of having both general and endocrine health treated together

How long will my visits be?

We believe that it is of the utmost importance to spend time with you! A new patient visit will be up to an hour, and a follow-up visit 30 minutes - whereas most doctor visits you will spend only 5-10 minutes with a provider, and much of that time they will be squeezing in their charting on their computer

How will we communicate between visits?

For all of our patients we will have portal messages, text messaging and phone calls available

Are there same day visits available?

Yes, for our members same day visits are prioritized and available at no additional cost, and other patients may still make a same day appointment for an additional fee

Are you a Concierge Medicine practice?

No, we are a Direct Specialty Care provider which means we do not directly bill insurance - though you may submit our visit as an insurance claim against your out-of-network benefits.

Concierge medicine means that there is a membership fee (e.g., $2,000/year) and the provider still submits all claims to insurance companies for reimbursement, and thus are beholden to insurance companies dictating patient care

Do you accept any insurances?

No we do not accept any commercial insurances, Medicare or Medicaid - however, we are planning to provide complimentary access to a service that helps you submit out-of-network claims to your insurance by simply taking a photo of your bill with your phone

Can my insurance reimburse me for my visit?

Yes, as long as you have an out-of-network benefit with your insurance provider; typically Medicare and Medicaid do not provide out of network benefits but some of the Medicare plans may allow out of network benefits, and for commercial insurances PPO plans usually cover out-of-network visits while HMO plans do not

Can I still use my medical insurance for labs and images?

Yes, and we would recommend having medical insurance to cover hospital visits (for Medicare patients this coverage is called Medicare Part A); we are planning to work with some of the local Direct Primary Care offices to provide discounted labs and imaging for those without insurance or high deductible plans

Can I use my Medicare or Medicaid coverage?

No, typically Medicare and Medicaid do not provide out-of-network benefits, however some of the Medicare plans may allow out of network benefits - please contact your plan administrators for details

Can I use my flex spending account to pay for my visit or membership?

Yes, typically out of network visits are covered by FSA, HSA and HRA plans; membership plans coverage will depends on the plan, please check with your account administrators for details

What forms of payment do you accept?

We accept debit or credit cards (including HSA, FSA and HRA credit/debit cards)

Why do you need a credit card on file? 

Credit cards on file will be used for last minute cancellations, missed appointment, virtual visits and services; you will not be charged on your card without a notice and communication

Is there a membership initiation fee?

Yes, for new members there is a $150 membership initiation fee. The fee is currently being waved for existing patients of our practice until August 1st, 2024

Can I cancel my membership plan?

Yes, membership plans may be canceled at any time, and will remain active for the duration of the last billing cycle

Can I restart my membership?

Yes, but you will need to pay the membership initiation fee and we will only allow patients to restart memberships one time (situations permitting)

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