Frequently Asked Questions

BLUF (Bottom Line Up Front)

Practicing medicine within the framework set by insurance companies got to be too much for me.  I was tired of diverting the majority of my time and energy away from patients and into satisfying arbitrary requirements. 

I could no longer participate in a system designed to limit/deny care and erode the patient-physician bond.

Through Direct Primary Care, I am free to build relationships that enable me to provide comprehensive and personalized care. 

You will receive the care you need when you need it … without the interference from traditional insurance.

No more barriers.

It’s just you and me … focused on your health.

What (the heck) is Direct Primary Care?

Direct Primary Care (DPC) is what being a doctor is all about … building and maintaining a personal and professional relationship with patients.

DPC allows me to spend more time with patients and less time navigating administrative burdens and insurance-driven red tape.

The result of opting out of traditional insurance is accessible and affordable primary care for patients by removing barriers.

I can now focus my energy on what matters most … providing competent, compassionate, and comprehensive care for every patient … at every visit.

Why the change?

Patients don’t receive the care or attention they deserve for the money they send to the insurance company. Co-pays and deductibles keep patients from seeking wanted (let alone needed) care.

Jumping through insurance hoops makes it difficult for a physician to focus on providing complete care for patients.

The insurance reimbursement model limits what can be done in any given appointment. Only 1 new issue, only 2 old issues, no procedures without authorization, no refills during a well visit … all arbitrary insurance rules to limit insurance pay outs.

The patient-doctor relationship needs to be rediscovered.

What’s the benefit of DPC membership?

That’s not a fair question.  There are MULTIPLE benefits!

One monthly membership fee entitles patients to unlimited access to me and my services .

I can be contacted through texting, emailing, phone calls, video visits, and in-person visits.  if the situation warrants, I even make house calls. No extra fees!

Patients no longer need to “save up” concerns or smuggle in a “secret list” of issues.  I’ll cover every concern you have.  Every scheduled visit is slated for 30 minutes. If more time is required for more issues, we’ll make it a 60 minute appointment. NO extra charge. Want a skin tag removed? NO extra charge. Need a wart destroyed? NO extra charge.

I now work 100% for you .. not your insurance company.  I don’t have to ask insurance for permission for anything I do in the office!

Without insurance barriers, we can enjoy a much more open, free, peaceful, and fulfilling relationship.  It’s pretty liberating!

What’s the “catch?”

Nothing .. that’s the beauty of it! However, in this model, I will serve fewer patients. You’ll be a part of an intimate family practice where I see hundreds of patients, not thousands. I am committed to providing fully attentive care, so membership is limited.

Are there other hidden costs?

Nope. No surprise fees. No fine print. No “extra” regardless of how often you access my care.

There are things your monthly fee does NOT cover …

Medications… Insurance can be billed, BUT, through DPC, I am able to obtain MOST of your medications at near WHOLESALE cost.

Labs… Insurance can be billed, BUT, we have contracted with QUEST Diagnostics to run your labs at drastically reduced prices.

Radiology studies… Insurance can be billed, BUT, contracted cash pricing will likely be significantly lower than an insurance co-pay … PLUS, no waiting for approval!

Durable medical equipment… Insurance continues to be the primary method of paying for this.

Specialists, surgeries, and hospital care… Insurance will be integral in paying for these services. This underlies the importance of maintaining some level of insurance.

Do I HAVE to have insurance to join?

No. But, it would be wise to have some form of health insurance to cover specialist care, surgeries, or hospitalizations.

DPC works well if you can find a cheaper insurance with a higher deductible. I can take care of 85-90% of health needs while the insurance can kick in when care exceeds his capabilities.

No one can predict when you will need catastrophic coverage.  So I highly recommend maintaining some form of insurance.

Should I keep my insurance if I have DPC?

Yes. Surgeries and hospitalizations can lead to unimaginable financial burden.

Insurance will be helpful when I can’t provide a particular service and you require referral for specialty care, surgeries, or hospitalizations.

DPC is NOT insurance. It allows you to access as much primary and preventive care to keep you as healthy as possible.

How does DPC work with my insurance?

Very well!

Your monthly DPC membership fee covers all services I provide.  Family Medicine typically covers 80-90% of any patient’s health care needs.

Your health insurance will cover any labs, medications, imaging, durable medical equipment, specialist services, operations, or hospitalizations. As always, insurance retains the right to choose who they contract with and what services are covered.

Your health insurance will not cover or reimburse your monthly membership fee.  We will sign an agreement that neither of us will submit such a request to your insurance company. 

Will ALL insurance plans work with DPC?

Not exactly! Medical Home and HMO insurance plans REQUIRE an insurance-specified primary care provider. Only that provider can refer to specialists or order certain tests. If you want to join DocPeff DPC, please make sure you choose an insurance which is NOT a “Medical Home” or HMO plan.

Patients with Oregon Health Plan are able to participate in this practice.  Medications, labs, radiology studies, and referrals are honored (new since 2022). My referrals to specialists have been accepted, but that could stop at any time.

Can I use my FSA or HSA to pay the membership fee?

Yes!  Not only is it convenient … but you are using PRE-TAX dollars.

The real question is …  Can you directly charge the FSA/HSA account?  Or do you need to submit a monthly receipt?

What about my CDL Physical!?!

I still perform CDL physicals.  Members receive this service at NO CHARGE.  If you are not a member, I continue to perform this service for $200. Same place, same price, same service.

Call (503) 507-7900 to schedule.