FREQUENTLY ASKED QUESTIONS
It refers to the fact that we do not take payments from insurance companies. (In fact, we don’t work with insurance at all.) This means that we work for you, and you alone. There is no insurance company intruding on the relationship between you and Dr. Bergland, i.e., you have a direct relationship with your doctor.
It’s care for the “day to day stuff”, in other words, wellness care / checkups, outpatient treatment of most medical problems (high blood pressure, diabetes, thyroid disease, arthritis, and many others), treatment of most minor injuries, stitching of minor wounds, and minor procedures such as skin biopsies, etc. On the other hand, the term subspecialty care refers to more specialized medical or major surgical care such as appendectomy, hernia repairs, joint replacements, care for advanced heart or lung disease, etc.
When it comes to primary care (see above if this term is unclear) health insurance has not been adding value for us. Rather, the involvement of health insurance in primary care has served to increase the costs for patients, burden the doctors and patients with red tape, and distract doctors from what matters most – the care of their patients. Think about how your auto or homeowner’s insurance works: you have it for the unplanned major expense, such as a car wreck or fire. You don’t use your auto insurance though to pay to fill up the gas tank. In U.S. healthcare though, we have been using insurance to pay for day to day expenses in primary care, which actually doesn’t have to be expensive. Primary care has become expensive though, largely because we are using insurance to pay for it. The Direct Primary Care movement is breaking this vicious cycle, eliminating the insurance company from the primary doctor / patient relationship, and allowing doctors to provide more personal, rational, and thorough care to their patients, all for a much lower cost than with insurance-based practices.
No, it’s part of the membership.
What about for stitches? No; again, it’s part of the membership.
What about for a cast or splint? You guessed it: no, that’s part of the membership too.
Yes, we do, and again, that would be part of the membership (no additional charge).
Call Dr. Bergland, anytime. In fact, we encourage that. Often times if something comes up at night or on a weekend, people assume an ER visit is needed, when in fact that may not be the case. One advantage of having a primary care doctor that knows you well and is available is that when something comes up, your doctor has your back. By calling Dr. Bergland and going over your symptoms or situation, he can advise you whether emergency care is needed, or if not, what the options may be. In some cases, the solution may be an appointment first thing the next morning, or meeting Dr. Bergland at the clinic after hours, or in some cases Dr. Bergland may do a house call (really; we are not kidding here).
Your credit card will be billed for the membership fee automatically each month.
Yes, you can. We certainly encourage folks to keep some type of coverage or arrangement to manage the major or unplanned medical expenses. When you don’t need to use your insurance to cover primary care though, then the high deductible plans can truly be used for “major medical” situations.
When clinics, labs, or hospitals work with insurance companies, this actually adds expense for them. Insurance companies have created complex billing requirements (which means added billing staff for the labs/hospitals/etc.), they often find reasons to deny claims (leading to repeat billing), and they generally do not pay promptly. On the other hand, when a lab or hospital knows that it can be paid promptly, without having to submit multiple complicated claim forms, then the billing process is less expensive for them, and they are often willing to give a more favorable price.
Yes, you can. The fact that Dr. Bergland has ordered an outside test / imaging study / etc. will not affect your ability to have it covered.
Yes, you can. The fact that Dr. Bergland has initiated the referral will not affect your ability to have it covered.
This would not work well. One important component of DPC is that by having an established relationship with a doctor, who knows you, has your records, etc., you and the doctor are both set up for success when something comes up. DPC is not meant to be an urgent care facility for nonmembers. Also, the enrollment process involves completing a Patient Agreement, and it would be unethical for us to expect you to sign such an agreement when you are in the midst of an urgent or emergent medical situation. If you think this type of clinic is for you, then it is to your advantage to enroll now, so that we can get to know each other well, obtain your prior medical records, and be ready if / when something does come up.
Depending on the reason for your hospital stay, your care there would be managed by a hospitalist (a doctor who takes care only of hospitalized patients, and is specialized in this type of care) or a surgeon. Dr. Bergland will, however, keep in close touch with you and the hospitalist or surgeon so as to be ready to pick up where the hospital care leaves off when you are discharged.