If your question is not answered here, please contact us!
Why is there a membership fee?
The membership fee allows us to provide the majority of primary care in an innovative way for a simple, fixed price. It allows members to better budget their health care finances and helps our practice provide the services we offer at affordable prices.
Why would I pay "extra" fees for health care?
The membership fee is better thought of as a more affordable and efficient way to access primary care. Most members will save money by combining WaltonMobile DPC with a high-deductible health insurance or medical cost sharing plan when compared to traditional insurance models.
Can I just have a visit without becoming a member?
Yes. We still provide services “a la carte” First time Office visits are $200, and follow up visits are $150. Labs would still be discounted, however medications and supplements will be at customary charges.
Are there any contracts or commitments? What if I decide to cancel?
We don't require members to sign for a set amount of time. However if you move out of our geographic area, please contact us 30 days in advance in writing to cancel your membership. Memberships are ongoing but must be paid ongoing in order to maintain service with us. If you decide to cancel and have a balance of prepaid membership fees remaining, a pro-rated refund will be given to you based upon date of cancellation. If your membership lapses and you would like to renew your membership with us there is a re-initiation fee of $100.
Is this “concierge” medicine?
NO. In concierge medicine the fees cover just access to your doctor, and he or she will continue billing your insurance. In Direct Primary Care (DPC) you pay not only for access. You are paying for medical care with no additional copays or billing to insurance. Also, DPC comes without the high price tag . . . or valet parking! We make things affordable for people of all incomes, with or without insurance.
Does WaltonMobile DPC accept members with existing medical problems?
Absolutely, and often these are the members who see the most benefit from our services. Our memberships (eligibility and fees) are not based upon any existing medical issues or conditions.
Are there any income or health guidelines for becoming a member?
No, we do NOT have any income or health guidelines to become a member. Our fees are the same regardless of income, insurance arrangement, level of health or utilization of our services.
What if I am healthy? And rarely go to the doctor?
That is great! Our primary focus is to keep members well and to avoid lots of "medical" care. As such, we can dedicate more time to prevention and lifestyle issues to continue to keep you away from the expensive, cumbersome health care system. However, when you do need care, we are available 24/7 to help get you back on track. Most of the unexpected trips to ER or urgent care that would have emptied your pocketbook can easily be covered in a same day visit at our office, often saving the member enough to justify the cost of a year worth of membership fees!
Can you provide memberships (virtual visits, etc.) to people “out of state”?
Our providers are only licensed in the state of Ohio and cannot practice medicine in other states. If a member establishes care (has a visit) in-person, we can provide remote monitoring of issues over phone and internet for some period of time. Ultimately, some care (sick visits, etc.) must be provided in-person, so we do not encourage people to join our practice unless they can reasonably visit us in person on a regular basis.
Are there any hidden fees?
Nope. We provide most care to members without any fees at all! If we do charge for non-covered services, we are always transparent with our pricing. If we recommend outside services, we try very hard to find you an upfront, reasonable price if paying cash.
What about lab work and other testing?
All members have access to many basic lab and diagnostic testing (strep, EKG, urine dipstick, pregnancy test, etc.) for no charge at all. For non-covered labs we offer significantly discounted, wholesale prices - 50-90% less than insurance based prices. Some of our prices can be seen here. If you require testing not listed, you can contact us for pricing of just about anything.
When do I pay my fees for medications, labs, etc.?
For any fees for non-covered services, we expect full payment at time of service for most services, including medications, labs, procedures, etc.
How much will my first visit cost?
We do not charge "per visit". New members must pay a minimum of one month of membership fees. If any non-covered services are required (labs, medications, etc.) the first visit cost may be slightly more.
How much does an annual physical/wellness visit cost?
All wellness visits are provided at no cost to all members!
What are your regular clinic hours? evenings? weekends?
Our regular clinic hours are Monday & Friday 10:00a - 4:00pm, Tuesday-Thursday by appointment only. However, all members have access to the doctor 24/7 by phone/text/email/video and after-hours visits if required.
Are you a walk-in clinic? Do I need an appointment?
While we can always offer same or next-day visits to our members (even newbies), we do require scheduling all visits beforehand. A quick phone call or text to verify that we are free is usually all that is required.
How long are visits?
As long as you need! Taking into the consideration the number and complexity of medical issues, most of our clinic visits are scheduled for 20-60 minutes.
What if I need outside care? Specialists, diagnostic testing, ER, hospital?
We can order or refer just as any insurance-based doctor can do. For some outside services, we can help find reasonable "cash" prices if you are paying out-of-pocket - especially radiology and lab. We also have agreements with the most commonly referred specialists for deeply discounted cash prices .We can provide many urgent care and minor emergency services during regular hours that can help people avoid a trip to the ER. However, we do recommend having health insurance in the case of an unexpected, expensive event such as surgery, ER visit, or hospitalization.
What type of visits can I do by phone or webcam?
"Virtual visits" should be thought of as a supplement to good primary care - not a replacement for in-person care. Generally, if the issue does NOT require a physical exam, a virtual visit is fine. Many chronic issues (e.g. diabetes, hypertension, etc.) can be largely managed by email and virtual visits. However, any issue requiring a physical exam (e.g. coughs, sinus infections, ear infection, new pain, etc.) we will recommend a traditional clinic visit.
INSURANCE & HEALTH PLANS
Is WaltonMobile DPC health insurance?
No. Thankfully, no!
Is WaltonMobile DPC plan a substitute for health insurance?
No. WaltonMobile is a great way to receive high quality primary health care, but we do believe insurance is needed for unexpected and expensive events. We'd be glad to help you find an insurance expert who can assist you in finding a plan that works well with WaltonMobile DPC plan offerings.
Can my insurance plan be billed?
Yes. Walton Mobile DPC currently contracts with United Healthcare(All plans), Medicaid, Medicare, & Caresource commercial insurance plan.
Does WaltonMobile satisfy the requirement for “insurance” under the Affordable Care Act/Obamacare?
Not likely for individuals. However, this type of practice is loosely termed “Direct Primary Care” and is mentioned briefly in the Affordable Care Act as "participating in insurance exchanges with a wrap-around insurance plan”.
Do I still need insurance?
We recommend that you do have insurance to comply with Federal Law. WaltonMobile DPC does not replace insurance, and ideally we encourage our patients to carry a high deductible or major medical plan or a plan with a health savings account, thereby ensuring financial help should hospitalization or referral to a specialist be necessary. You should consult with your insurance provider to help you find a plan that works best with our medical model and that will meet your specific needs.
What about Medicare?
At this time, we accept traditional Medicare and the Medicare plans that we are contracted with.
Can I use my insurance elsewhere if I join WaltonMobile DPC?
Not for our services, but we will be able to order your labs, x-rays and medications at the facilities preferred by your insurance if you would like. Your insurance plans will continue to operate “as usual” at other doctor's office, hospitals and pharmacies. PPO-style plans do not require a designated “gatekeeper” doctor for referrals, medications, tests, etc. Our physicians can order or refer just as another doctor would do. HMO-style plans do require an in-network designated primary doctor for access to other services.
Can I submit visit claims to my health insurance plan for reimbursement?
For the time being, insurance companies do NOT recognize our membership fees as a reimbursable expense. For non-covered service fees (labs, meds, imaging, etc.), we can provide a receipt of payment so you can process with your insurance plan if you wish. However, most of our members have not found it not worth the time and effort to do so except for large expenses
Can I use my FSA or HSA accounts with WaltonMobile DPC?
Please contact an accounting or legal professional to discuss this matter as there is considerable debate regarding what qualifies for FSA and HSA spending. At a minimum, ancillary services (labs, meds, imaging, etc.) can paid for with FSA or HSA dollars.
What type of insurance would you recommend?
We are not financial or health insurance advisers and recommend you speak with a professional in that industry if you have questions. However, our members often find that a high-deductible (or catastrophic) insurance plan with a healthcare savings account (HSA) or a healthcare cost sharing ministry tend to be the best pair with Walton Mobile DPC Plan. We can provide day-to-day services and a high-deductible plan or a cost sharing ministry can help limit the enormous expenses of a major event.
MEDICAL SERVICES & MEDICATIONS
Can you do women’s care? Pap smears?
Yes. We can provide standard women’s and gynecologic services, including pelvic exams, pap smears, birth control and menopause management.
What happens if I go to the hospital? Can my doctor see me?
We hope to decrease hospitalizations to a minimum through excellent preventative care, but in the event that you do go to the hospital, We are committed to staying updated on your case while you are in the hospital, then we will see you quickly after discharge to eliminate any interruptions in care.
Can WaltonMobile DPC work for kids? Pediatrics?
Absolutely! We love little dudes and dudettes. We can provide all standard childhood health care services including yearly physicals, acute care (sore throats) and chronic disease management (asthma, allergies, etc.).
Do you give vaccines?
Currently we do not stock vaccines.
What about mental health problems? Depression, anxiety?
Our Providers are comfortable providing primary care for most any mental health problem, including prescribing medications related to these problems. Our providers generally have a conservative and careful approach when using controlled medications (particularly benzodiazepines such as Xanax or Valium) and strongly promotes the use of non-medicine therapies and lifestyle changes.
Can you treat ADD/ADHD? Prescribe amphetamines, Adderall?
Most cases of attention-related problems can be managed with lifestyle changes, therapy and educational techniques. Our providers do not prescribe or manage use of amphetamine medications (Ritalin, Adderall, etc.). If someone does require pharmaceutical assistance for ADD/ADHD, we can refer them to a specialist for medication management.
Do you share my medical records with anyone?
No. Patient privacy is a natural benefit of this medical model. We will never provide any third party with a copy of your records, unless you specifically ask us to do so.
What if i need medical attention away from home ?
In the age of technology, many conditions can be diagnosed and treated via a simple conversation by phone or email. If appropriate, Our providers will locate the nearest pharmacy and order medication most suited for your circumstance. If you need to go to the hospital or seek other medical attention while away from home, we can advise you on that as well.