FAQ
Frequently Asked Questions about Direct Patient Care
Is Direct Patient Care insurance?
Simply put, no. It was not and is not intended to be "insurance" but rather affordable Osteopathic & Integrative medical care for the masses.
What impact does the Direct Care Plan have on my existing insurance plan?
None.
What about catastrophic coverage?
Patients are urged to have coverage since this is not an insurance plan: keep their present insurance plan, to buy complementary insurance plan such as high deductible health plan, to pay for any complex or catastrophic medical services outside of outpatient medicine. We strongly recommend that all patients have some sort of medical insurance such as catastrophic coverage and actively recommend the cooperative plans such as as those from Liberty Share, Medi-Share, or Samaritan which provide catastrophic coverage.
If I enroll in the Direct Care Plan, will my insurance company cover lab testing, prescriptions, and referrals to other physician?
The benefits you receive from your insurance company are determined by... well, the insurance company, whose sole purpose is to be profitable. They should honor any lab or diagnostic testing, prescriptions and referrals ordered; however, that doesn't mean that they make it easy for patients and physicians. We encourage all patients to familiarize themselves with their coverage benefits as insurance companies routinely require "prior approval" or "prior authorizations" for routine diagnostic testing and services.
Will this practice replace my Primary Care Physician (PCP)?
No. We are a supplemental model of care for specialist services such as Osteopathy, Clinical Homeopathy and Integrative Medicine.
Do I need a referral to see Dr. Sousa?
In general, you do not need a referral to be seen especially if you join our subscription service to Direct Patient Care. As for out of network insurance, it all depends on your insurance carrier. There are some that may need prior authorization to be seen. This is reviewed on a case by case basis.
If I choose not to sign-up, can I still receive my care here?
Of course! You won't be able to access those services available with the membership, but we will continue to provide you with high-quality, comprehensive Osteopathic and Integrative medical care if you decide our cost-effective membership plan is not a good fit for you. Payment for services is expected on the day you receive them. We will provide you a receipt which you can submit to your insurance carrier for possible reimbursement.
Where can I find more information about the Direct Patient Care membership plan and where can I sign up?
Signing up is the easy part! Simply complete our signup form and you're ready to go!
Our Direct Care membership plan is focused on alleviating the burdensome and escalating costs of healthcare and built around providing the best, high-quality, cost-effective care possible.
Our Direct Care membership plan includes:
· Priority Access to Dr Sousa’s schedule
· Flat rate $35 charge for basic office visits* (per patient). It doesn't matter if you're scheduling a visit for Osteopathy, Clinical Homeopathy or Integrative Medical office visits...the rate remains the same $35 per basic office visit.*
· Discounts on Supplements from Fullscript
· More membership benefits to be added.
What is not included?
· Services provided by another physician or healthcare institution, such as hospitalizations, consultations with specialists, laboratory services, and imaging studies such as CT scans, X-rays and MRIs.
· Legal proceedings. In the rare instances where a service such as a deposition is needed, we are willing to negotiate a special rate with your attorney.
What is the cost of membership?
Click here to learn more about pricing.