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 are out-of-network) 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, to submit their bills for reimbursement as an out-of-network visit.

We decided to transition our medical practice from an insurance-based model to an out-of-network practice (direct specialty practice) for two reasons: improved patient care, and the unsustainable financial pressures of continually reducing insurance payments and rising operational costs.

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Over the last 20 years Medicare has reduced physician payments for a cumulative 26% decrease, while the cost of running a medical practice has surged nearly 50% = a disparity which has created a substantial financial strain on independent medical practices like ours. Furthermore, commercial insurance contracts (e.g., Aetna, CareFirst, Cigna, United Healthcare, etc) are tied to Medicare rates, and consequently when Medicare rates decrease (as they did 3% for 2024) it triggers a corresponding decrease in payments across all insurance-based reimbursements (i.e., 3% in 2024), further eroding the financial viability of maintaining an insurance-based practice. And while we don't celebrate Walmart's announcement in April of 2024 that they were closing all of their health clinics, it validated that our decision to move away from an insurance-based model was the right one for our practice and our patients. In addition, unlike hospital-affiliated practices, private medical practices are not permitted to offset rising operational costs through facility fees - fees which have helped hospitals so far offset the decrease in insurance payments.

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Our decision to move to an out-of-network direct specialty model is not driven by greed but by necessity. It is a strategic response to ensure the sustainability of our practice, where both patients and physicians are valued. By going out of network, we aim to provide even better care and more personalized attention without the constraints imposed by inadequate reimbursement rates, spending more time with each of our patients and not having insurance companies reject medical judgements and delay care. We believe this change allows us to continue delivering high-quality healthcare while preserving the integrity and viability of our practice.

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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