Frequently Asked Questions
Direct Care and Insurance Questions
Direct Endocrinology care is a healthcare model that operates independently of the limitations imposed by health insurance. Patients are attended to regardless of their insurance status, as the middleman (insurance) is eliminated. This model empowers doctors and patients alike, as we can dedicate more time to our patients and remain available to them even in between visits. Patients have the option to choose either a “fee-for-service” plan or a membership plan. Patients with private health insurance plans may seek reimbursement from their plan for their visits if they have an out-of-network benefit. I can provide you with a superbill that can be submitted to your insurance, and these expenses can usually be applied towards your deductible. As an “out-of-network” provider for all insurance carriers, I offer my services independently of insurance constraints.
My practice does not bill insurance plans for the services we provide. I welcome patients regardless of their insurance status. However, I am pleased to offer a superbill that you may submit to your insurance for “out-of-network” reimbursement, should you choose to do so. All labs, imaging orders and medications still go through your insurance.
No. I do not bill Medicaid and my services cannot be submitted to Medicaid for reimbursement. However Medicaid will still pay for all your labs, imaging and medications.
Please contact Dr. K to discuss for further information before scheduling an appointment.
Dr. K “opted out” of all Medicare plans. This means that we do see patients who have Medicare insurance, however patients pay out of pocket fee for the visit which can’t be submitted to Medicare for reimbursement. However Medicare will still pay for all the labs, imaging and medications that Dr. K orders the same way that gets taken care of by in-network office. The only difference is the transparent visit fee that is not reimbursed by Medicare.
Please note, that Medicare will not be Billed and you can not submit charges from our clinic to Medicare for reimbursement.
Please contact Dr. K to discuss for further information.
If your insurance plan provides coverage for out-of-network services, I can provide you with a “superbill” that you can submit to your insurance company for possible reimbursement. However, I cannot guarantee that you will receive reimbursement. I suggest that you contact your insurance provider to determine if you are eligible for out-of-network benefits and to understand their requirements for reimbursement. Additionally, you may be able to apply the costs of our services to your HSA or FSA accounts, but we advise that you confirm with your HR representative. Please note that we cannot guarantee any reimbursement from your insurance or HSA/FSA accounts.
If you have insurance, you may be able to use it to cover the cost of labs, imaging, or medications. Please consult your insurance policy for further information. Alternatively, if cash prices are more affordable than going through your insurance, you may choose to pay for these services out of pocket.
I offer transparent pricing, so you can rest assured that there will be no unexpected bills. Additionally, I have established negotiated prices for lab testing and imaging, and I am pleased to extend those savings on to you.
We accept all major credit cards, and payment is due at the time of service. Upon registration, you will be required to provide your credit card information. Your credit card will be charged at the end of each visit or service provided.
I would advise you to contact your HR department to confirm whether your HSA can be used to pay for my services. Please note that there may be restrictions related to paying for membership, and I recommend that you clarify this with your HR representative. If you plan to use your HSA card, please bring written approval documentation from your employer.
General Questions
I strongly advise patients to maintain health insurance coverage to address emergencies, hospitalizations, surgeries, and other healthcare needs that are not covered by my membership plan.
Absolutely! It would be my pleasure to provide care for you, whether or not you have insurance.
Yes, I strongly advise our patients to maintain a relationship with their primary care provider. While I will provide care for endocrine needs, I generally defer treatment of infections, injuries, cancer screenings, and vaccinations to your primary care doctor. If requested, I will communicate with your primary care doctor and any other physicians involved in your care.
I guarantee appointments to all our members within 48 hours.
You will have direct communication with me at all times. You may access me through my portal messaging system, email, or phone call, all of which are included in your membership.
I do provide telemedicine services through our HIPAA-compliant video-conferencing platform. However, for the initial consultation, I prefer an in-person visit.
My membership plan does not require a long-term contract, and you may cancel it at any time with a 30-day notice. If you decide to re-enroll, please note that there will be a re-enrollment fee.
An Endocrinologist is a medical practitioner who has fulfilled the requirements of medical school, 3 years of Internal Medicine residency, and 2 years of specialized training in Endocrinology. These professionals specialize in diagnosing and treating hormone disorders, including conditions such as diabetes, thyroid disease, calcium and bone problems, among others. Please see the list of services provided.
I opted for the direct care practice model because it enables me to offer improved care to my patients. When billing insurance, additional staff is required, and the process complicates workflow, driving up costs and forcing physicians to attend to a larger number of patients per day, with less time for each patient. By eliminating the “middleman” (insurance company) from the doctor-patient interaction, I can devote more time to each patient, minimize or eliminate wait times, and remain accessible to patients between visits.
Typically, concierge practices bill insurance and charge several hundred dollars a month in addition to that. At our practice, we replace the insurance model with transparent pricing.
