Frequently Asked Questions

A direct care rheumatology practice offers a simplified model where patients pay a predictable membership fee directly to the practice, bypassing insurance entirely. This eliminates the hassles of referrals, network restrictions, and complex billing, allowing us to provide more accessible and affordable care. Without the constraints of insurance, we can offer longer, unhurried appointments and immediate access, ensuring we have the time needed to thoroughly address complex autoimmune conditions.

We pride in commitment towards personalized precision Rheumatology care deliverance and patient relationship is the foundational pillar of our practice. The membership model allows us to maintain patient continuity; tailor therapy plans and monitor disease activity which is critical to control and treat rheumatological conditions. For a predictable monthly or annual fee, you receive direct access to comprehensive rheumatology services, including consultations, follow-ups, and chronic disease management, without additional per-visit fees.

We do not participate in commercial insurance, Medicare or Medicaid, and operate on a direct care (cash-based) membership model. This allows us to focus entirely on patient care without insurance-related restrictions, prior authorizations, or billing delays. You are able to use your insurance for services covered by your insurance including but not limited to laboratory tests, imaging, medications, physical therapy. At this time, we are not able to enroll Medicare recipients. Until our Medicare opt-out is complete, federal law prohibits us from seeing Medicare patients, even for cash payments. Once opted out, Medicare patients may join under a direct-pay agreement but cannot submit claims for reimbursement.

Good to know:

• You can still use insurance for labs, imaging, and medications.

• Some patients with high-deductible plans find our model more affordable than traditional co-pays and coinsurance.

• We provide documentation for possible out-of-network reimbursement (except for Medicare, which legally cannot be reimbursed for our services).

Our practice is in the process of formally opting out of Medicare but has not yet received final confirmation from CMS. Until our opt-out is approved:

• We cannot enter into private contracts with Medicare beneficiaries.

• We are unable to bill Medicare or see Medicare-enrolled patients (even for cash payments).

• If you become a Medicare beneficiary while a patient, you must notify us immediately.

Once our opt-out is complete:

• Medicare patients may join under a direct-pay agreement.

• Services will not be billed to Medicare, and patients cannot submit claims for reimbursement.

We apologize for this temporary limitation and will update our website once opt-out is complete.

 Benefits include: 

• More time with your doctor (longer, unhurried visits) 

• Same-week or next-day appointments (no long wait times) 

• Transparent, affordable pricing (all costs are disclosed upfront with no surprise bills) 

• Direct access to your rheumatologist (via phone, email, or telehealth) 

• No insurance denials or pre-authorization delays 

• No insurance billing (removing administrative burdens that reduce physician availability)

• No coding restrictions; we provide the care you need

In short: Better care, fewer hassles.