Direct Primary Care (DPC) is a model of healthcare that aims to return medicine to its origins, where the focus is on the doctor patient relationship. This model is growing, with over 1000+ practices nationwide. In a DPC model, patients pay a fixed monthly membership fee in exchange for primary care services. Like a traditional fee for service practice that accepts insurance, this includes preventive, chronic and acute care, but there are unique features to DPC that benefit the patient:
• longer visit times (30-60 minutes) to address concerns and to really work on getting to the root of patient’s symptoms. Personalized medicine takes time!
• direct communication with your doctor by using phone, email. text and video visits
• smaller patient panels, allowing for better accessibility and same day or next day appointments
• transparent pricing: no copays for visits. DPC offices partner with imaging and lab facilities to obtain discounted prices for their patients

No. DPC is not insurance. The monthly membership fee is your payment for receiving ongoing primary care services provided at my office.

No, I do not accept insurance. By taking out the “middleman”, I am able to work for you instead of spending time on administrative tasks that do not directly benefit your personal health. It also allows me more freedom to practice medicine in a more comprehensive, unrushed way while keeping costs affordable to you.

No, insurance is not required, but it is recommended. One of the focuses of primary care is prevention of disease and promoting a health lifestyle, as to avoid many chronic illnesses. However, in the case of a catastrophic event, unplanned accident, surgery or serious illness, it is important to have some type of insurance coverage. Patients find that a high deductible insurance plan with HSA pairs well with the primary care services provided through DPC.

One analogy is car insurance. We wouldn’t expect to use our car insurance for small maintenance tasks like windshield wiper replacement or oil change. But if we are in a car accident, car insurance is definitely of benefit.

Yes. Dr. Mauss is a non-par Medicare provider. This means she charges per visit instead of the DPC membership fee. The charge of the visit is based on what Medicare allows for the type of visit for that day. In Pennsylvania, non-par providers are limited to charging 5% below Medicare’s allowable rates. Dr. Mauss does collect payment from the patient at time of service, but will submit a claim to Medicare on your behalf. Medicare then will reimburse you directly. This is usually at a rate of 80%. If you have supplemental insurance, the additional 20% may be covered. This does not apply for Medicare Advantage plans, who usually do not reimburse even if the claim is submitted. Reimbursement for visits is not guaranteed and ultimately you are responsible for any costs not covered by Medicare. Here is a link that provides some additional information about a Non-par Medicare provider:

https://www.medicareinteractive.org/get-answers/medicare-covered-services/outpatient-provider-services/participating-non-participating-and-opt-out-providers

Please contact Dr. Mauss with any additional questions. 

Billing occurs monthly with no long-term contracts. I value the physician patient relationship so if there is something that you are not satisfied with, please let me know! As a new practice, I expect that there will a steep learning curve so I am open to receiving feedback and working out a solution that works for both of us if possible. I understand that circumstances change, so if you do decide to terminate your membership, we just ask for 30 days notice so we can ensure a smooth transition to your new PCP. If you decide to re-enroll at any time after transferring care, please be advised that there is a $150 re-enrollment fee.