What is a direct specialty care clinic?

Direct care is a model of providing healthcare independent of the limitations imposed by health insurance. This approach emphasizes personalized and timely care directly from your endocrinologist. Direct care fosters a stronger patient-doctor relationship, providing patients with increased time and access to their doctor.

In this model of care, a patient pays the physician directly, generally as a flat monthly fee, in exchange for personalized attention, longer visits, and easy communication between visits. This means, at River City Endocrine, we do not accept nor bill any health insurance. You can pay for your care by credit card, ACH, or HSA/FSA. Additionally, if you have commercial insurance with out of network benefits, you can also submit for reimbursement.

By functioning outside the demands of insurance, I can focus on providing you quality care rather than meeting insurance demands for documentation. Direct care puts your health first rather than the requirements for billing.

In this model a physician generally cares for 400-600 patients total, as compared to 2000-3000 patients or more in a typical insurance-based practice, allowing time for more lengthy visits and prompt attention between appointments as needed. You can expect to have prompt answers to email, text, and phone calls—no more waiting days for questions to be answered.

I will care for you regardless of insurance status and provide the care you need. Patients with private health insurance may seek reimbursement from their plan through out-of-network benefits; sometimes the cost for care can be applied towards a deductible. While River City Endocrine does not bill insurance for its services, patients can use their health insurance to cover other healthcare expenses, including labs, imaging and medications.

Direct Endocrine Care puts the patient doctor relationship back at the center of healthcare

Does it Cost More?

For patients in Tennessee, where many health insurance plans come with high copays, high deductibles, and high out-of-pocket maximums, the out of pocket expense for specialty care through insurance may ultimately be close to the costs in a direct care model. The difference being there will never be surprise bils or hidden fees at River City Endocrine AND you will get more time with your doctor in exchange.

Let’s consider a patient with poorly controlled diabetes who needs an endocrinologist care:

Traditional Model of Medicine, high deductible insurance, 6 months of care

Initial visit: 30 min with doctor, $350

Follow-up: 3 months later, 10 min visit, $250

Follow-up: 3 months later, 10 min visit, $250

Improvement in A1c limited as infrequent and short visits prevented titration or additions of necessary medications and further counseling of lifestyle changes

Total: $850

River City Endocrine direct specialty care, any insurance, 6 months of care:

Initial visit: 90 min with the doctor, $400, followed by 95$ per month

Follow-up scheduled every 2 weeks until blood sugars are improved then as needed to maintain.

In 6 months, such a patient may have 6 visits with the doctor, all at least 30 min in length, with direct access to the doctor between visits for questions. A1c markedly improves.

Total cost: $875, with possible insurance reimbursement for commercial patients

The cost is nearly the same but for very different quality of care and results. It pays to have direct endocrine care!

Learn more about the benefits of direct endocrine care

  • In traditional practices, an endocrinologist will have a panel of 1500-3000 patients, all needing time and attention from the physician. In a direct care model, the patient membership is limited to allow direct access to your physician, same day responses direct from your doctor, and urgent attention to needs. Same day or next day appointments are available for members.

  • Visits are scheduled for 30-90 minutes, allowing plenty of time to discuss patient concerns and develop a individualized plan. This means you will not be waiting for your visit when you arrive, saving you valuable time.

  • All costs associated with your membership or fee-for-service visits are simple and will be clearly communicated prior to scheduling. These are available on this website. Payment will be due at the time of service with no surprise bills.

  • I have worked to establish discounted lab and diagnostic imaging costs for my patients. Additionally, I will work to find the cheapest medication option with you, possibly saving hundreds of dollars a month. If you have medicare, I will ensure we take advantage of all patient assistance programs you may qualify for to get access to free medications.