What Is the Difference Between Concierge Medicine & Direct Primary Care?

What Is Direct Primary Care?The terms “concierge medicine” and “direct primary care (DPC)” and are often used interchangeably. While both are alternatives to the traditional primary health care model, there is a fundamental difference between the two that patients should be aware of when choosing their health care providers.

Concierge Medicine

This membership-based primary health care model was established to meet the demands of certain individuals who wanted to avoid the hassles of traditional fee-for-service health care. In exchange for a monthly concierge fee, patients receive extended access to select doctors, including same-day appointments and round-the-clock telemedicine consultations. To accommodate this extended access, concierge doctors generally limit their patient panels to several hundred patients at most (as compared to the typical 2,500-plus patient panel of a traditional primary care practice).

Significantly, the monthly fee paid to a concierge practice covers only those services that are not covered by insurance. Therefore, many concierge doctors also bill their patients’ health insurance providers for medical visits. As a result, most patients pay a premium for primary health insurance in addition to the monthly concierge fee.

Direct Primary Care

Like concierge medicine, DPC is a membership-based primary health care model in which patients pay a monthly fee that entitles them to extended access to select doctors. However, DPC completely eliminates insurance companies and other third parties from the equation – DPC doctors do not bill their patients’ health insurance providers for medical visits. This means the overhead associated with procedure coding, claim filing, write-offs, billing, and claims-centric electronic medical records (EMR) systems is also eliminated, further streamlining the health care process.

DPC members do not need to pay for costly primary health insurance in addition to the monthly membership fee. With that said, they are still encouraged to carry insurance to cover the costs associated with specialist care for complex illnesses and injuries, hospitalizations, and life-threatening emergencies.

In sum, DPC is a primary care practice model that is directly reimbursed by the patient for both doctor access and primary health care services. Unlike many concierge practices, however, a DPC practice does not accept or bill third-party payers – this is the main difference between the two health care models.

If you have questions, you are welcome to contact Optimum Direct Care. We’ll be happy to tell you about our DPC practice, which is led by Dr. Toni “Muzzi” Muzzonigro and located near Orlando, FL.

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“We made an initial appointment with her and learned so many things that we didn’t think existed anymore. Her main focus is on the patient and not the insurance companies! When she doesn’t have to worry about the bureaucracy and red tape of insurance companies, she has so much more time to listen to the patient and come up with a truly great level of care. The patient comes first and foremost. ”

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“My husband and I are big fans of Dr. Toni Muzzonigro and ODC. She takes great time and care in both listening to us and explaining medical issues. We didn’t get this when we were part of an HMO or PPO healthcare network. For those rare emergencies, I can reach her after hours and receive an immediate response. We also like that she is not totally westernized in her viewpoints and will give holistic advice. Erin and the staff are amazing. They are warm and welcoming. You don’t feel like a number when you visit ODC. Love them!”

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